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Warioba CS, Liu M, Peñano S, Carroll TJ, Foxley S, Christoforidis G. Efficacy Assessment of Cerebral Perfusion Augmentation through Functional Connectivity in an Acute Canine Stroke Model. AJNR Am J Neuroradiol 2024:ajnr.A8320. [PMID: 38684318 DOI: 10.3174/ajnr.a8320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND PURPOSE Ischemic stroke disrupts functional connectivity within the brain's resting-state networks (RSNs), impacting recovery. This study evaluates the effects of norepinephrine and hydralazine (NEH), a cerebral perfusion augmentation therapy, on RSN integrity in a hyperacute canine stroke model. MATERIALS AND METHODS Fifteen adult purpose-bred mongrel canines, divided into treatment and control (natural history) groups, underwent endovascular induction of acute middle cerebral artery occlusion (MCAO). Postocclusion, the treatment group received intra-arterial norepinephrine (0.1-1.52 µg/kg/min, adjusted for 25-45 mm Hg above baseline mean arterial pressure) and hydralazine (20 mg). Resting-state fMRI (rs-fMRI) data were acquired with a 3T scanner by using a blood oxygen level dependent-EPI sequence (TR/TE = 1400 ms/20 ms, 2.5 mm slices, 300 temporal positions). Preprocessing included motion correction, spatial smoothing (2.5 mm full width at half maximum), and high-pass filtering (0.01 Hz cutoff). Functional connectivity within RSNs were analyzed through group-level independent component analysis and weighted whole-brain ROI-to-ROI connectome, pre- and post-MCAO. RESULTS NEH therapy significantly maintained connectivity post-MCAO in the higher-order visual and parietal RSNs, as evidenced by thresholded statistical mapping (threshold-free cluster enhancement P corr > .95). However, this preservation was network-dependent, with no significant (P corr < .95) changes in the primary visual and sensorimotor networks. CONCLUSIONS NEH demonstrates potential as a proof-of-concept therapy for maintaining RSN functional connectivity after ischemic stroke, emphasizing the therapeutic promise of perfusion augmentation. These insights reinforce the role of functional connectivity as a measurable end point for stroke intervention efficacy, suggesting clinical translatability for patients with insufficient collateral circulation.
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Affiliation(s)
- Chisondi S Warioba
- From the Department of Radiology (C.S.W., M.L., S.P., T.J.C., S.F.), University of Chicago, Chicago, Illinois
| | - Mira Liu
- From the Department of Radiology (C.S.W., M.L., S.P., T.J.C., S.F.), University of Chicago, Chicago, Illinois
| | - Sagada Peñano
- From the Department of Radiology (C.S.W., M.L., S.P., T.J.C., S.F.), University of Chicago, Chicago, Illinois
| | - Timothy J Carroll
- From the Department of Radiology (C.S.W., M.L., S.P., T.J.C., S.F.), University of Chicago, Chicago, Illinois
| | - Sean Foxley
- From the Department of Radiology (C.S.W., M.L., S.P., T.J.C., S.F.), University of Chicago, Chicago, Illinois
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Smolders L, De Baene W, Rutten GJ, van der Hofstad R, Florack L. Can structure predict function at individual level in the human connectome? Brain Struct Funct 2024; 229:1209-1223. [PMID: 38656375 PMCID: PMC11147846 DOI: 10.1007/s00429-024-02796-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/25/2024] [Indexed: 04/26/2024]
Abstract
Several studies predicting Functional Connectivity (FC) from Structural Connectivity (SC) at individual level have been published in recent years, each promising increased performance and utility. We investigated three of these studies, analyzing whether the results truly represent a meaningful individual-level mapping from SC to FC. Using data from the Human Connectome Project shared accross the three studies, we constructed a predictor by averaging FC of training data and analyzed its performance in the same way. In each case, we found that group average FC is an equivalent or better predictor of individual FC than the predictive models in terms of raw prediction performance. Furthermore, we showed that additional analyses performed by the authors of the three studies, in which they attempt to show that their predicted FC has value beyond raw prediction performance, could also be reproduced using the group average FC predictor. This makes it unclear whether any of the three methods represent a meaningful individual-level predictive model. We conclude that either the methods are not appropriate for the data, that the sample size is too small, or that the data does not contain sufficient information to learn a mapping from SC to FC. We advise future individual-level studies to explicitly report results in comparison to the performance of the group average, and carefully demonstrate that their predictions contain meaningful individual-level information. Finally, we believe that investigating alternatives for the construction of SC and FC may improve the chances of developing a meaningful individual-level mapping from SC to FC.
