Clinical Research Directory

Language Function Reorganization in Patients With Arteriovenous Malformations

Brain arteriovenous malformation (AVM) is generally considered as a congenital lesion. Its unique clinical manifestation is that when the unruptured AVM involves and destroys the language function area of the left hemisphere, the patient has almost no language disorder. This phenomenon is distinct from those of acquired diseases such as cerebral infarction and gliomas. There is a hypothesis that it might be associated with that the occurrence of AVM is earlier than period of language learning. Therefore, patients with AVMs involving language areas can be regarded as population whose language areas are congenital "knocked out" but the language functions remain normal, which provide a special model and new insights for language reorganization research. Previous studies have found that the right hemisphere plays an important role in the remodeling of language function in patients with AVMs, but the specific mechanism remains unclear. The purpose of this study is to further elaborate the role of the right cerebral hemisphere in the reorganized language network and the interhemispheric interaction mechanisms in patients with AVMs involving the language areas, using multimodal magnetic resonanceimaging and from multiple dimensions such as functional remodeling, white matter pathway remodeling, structural remodeling, etc., so as to further understand the remodeling mechanism of the Chinese language network after damage of language areas, and also to provide a theoretical basis for the protection of language function in brain network surgery.

In Situ Injection of Anti-angiogenics in Patients With Brain Arteriovenous Malformations Not Eligible for Exclusion Treatment

Brain arteriovenous malformations (bAVMs) are rare aggressive vascular malformations affecting mostly young and healthy adults. The most frequent revealing condition (in almost 50% of cases) is an intra-cerebral hemorrhage, which is a considerable source of disability and mortality. The only way to prevent a bleeding or a rebleeding is to perform an exclusion treatment (endovascular embolization, microsurgery, stereotactic radiosurgery, or a combination of these techniques). The major drawback of these treatments is the risk of severe complications, which can reach 20%, especially in patients presenting a bAVM with complex angio-architecture (i.e., grade IV to V in the Spetzler Martin grading scale). There is a growing evidence about the strong implication of angiogenesis (mainly mediated by the type A vascular endothelial growth factor \[VEGF-A\]) on the size and growth of the bAVM and even in the occurrence of bleeding events. Our hypothesis is that an in situ injection of bevacizumab, a monoclonal antibody inhibiting VEGF-A, in patients with bAVM deemed not suitable for exclusion treatment may be safe and help to reduce the nidus volume.

An Exploratory Study to Evaluate the Efficacy and Safety of FCN-159 in Patients With Brain Arteriovenous Malformations

A single-center, open-label, non-randomized controlled exploratory study is conducted in the Xuanwu Hospital Capital Medical University to evaluate the efficacy and safety of FCN-159 in patients with brain arteriovenous malformations (BAVM), aiming to overcome the current clinical challenges caused by the lack of available drugs for this disease.

Evaluation of Clinical Outcomes of Unruptured bAVMs Treated With Medical Management Alone Based on Multimodal CT

The purpose of this study is to investigate the role of multimodal CT in evaluating and predicting different clinical outcomes in patients with unruptured brain arteriovenous malformations with medical management alone. This study will be undertaken in the following aspects: 1. Morphological, structural and imaging histological signal analysis based on multimodal CT to explore the relationship between imaging features and different clinical outcomes of bAVMs. 2. Hemodynamic and flow pattern analysis of local and peripheral bAVMs based on multimodal CT to explore the association between blood flow features and different clinical outcomes. 3. Based on multimodal CT and deep learning algorithms to create an automated segmentation model for bAVMs and a prediction model for distinct clinical outcomes. The obtained patient information includes: Baseline information, CT, MRI, DSA (Optional), and follow-up information. Follow-up will be undertaken at 6 months, 12 months, 24 months and 36 months after enrollment with the following primary observation. Main observation endpoints: 1. Hemorrhage events associated with bAVMs 2. New epilepsy symptoms or exacerbations 3. New neurological dysfunction(including motor dysfunction, cognitive dysfunction, etc).