The Dual Associations of Peripheral Inflammatory Cells With Brain Reorganization in Insular Gliomas With/Without Epilepsy: An Exploratory Analysis.

Abstract

<h4>Objectives</h4>The insula was invaded by gliomas and epilepsy occurred frequently. Our study aimed to reveal brain reorganization and explore potential peripheral biomarkers that reflect these processes.<h4>Methods</h4>51 insular glioma-related epilepsy (IRE) and 52 without epilepsy (IRnE) patients were included. Deep learning was used for tumor segmentation to generate masks for subsequent analyses. Virtual brain grafting was applied to eliminate the mass effect. Morphological analyses relied on MATLAB, SPM, and CAT12. Statistical analyses included χ² test, t test, one-way ANOVA, regression, principal component, and correlation analysis.<h4>Results</h4>Increased gyrification (GI) occurred on the contralateral side of IRnE. Increased gray matter volume and toroidal GI (Toro GI) appeared on the same and contralateral sides of IRE, respectively. Elevated Toro GI showed an initial predictive value for the control of postoperative epilepsy and was negatively associated with blood white cell, monocyte, and neutrophil counts in IRE. The opposite relationship was observed for GI in IRnE.<h4>Significance</h4>The brain would conduct different reorganization models to adapt to IRE and IRnE. These processes may be associated with specific peripheral inflammatory cells. Longitudinal studies and explorations of more specific biomarkers are necessary for elucidating the causal relationships and providing suggestions for therapeutic concepts of different insular glioma subtypes.