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Affiliation(s)
- Lars Smolders
- Eindhoven University of Technology , Department of Mathematics and Computer Science, PO Box 513, Eindhoven, 5600 MB, Netherlands.
- Elisabeth-TweeSteden Hospital, Department of Neurosurgery, Hilvarenbeekseweg 60, Tilburg, 5022 GC, The Netherlands.
| | - Wouter De Baene
- Tilburg University, Department of Cognitive Neuropsychology, Warandelaan 2, Tilburg, 5000 LE, Netherlands
| | - Geert-Jan Rutten
- Elisabeth-TweeSteden Hospital, Department of Neurosurgery, Hilvarenbeekseweg 60, Tilburg, 5022 GC, The Netherlands
| | - Remco van der Hofstad
- Eindhoven University of Technology , Department of Mathematics and Computer Science, PO Box 513, Eindhoven, 5600 MB, Netherlands
| | - Luc Florack
- Eindhoven University of Technology , Department of Mathematics and Computer Science, PO Box 513, Eindhoven, 5600 MB, Netherlands
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Smolders L, De Baene W, van der Hofstad R, Florack L, Rutten GJ. Working memory performance in glioma patients is associated with functional connectivity between the right dorsolateral prefrontal cortex and default mode network. J Neurosci Res 2023; 101:1826-1839. [PMID: 37694505 DOI: 10.1002/jnr.25242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/26/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023]
Abstract
In healthy subjects, activity in the default mode network (DMN) and the frontoparietal network (FPN) has consistently been associated with working memory (WM). In particular, the dorsolateral prefrontal cortex (DLPFC) is important for WM. The functional-anatomical basis of WM impairment in glioma patients is, however, still poorly understood. We investigated whether WM performance of glioma patients is reflected in resting-state functional connectivity (FC) between the DMN and FPN, additionally focusing on the DLPFC. Resting-state functional MRI data were acquired from 45 glioma patients prior to surgery. WM performance was derived from a pre-operative N-back task. Scans were parcellated into ROIs using both the Gordon and Yeo atlas. FC was calculated as the average Pearson correlation between functional time series. The FC between right DLPFC and DMN was inversely related to WM performance for both the Gordon and Yeo atlas (p = .010). No association was found for FC between left DLPFC and DMN, nor between the whole FPN and DMN. The results are robust and not dependent on atlas choice or tumor location, as they hold for both the Gordon and Yeo atlases, and independently of location variables. Our findings show that WM performance of glioma patients can be quantified in terms of interactions between regions and large-scale networks that can be measured with resting-state fMRI. These group-based results are a necessary step toward development of biomarkers for clinical management of glioma patients, and provide additional evidence that global disruption of the DMN relates to cognitive impairment in glioma patients.
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Affiliation(s)
- Lars Smolders
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Wouter De Baene
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Remco van der Hofstad
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Luc Florack
- Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Geert-Jan Rutten
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
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Maas DA, Douw L. Multiscale network neuroscience in neuro-oncology: How tumors, brain networks, and behavior connect across scales. Neurooncol Pract 2023; 10:506-517. [PMID: 38026586 PMCID: PMC10666814 DOI: 10.1093/nop/npad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Network neuroscience refers to the investigation of brain networks across different spatial and temporal scales, and has become a leading framework to understand the biology and functioning of the brain. In neuro-oncology, the study of brain networks has revealed many insights into the structure and function of cells, circuits, and the entire brain, and their association with both functional status (e.g., cognition) and survival. This review connects network findings from different scales of investigation, with the combined aim of informing neuro-oncological healthcare professionals on this exciting new field and also delineating the promising avenues for future translational and clinical research that may allow for application of network methods in neuro-oncological care.
