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Alterations in Functional Connectomics Associated With Neurocognitive Changes Following Glioma Resection.

Authors
  • Noll, Kyle R1
  • Chen, Henry S2
  • Wefel, Jeffrey S1, 3
  • Kumar, Vinodh A4
  • Hou, Ping2
  • Ferguson, Sherise D5
  • Rao, Ganesh5
  • Johnson, Jason M4
  • Schomer, Donald F4
  • Suki, Dima5
  • Prabhu, Sujit S5
  • Liu, Ho-Ling2
  • 1 Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  • 2 Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  • 3 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  • 4 Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
  • 5 Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Type
Published Article
Journal
Neurosurgery
Publication Date
Feb 16, 2021
Volume
88
Issue
3
Pages
544–551
Identifiers
DOI: 10.1093/neuros/nyaa453
PMID: 33080024
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Decline in neurocognitive functioning (NCF) often occurs following brain tumor resection. Functional connectomics have shown how neurologic insults disrupt cerebral networks underlying NCF, though studies involving patients with brain tumors are lacking. To investigate the impact of brain tumor resection upon the connectome and relationships with NCF outcome in the early postoperative period. A total of 15 right-handed adults with left perisylvian glioma underwent resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological assessment before and after awake tumor resection. Graph theoretical analysis was applied to rs-fMRI connectivity matrices to calculate network properties. Network properties and NCF measures were compared across the pre- to postoperative periods with matched pairs Wilcoxon signed-rank tests. Associations between pre- to postoperative change in network and NCF measures were determined with Spearman rank-order correlations (ρ). A majority of the sample showed postoperative decline on 1 or more NCF measures. Significant postoperative NCF decline was found across measures of verbal memory, processing speed, executive functioning, receptive language, and a composite index. Regarding connectomic properties, betweenness centrality and assortativity were significantly smaller postoperatively, and reductions in these measures were associated with better NCF outcomes. Significant inverse associations (ρ = -.51 to -.78, all P < .05) were observed between change in language, executive functioning, and learning and memory, and alterations in segregation, centrality, and resilience network properties. Decline in NCF was common shortly following resection of glioma involving eloquent brain regions, most frequently in verbal learning/memory and executive functioning. Better postoperative outcomes accompanied reductions in centrality and resilience connectomic measures. Copyright © 2020 by the Congress of Neurological Surgeons.

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