Article
Alterations of intrinsic frontoparietal functional connectivity in patients with tumour lesions in the supplementary motor area (SMA)
Veränderungen der frontoparietalen funktionellen Ruhekonnektivität bei Patienten mit Tumoren in der supplementär-motorischen Area (SMA)
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Authors
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Chuh-Hyoun Na
- Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland; Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Deutschland
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Rik Sijben
- Universitätsklinikum RWTH Aachen, Brain Imaging Facility, Interdisciplinary Center for Clinical Research (IZKF), Aachen, Deutschland
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Hans Clusmann
- Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland; Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Deutschland
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Martin Wiesmann
- Universitätsklinikum RWTH Aachen, Institut für diagnostische und interventionelle Neuroradiologie, Aachen, Deutschland
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Daniel Delev
- Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland; Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Deutschland
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Rea Rodriguez-Raecke
- Universitätsklinikum RWTH Aachen, Brain Imaging Facility, Interdisciplinary Center for Clinical Research (IZKF), Aachen, Deutschland
| Published: | May 25, 2022 |
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Outline
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Objective: Patients with SMA tumor lesions typically develop postoperatively a contralateral akinesia (“SMA syndrome”), which often regresses within the first three months. Neither the neural correlates of functional recovery nor of preoperatively preserved motor functions are however sufficiently understood. With the SMA being considered as gateway between motor but as well cognitive control functions, the SMA-syndrome has even been suggested to be primarily a cognitive disorder of executive functions. As functional reorganization may precedes surgical intervention, we investigated potential alterations of intrinsic sensorimotor and frontoparietal resting-state network (RSN) connectivity in SMA tumor patients.
Methods: 13 patients with tumor lesions (10 gliomas, 2 metastases, 1 meningioma) involving the SMA (5 right-sided, mean age 49 ± 21 yrs), and 13 matched healthy controls (49 ± 16 yrs) underwent resting-state-fMRI. Patients were scanned preoperatively, and evaluated with regard to motor and language functions. Imaging data of patients with right-hemispheric tumor lesions were flipped, in order to analyze ipsi- and contralesional resting-state functional connectivity (FC) across group within the sensorimotor and frontoparietal RSN. Using seed-to-voxel analysis with seeding in the contralesional hemisphere, sensorimotor RSN FC as well as frontoparietal RSN FC were analyzed and compared between groups.
Results: Most patients had no (11/13) or only minor (2/13) motor deficits preoperatively. However, after tumor resection, the majority (11/13) developed a contralateral hemiparesis, with additional language deficits in 5 (out of 8 left-sided tumor) patients. Motor deficits regressed in most (90%), and language deficits in all patients within 62+/-61 days after surgery, albeit to varying degrees. No significant between-group differences were found with regard to FC of the sensorimotor RSN. In contrast, FC within the frontoparietal RSN was significantly increased (p<.05) in the inferior frontal gyrus of the contralesional hemisphere.
Conclusion: Intrinsic frontoparietal connectivity was increased in SMA tumor patients as compared to healthy controls in the contralesional hemisphere. It should be further investigated, whether executive control functions may exert a modulatory if not compensatory effect on motor functions in SMA tumor patients, and whether reorganization of frontoparietal connectivity might subserve postoperative functional recovery in SMA syndrome.