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Affiliation(s)
- Dorien A Maas
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Linda Douw
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Amsterdam, The Netherlands
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5
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Moretto M, Silvestri E, Facchini S, Anglani M, Cecchin D, Corbetta M, Bertoldo A. The dynamic functional connectivity fingerprint of high-grade gliomas. Sci Rep 2023; 13:10389. [PMID: 37369744 DOI: 10.1038/s41598-023-37478-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/22/2023] [Indexed: 06/29/2023] Open
Abstract
Resting state fMRI has been used in many studies to investigate the impact of brain tumours on functional connectivity (FC). However, these studies have so far assumed that FC is stationary, disregarding the fact that the brain fluctuates over dynamic states. Here we utilised resting state fMRI data from 33 patients with high-grade gliomas and 33 healthy controls to examine the dynamic interplay between resting-state networks and to gain insights into the impact of brain tumours on functional dynamics. By employing Hidden Markov Models, we demonstrated that functional dynamics persist even in the presence of a high-grade glioma, and that patients exhibited a global decrease of connections strength, as well as of network segregation. Furthermore, through a multivariate analysis, we demonstrated that patients' cognitive scores are highly predictive of pathological dynamics, thus supporting our hypothesis that functional dynamics could serve as valuable biomarkers for better understanding the traits of high-grade gliomas.
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Affiliation(s)
- Manuela Moretto
- Padova Neuroscience Center, University of Padova, 35131, Padova, Italy
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6/B, 35131, Padova, Italy
| | - Erica Silvestri
- Padova Neuroscience Center, University of Padova, 35131, Padova, Italy
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6/B, 35131, Padova, Italy
| | - Silvia Facchini
- Padova Neuroscience Center, University of Padova, 35131, Padova, Italy
- Department of Neuroscience, University of Padova, 35121, Padova, Italy
| | | | - Diego Cecchin
- Padova Neuroscience Center, University of Padova, 35131, Padova, Italy
- Unit of Nuclear Medicine, University of Padova, 35121, Padova, Italy
| | - Maurizio Corbetta
- Padova Neuroscience Center, University of Padova, 35131, Padova, Italy
- Department of Neuroscience, University of Padova, 35121, Padova, Italy
- Venetian Institute of Molecular Medicine, 35131, Padova, Italy
| | - Alessandra Bertoldo
- Padova Neuroscience Center, University of Padova, 35131, Padova, Italy.
- Department of Information Engineering, University of Padova, Via G. Gradenigo 6/B, 35131, Padova, Italy.
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Hense K, Deuter D, Greenlee MW, Wendl C, Schmidt NO, Stroszczynski C, Doenitz C, Ott C, Rosengarth K. Analysis of Functional Neuroplastic Changes in the Cortical Language System in Relation to Different Growth Patterns of Glioblastoma. Brain Sci 2023; 13:867. [PMID: 37371347 DOI: 10.3390/brainsci13060867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/15/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
The interpretation of fMRI data in glioblastoma (GB) is challenging as these tumors exhibit specific hemodynamic processes which, together with malignancy, tumor volume and proximity to eloquent cortex areas, may lead to misinterpretations of fMRI signals. The aim of this study was to investigate if different radiologically defined GB tumor growth patterns may also influence the fMRI signal, activation pattern and functional connectivity differently. Sixty-four patients with left-hemispheric glioblastoma were included and stratified according to their radiologically defined tumor growth pattern into groups with a uniform (U-TGP) or diffuse tumor growth pattern (D-TGP). Task-based fMRI data were analyzed using SPM12 with the marsbar, LI and CONN toolboxes. The percent signal change and the laterality index were analyzed, as well as functional connectivity between 23 selected ROIs. Comparisons of both patient groups showed only minor non-significant differences, indicating that the tumor growth pattern is not a relevant influencing factor for fMRI signal. In addition to these results, signal reductions were found in areas that were not affected by the tumor underlining that a GB is not a localized but rather a systemic disease affecting the entire brain.
