Mechanism of Aphasia and Recovery of Language After the Injury of Geschwind's Territory: a Study Based on the Brain Network Analysis

Study Overview
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Brief Summary
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At present, functional imaging studies have suggested that the Geschwind's territory (the inferior parietal lobe) is an important language area. It is the hub for semantics and phonetic language processing. However, the type and mechanism of aphasia after injury of Geschwind's territory and the subsequent recovery of language are still unclear. In our study based on brain injury model of brain arteriovenous malformation (BAVMs) resection, investigators found that the incidence of aphasia was higher after the injury of Geschwind's territory than after injury of the classical language area, and the type of aphasia was complicated, while the recovery rate of language disorder was high during follow-up. Investigators hypothesized that the type of aphasia may be associated with the type of brain connectivity damaged, and that reorganization of brain connections and brain network promote the recovery of language function. In this study, we aim to investigate the types of aphasia and their corresponding brain network changes after the resection of BAVMs located in the Geschwind's territory. Investigators will evaluate language function and collect multimodality images of the patients before resection of the lesions, as well as 7 days, 3 months and 6 months afterwards. In addition, the anatomical brain connectivity and brain network will also be analyzed. Our research will not only be a meaningful exploration for mechanisms of human language function damage and reorganization, but will also provide an important basis for the protection of brain function in neurosurgery.

Official Title
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Mechanism of Aphasia and Recovery of Language After the Injury of Geschwind's Territory: a Study Based on the Brain Network Analysis

Conditions
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AVM - Cerebral Arteriovenous Malformation, Language

Intervention / Treatment
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* Procedure: Surgical removal of the BAVMs


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Signed the informed consent form; The dominant hand is the right hand (evaluated by the Edinburgh hand scale); BAVM located in the left inferior parietal lobe No history of rupture and bleeding and neurosurgical treatment Exclusion Criteria: There are implants in the body (cardiac pacemaker, artificial femoral head, etc.); The dominant hand is unclear; Illiterate or other patients who can not cooperate well with cognitive function tests; The history of bleeding in BAVM patients within one month; History of neurosurgical treatment.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Geschwind's area BAVMs<br> | Procedure: Surgical removal of the BAVMs<br>* Resection the BAVM nidus by microsurgery.<br>|
| Healthy controls<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain network of BAVMs in Geschwind's area | compare the brain network of the Geschwind's area BAVMs patients and normal controls | 2 years | 
| Brain network after injury of Geschwind's area | compare the preoperative and postoperative brain network of Geschwind's area BAVMs. | 2 years | 
| Brain network of the brain reorganization after surgery | After surgery, we compare the brain network before and after the reorganization. | 3 years |