gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Postoperative cognitive and functional resting-state connectivity alterations in glioma patients

Postoperative Veränderungen von Kognition und funktioneller Ruhekonnektivität bei Gliompatienten

Meeting Abstract

  • presenting/speaker Chuh-Hyoun Na - Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland; Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Deutschland
  • Hans Clusmann - Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland; Center for Integrated Oncology, Aachen Bonn Cologne Düsseldorf (CIO ABCD), Aachen, Deutschland
  • Martin Wiesmann - Universitätsklinikum RWTH Aachen, Institut für diagnostische und interventionelle Neuroradiologie, Aachen, Deutschland
  • Verena Mainz - Universitätsklinikum RWTH Aachen, Institut für Medizinische Psychologie und Medizinische Soziologie, Aachen, Deutschland
  • Kerstin Jütten - Universitätsklinikum RWTH Aachen, Klinik für Neurochirurgie, Aachen, Deutschland; authors contributed equally, *, Aachen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV252

doi: 10.3205/22dgnc244, urn:nbn:de:0183-22dgnc2446

Published: May 25, 2022

© 2022 Na et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Cognitive outcome predictions in glioma patients undergoing surgery are difficult in view of the diffusely infiltrating tumor nature and the widely distributed neural network representations of higher order functions. Previous studies suggest, that functional connectivity (FC) of tumor/peritumoral areas to the rest of the brain might be indicative for postoperative neurological outcome. We therefore investigated, in how far FC of tumor lesions to the rest of the brain, as well as extralesional (EL) FC may relate to cognitive outcome in glioma patients.

Methods: 18 glioma patients (11 IDH mutated) were compared to 18 healthy controls. All participants underwent resting-state-fMRI, as well as standardized neuropsychological testing. Subjects were examined pre- and 4.5 months postoperatively. Tumor lesions were segmented, and tumor-to-whole-brain (T-WB) FC, as well as extralesional whole-brain (EL-WB) connectivity estimates were determined based on a WB parcellation using the Brainnetome atlas. In addition, network-specific tumor-to-frontoparietal (T-FP) connectivity, as well as extralesional connectivity within the frontoparietal network (EL-FP) were determined accordingly, and partial correlations with test metrics analysed, as well as FC was compared between patients with better and worse cognitive outcome.

Results: Preoperatively, patients performed worse compared to healthy controls, which was significant with regard to verbal recall (p<.01). Postoperatively, cognitive performance further deteriorated in patients, albeit significantly only with regard to attention (p<.05). While neither T-FP, T-WB nor EL FC significantly correlated with task performance, patients with better postoperative attentional performance showed preoperatively lower T-FP connectivity (by trend, p<.052) compared to worse performing subjects. Moreover, patients with better attentional performance showed postoperatively significantly higher EL-FP connectivity in the contralesional hemisphere (p<.046) than worse performing subjects. Although EL-WB functional connectivity significantly decreased longitudinally (p<.01) in patients, mean EL-FP connectivity was maintained.

Conclusion: Extralesional FC longitudinally decreased in glioma patients, but frontoparietal connectivity was maintained. FC of tumor to task relevant extralesional brain regions may provide cognitive outcome estimates in some glioma patients, but needs as well to take into account functional (re)organization of extralesional brain regions.