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Affiliation(s)
- Katharina Hense
- Department of Neurosurgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Daniel Deuter
- Department of Neurosurgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Mark W Greenlee
- Institute for Experimental Psychology, University of Regensburg, 93053 Regensburg, Germany
| | - Christina Wendl
- Department of Radiology, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Nils Ole Schmidt
- Department of Neurosurgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | | | - Christian Doenitz
- Department of Neurosurgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Christian Ott
- Department of Neurosurgery, University Hospital Regensburg, 93053 Regensburg, Germany
| | - Katharina Rosengarth
- Department of Neurosurgery, University Hospital Regensburg, 93053 Regensburg, Germany
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Meyer-Baese A, Jütten K, Meyer-Baese U, Amani AM, Malberg H, Stadlbauer A, Kinfe T, Na CH. Controllability and Robustness of Functional and Structural Connectomic Networks in Glioma Patients. Cancers (Basel) 2023; 15:2714. [PMID: 37345051 DOI: 10.3390/cancers15102714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 06/23/2023] Open
Abstract
Previous studies suggest that the topological properties of structural and functional neural networks in glioma patients are altered beyond the tumor location. These alterations are due to the dynamic interactions with large-scale neural circuits. Understanding and describing these interactions may be an important step towards deciphering glioma disease evolution. In this study, we analyze structural and functional brain networks in terms of determining the correlation between network robustness and topological features regarding the default-mode network (DMN), comparing prognostically differing patient groups to healthy controls. We determine the driver nodes of these networks, which are receptive to outside signals, and the critical nodes as the most important elements for controllability since their removal will dramatically affect network controllability. Our results suggest that network controllability and robustness of the DMN is decreased in glioma patients. We found losses of driver and critical nodes in patients, especially in the prognostically less favorable IDH wildtype (IDHwt) patients, which might reflect lesion-induced network disintegration. On the other hand, topological shifts of driver and critical nodes, and even increases in the number of critical nodes, were observed mainly in IDH mutated (IDHmut) patients, which might relate to varying degrees of network plasticity accompanying the chronic disease course in some of the patients, depending on tumor growth dynamics. We hereby implement a novel approach for further exploring disease evolution in brain cancer under the aspects of neural network controllability and robustness in glioma patients.
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Affiliation(s)
- Anke Meyer-Baese
- Department of Scientific Computing, Florida State University, Tallahassee, FL 32306, USA
- Institute for Biomedical Engineering, Technical University of Dresden, 01069 Dresden, Germany
| | - Kerstin Jütten
- Department of Neurosurgery, RWTH Aachen University, 52074 Aachen, Germany
| | - Uwe Meyer-Baese
- Department of Electrical and Computer Engineering, Florida State University, Tallahassee, FL 32310, USA
| | - Ali Moradi Amani
- School of Engineering, RMIT University, Melbourne, Victoria 3001, Australia
| | - Hagen Malberg
- Institute for Biomedical Engineering, Technical University of Dresden, 01069 Dresden, Germany
| | - Andreas Stadlbauer
- Department of Neurosurgery, Friedrich-Alexander University of Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Thomas Kinfe
- Department of Neurosurgery, Friedrich-Alexander University of Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Chuh-Hyoun Na
- Department of Neurosurgery, RWTH Aachen University, 52074 Aachen, Germany
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), 52074 Aachen, Germany
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Chang WH, Wei KC, Chen PY, Chen YC, Wu YY, Tsai HC, Chen MH, Chao YP, Chen KT. The impact of patient factors and tumor characteristics on language neuroplasticity in left hemispheric diffuse gliomas prior to surgical resection. J Neurooncol 2023; 163:95-104. [PMID: 37093525 DOI: 10.1007/s11060-023-04311-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/07/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE Language networks are reorganized during glioma growth, leading to varying language performance in patients with gliomas located in or around language-eloquent areas. Therefore, pre-treated language performance reflects the neuroplasticity potential. Different domains of language processing, such as speech expression, repetition, and comprehension, involving different neural networks. We analyzed the effects of patient factors and tumor characteristics on the pre-treated performance to investigate neuroplastic potential of different language domains. METHODS Patient age, sex, education level, tumor grade, language pathway involvement, T1 contrast enhanced (C+), and FLAIR (T2) volume were selected as variables. The correlation with abnormal language performance was verified using univariate and multivariate logistic regression. RESULTS In total, 104 left hemispheric glioma patients were enrolled in this study. 