Editorial for “An MRI Study Combining Virtual Brain Grafting and Surface‐Based Morphometry Analysis to Investigate Contralateral Alterations in Cortical Morphology in Patients With Diffuse Low‐Grade Glioma”

Editorial for “An MRI Study Combining Virtual Brain Grafting and Surface-Based Morphometry Analysis to Investigate Contralateral Alterations in Cortical Morphology in Patients With Diffuse Low-Grade Glioma” Gliomas are neuroepithelial tumors originating in the supporting glial cells of the central nervous system. It classifies Grades 1 to 4 based on histopathological characteristics such as cytologic atypia, anaplasia, microvascular proliferation, and necrosis. Diffuse low-grade gliomas (DLGG) are Grade 2 rare tumors that median age at diagnosis is around 40 years old, and they can be showing infiltrative features but slowly growing intrinsic brain tumors. Glioma is also defined as lesions that result in modifications of brain networks known as functional reorganization. The modifications to brain networks in patients with low-grade gliomas can be indicated the potential for more functional reorganization to occur as slower growth of tumor giving the brain more time to adapt to damage. Therefore, it can be assumed that there is a high possibility to have a specific pattern in which brain function is reconstructed by DLGG, although there will be variables depending on the difference of lesional origin. To explore the functional networks of the brain, it is necessary to understand the brain morphometry aimed at the measurement of brain structure and changes due to development, aging, and disease. Typically, brain morphometry is performed by collecting noninvasive neuroimaging data obtained from computed tomography scans or magnetic resonance imaging (MRI), and this allows to quantify of brain anatomical features in terms of brain shape, mass, and volume, and to derive more specific information such as encephalization index and gray matter density. The information can be mapped to brain volume or brain surface to assess differences in patterns. Recently, there have been a lot of attempts to investigate the relationship between structure and function through functional MRI. However, it does not provide accurate information about the brain network because of the disregard for long-distance and fibercross connections. It can also lead to inaccurate representations of brain networks as each voxel does not directly measure neural activity. In this context, this retrospective study paid attention to the disadvantages of the existing voxel-based morphometrybased morphometric analysis of the cerebral structure in patients with DLGG and then suggests alternative methods. The study performed the analysis of cortical thickness and local gyration index by applying virtual brain grafting among patients with frontal lobe DLGG. The main inclusion criteria were histopathologically confirmed DLGG patients with no treatment history prior to MRI, and the lesion of the left or right frontal lobe was distinguishable. Data from a total of 99 patients were compared with 53 healthy controls. The results indicated that the patient groups showed compensations in the contralateral hemisphere. Concretely, they reported the left frontal lobe DLGG invading group showed increased cortical thickness in the left rostral middle frontal gyrus (RMF), and the right frontal lobe DLGG invading group exhibited increased cortical thickness in the middle temporal (MT), lateral occipital (LO) extending to isthmus cingulate gyrus (IC). The results indicated that it is possible to distinguish the cerebral morphological changes by suggested methods in DLGG patients compared with the healthy controls. However, it should be recognized that the cases cannot represent all features of DLGG patients to be discussed the clinical implications of the findings. Because the brain is responsible for various functions in each area, unlike other organs. Therefore, functional investigations in charge of the region where the morphological changes are induced should be described, and the functional effects of changes on the brain in each area can be classified as follows: Changes in RMF and MT affect multisensory integration functions, including literacy development, memory processing, and visual perception. Changes in LO and IC imply that it may cause problems with object perception or control of emotions and pain.