44% of patients had repetitive abnormalities, 34.9% had comprehensive abnormalities, and 32.1% had expressive abnormalities. The proportion of normal language performance was 60% in grade 2 and 3 gliomas and 16% in grade 4 gliomas. Tumor grade (p = 0.006) and T2 volume (p = 0.008) were associated with abnormal performance in the expressive domain, education level (p = 0.004) and T1 C+ volume (p = 0.049) in the repetitive domain, and education level (p = 0.013), T2 volume (p = 0.011), and tumor grade (p = 0.089) in the comprehensive domain. CONCLUSION Different clinical and radiological factors affected the abnormal performance of the three language domains, indicating their functional connectivity and neuroplastic potential are inherently varied. The dynamic interactions between patient factors, tumor characteristics, and language processing should be considered when resecting left hemispheric gliomas.
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Affiliation(s)
- Wei-Han Chang
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Keelung, New Taipei, Taiwan
- Department of Nutrition and Health Sciences, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Kuo-Chen Wei
- Department of Neurosurgery, New Taipei Municipal TuCheng Hospital, Chang Gung Medical Foundation, New Taipei, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Pin-Yuan Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Neurosurgery, Chang Gung Memorial Hospital at Keelung, New Taipei, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-Chun Chen
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan
- Dementia Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yah-Yuan Wu
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan
- Dementia Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hong-Chieh Tsai
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan, 33305, Taiwan
| | - Mei-Hui Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-Ping Chao
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Ko-Ting Chen
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.
- Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan, 33305, Taiwan.
- Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
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Sahrizan NSA, Manan HA, Abdul Hamid H, Abdullah JM, Yahya N. Functional Alteration in the Brain Due to Tumour Invasion in Paediatric Patients: A Systematic Review. Cancers (Basel) 2023; 15:cancers15072168. [PMID: 37046828 PMCID: PMC10093754 DOI: 10.3390/cancers15072168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/29/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023] Open
Abstract
Working memory, language and speech abilities, motor skills, and visual abilities are often impaired in children with brain tumours. This is because tumours can invade the brain's functional areas and cause alterations to the neuronal networks. However, it is unclear what the mechanism of tumour invasion is and how various treatments can cause cognitive impairment. Therefore, this study aims to systematically evaluate the effects of tumour invasion on the cognitive, language, motor, and visual abilities of paediatric patients, as well as discuss the alterations and modifications in neuronal networks and anatomy. The electronic database, PubMed, was used to find relevant studies. The studies were systematically reviewed based on the type and location of brain tumours, cognitive assessment, and pre- and post-operative deficits experienced by patients. Sixteen studies were selected based on the inclusion and exclusion criteria following the guidelines from PRISMA. Most studies agree that tumour invasion in the brain causes cognitive dysfunction and alteration in patients. The effects of a tumour on cognition, language, motor, and visual abilities depend on the type of tumour and its location in the brain. The alteration to the neuronal networks is also dependent on the type and location of the tumour. However, the default mode network (DMN) is the most affected network, regardless of the tumour type and location.Furthermore, our findings suggest that different treatment types can also contribute to patients' cognitive function to improve or deteriorate. Deficits that persisted or were acquired after surgery could result from surgical manipulation or the progression of the tumour's growth. Meanwhile, recovery from the deficits indicated that the brain has the ability to recover and reorganise itself.
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Affiliation(s)
- Nur Shaheera Aidilla Sahrizan
- Department of Radiology, Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Department of Radiology and Intervency, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Hanani Abdul Manan
- Department of Radiology, Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Department of Radiology and Intervency, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology, Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur 56000, Malaysia
- Department of Radiology and Intervency, Hospital Pakar Kanak-Kanak (Children Specialist Hospital), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Jafri Malin Abdullah
- Jabatan Neurosains, Pusat Pengajian Sains Perubatan, Jalan Hospital USM, Kampus Kesihatan, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
- Brain and Behaviour Cluster, Pusat Pengajian Sains Perubatan, Kampus Kesihatan, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
- Department of Neurosciences & Brain Behaviour Cluster, Hospital Universiti Sains Malaysia, Kampus Kesihatan, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| | - Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Program, School of Diagnostic & Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
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10
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Samuel N, Harmsen IE, Ding MYR, Sarica C, Vetkas A, Wong C, Lawton V, Yang A, Rowland NC, Kalia SK, Valiante T, Wennberg R, Zadeh G, Kongkham P, Kalyvas A, Lozano AM. Investigation of neurophysiologic and functional connectivity changes following glioma resection using magnetoencephalography. Neurooncol Adv 2023; 5:vdad091. [PMID: 37547265 PMCID: PMC10403751 DOI: 10.1093/noajnl/vdad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Background In patients with glioma, clinical manifestations of neural network disruption include behavioral changes, cognitive decline, and seizures. However, the extent of network recovery following surgery remains unclear. The aim of this study was to characterize the neurophysiologic and functional connectivity changes following glioma surgery using magnetoencephalography (MEG). Methods Ten patients with newly diagnosed intra-axial brain tumors undergoing surgical resection were enrolled in the study and completed at least two MEG recordings (pre-operative and immediate post-operative). An additional post-operative recording 6-8 weeks following surgery was obtained for six patients. Resting-state MEG recordings from 28 healthy controls were used for network-based comparisons. MEG data processing involved artifact suppression, high-pass filtering, and source localization. Functional connectivity between parcellated brain regions was estimated using coherence values from 116 virtual channels. Statistical analysis involved standard parametric tests. Results Distinct alterations in spectral power following tumor resection were observed, with at least three frequency bands affected across all study subjects. Tumor location-related changes were observed in specific frequency bands unique to each patient. Recovery of regional functional connectivity occurred following glioma resection, as determined by local coherence normalization. Changes in inter-regional functional connectivity were mapped across the brain, with comparable changes in low to mid gamma-associated functional connectivity noted in four patients. Conclusion Our findings provide a framework for future studies to examine other network changes in glioma patients. We demonstrate an intrinsic capacity for neural network regeneration in the post-operative setting. Further work should be aimed at correlating neurophysiologic changes with individual patients' clinical outcomes.
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Affiliation(s)
- Nardin Samuel
- Corresponding Author: Andres M. Lozano, OC, MD, PhD, FRCSC, FRSC, FCAHS, University Professor and Alan and Susan Chair in Neurosurgery, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, West Wing 4-431, Toronto, ON, Canada M5T 2S8 ()
| | | | - Mandy Yi Rong Ding
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Can Sarica
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
| | - Artur Vetkas
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
| | - Christine Wong
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
| | - Vanessa Lawton
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
| | - Andrew Yang
- Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Nathan C Rowland
- Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
- Murray Center for Research on Parkinson’s Disease and Related Disorders, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Suneil K Kalia
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Taufik Valiante
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
| | - Richard Wennberg
- Mitchell Goldhar MEG Unit, University Health Network, Toronto, Canada
- Toronto Western Hospital, Division of Neurology, University Health Network, Toronto, Ontario, Canada
| | - Gelareh Zadeh
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Paul Kongkham
- Toronto Western Hospital, Division of Neurosurgery, University Health Network, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
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11
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Nichols NM, Hadjipanayis CG. Editorial. Supramaximal resection of eloquent glioblastoma: a continued paradigm shift in neurosurgical oncology. J Neurosurg 2023; 138:58-60. [PMID: 35623364 DOI: 10.3171/2022.3.jns22564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Noah M Nichols
- 1Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York
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12
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Ueda M, Usami K, Yamao Y, Yamawaki R, Umaba C, Liang N, Nankaku M, Mineharu Y, Honda M, Hitomi T, Ikeguchi R, Ikeda A, Miyamoto S, Matsuda S, Arakawa Y. Correlation between brain functional connectivity and neurocognitive function in patients with left frontal glioma. Sci Rep 2022; 12:18302. [PMID: 36347905 PMCID: PMC9643499 DOI: 10.1038/s41598-022-22493-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022] Open
Abstract
The association between neurocognitive function (NCF) impairment and brain cortical functional connectivity in glioma patients remains unclear. The correlations between brain oscillatory activity or functional connectivity and NCF measured by the Wechsler Adult Intelligence Scale full-scale intelligence quotient scores (WAIS FSIQ), the Wechsler Memory Scale-revised general memory scores (WMS-R GM), and the Western aphasia battery aphasia quotient scores (WAB AQ) were evaluated in 18 patients with left frontal glioma using resting-state electroencephalography (EEG). Current source density (CSD) and lagged phase synchronization (LPS) were analyzed using exact low-resolution electromagnetic tomography (eLORETA). Although 2 and 2 patients scored in the borderline range of WAIS FSIQ and WMS-R GM, respectively, the mean WAIS FSIQ, WMS-R GM, and WAB AQ values of all patients were within normal limits, and none had aphasia. In the correlation analysis, lower WMS-R GM was associated with a higher LPS value between the right anterior prefrontal cortex and the left superior parietal lobule in the beta1 band (13-20 Hz, R = - 0.802, P = 0.012). These findings suggest that LPS evaluated by scalp EEG is associated with memory function in patients with left frontal glioma and mild NCF disorders.
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Affiliation(s)
- Masaya Ueda
- grid.411217.00000 0004 0531 2775Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Kiyohide Usami
- grid.258799.80000 0004 0372 2033Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yukihiro Yamao
- grid.258799.80000 0004 0372 2033Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Rie Yamawaki
- grid.411217.00000 0004 0531 2775Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Chinatsu Umaba
- grid.411217.00000 0004 0531 2775Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan ,grid.258799.80000 0004 0372 2033Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Nan Liang
- grid.258799.80000 0004 0372 2033Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Manabu Nankaku
- grid.411217.00000 0004 0531 2775Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan
| | - Yohei Mineharu
- grid.258799.80000 0004 0372 2033Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan ,grid.258799.80000 0004 0372 2033Department of Artificial Intelligence in Healthcare and Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masayuki Honda
- grid.258799.80000 0004 0372 2033Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takefumi Hitomi
- grid.258799.80000 0004 0372 2033Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Ikeguchi
- grid.411217.00000 0004 0531 2775Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan ,grid.258799.80000 0004 0372 2033Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akio Ikeda
- grid.258799.80000 0004 0372 2033Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- grid.258799.80000 0004 0372 2033Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shuichi Matsuda
- grid.411217.00000 0004 0531 2775Rehabilitation Unit, Kyoto University Hospital, Kyoto, Japan ,grid.258799.80000 0004 0372 2033Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiki Arakawa
- grid.258799.80000 0004 0372 2033Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
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13
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Self-Referential Processing and Resting-State Functional MRI Connectivity of Cortical Midline Structures in Glioma Patients. Brain Sci 2022; 12:brainsci12111463. [DOI: 10.3390/brainsci12111463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
Metacognition has only scarcely been investigated in brain tumor patients. It is unclear if and how the tumor-lesioned brain might be able to maintain an adequate sense-of-self. As cortical midline structures (CMS) are regarded as essential for self-referential mental activity, we investigated resting-state fMRI connectivity (FC) of CMS to the default-mode network (DMN) and to the whole brain, comparing glioma patients and matched controls. Subjects furthermore performed a trait judgement (TJ), a trait recall task (TR), and neuropsychological testing. In the TJ, adjectives had to be ascribed as self- or non-self-describing, assessing the self-serving effect (SSE), a normally observed bias for positive traits. In the TR, the mnemic neglect effect (MNE), a memory advantage for positive traits, was tested. The groups were compared and partial correlations between FC and test metrics were analyzed. Although patients were significantly impaired in terms of verbal memory, groups did not differ in the SSE or the MNE results, showing preserved metacognitive abilities in patients. FC of CMS to the DMN was maintained, but was significantly decreased to whole brain in the patients. FC of the dorsomedial prefrontal cortex (DMPFC) to whole brain was correlated with the MNE in patients. Preserving the DMPFC in therapeutic interventions might be relevant for maintaining self-related verbal information processing in the memory domain in glioma patients.
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14
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Kirkman MA, Hunn BHM, Thomas MSC, Tolmie AK. Influences on cognitive outcomes in adult patients with gliomas: A systematic review. Front Oncol 2022; 12:943600. [PMID: 36033458 PMCID: PMC9407441 DOI: 10.3389/fonc.2022.943600] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
People with brain tumors, including those previously treated, are commonly affected by a range of neurocognitive impairments involving executive function, memory, attention, and social/emotional functioning. Several factors are postulated to underlie this relationship, but evidence relating to many of these factors is conflicting and does not fully explain the variation in cognitive outcomes seen in the literature and in clinical practice. To address this, we performed a systematic literature review to identify and describe the range of factors that can influence cognitive outcomes in adult patients with gliomas. A literature search was performed of Ovid MEDLINE, PsychINFO, and PsycTESTS from commencement until September 2021. Of 9,998 articles identified through the search strategy, and an additional 39 articles identified through other sources, 142 were included in our review. The results confirmed that multiple factors influence cognitive outcomes in patients with gliomas. The effects of tumor characteristics (including location) and treatments administered are some of the most studied variables but the evidence for these is conflicting, which may be the result of methodological and study population differences. Tumor location and laterality overall appear to influence cognitive outcomes, and detection of such an effect is contingent upon administration of appropriate cognitive tests. Surgery appears to have an overall initial deleterious effect on cognition with a recovery in most cases over several months. A large body of evidence supports the adverse effects of radiotherapy on cognition, but the role of chemotherapy is less clear. To contrast, baseline cognitive status appears to be a consistent factor that influences cognitive outcomes, with worse baseline cognition at diagnosis/pre-treatment correlated with worse long-term outcomes. Similarly, much evidence indicates that anti-epileptic drugs have a negative effect on cognition and genetics also appear to have a role. Evidence regarding the effect of age on cognitive outcomes in glioma patients is conflicting, and there is insufficient evidence for gender and fatigue. Cognitive reserve, brain reserve, socioeconomic status, and several other variables discussed in this review, and their influence on cognition and recovery, have not been well-studied in the context of gliomas and are areas for focus in future research. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier CRD42017072976.
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Affiliation(s)
- Matthew A. Kirkman
- Department of Psychology and Human Development, University College London (UCL) Institute of Education, UCL, London, United Kingdom
- Department of Neurosurgery, Queen’s Medical Centre, Nottingham University Hospitals National Health Service (NHS) Trust, Nottingham, United Kingdom
| | - Benjamin H. M. Hunn
- Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Neurosurgery, Royal Hobart Hospital, Hobart, TAS, Australia
- School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Michael S. C. Thomas
- Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom
| | - Andrew K. Tolmie
- Department of Psychology and Human Development, University College London (UCL) Institute of Education, UCL, London, United Kingdom
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15
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Romero-Garcia R, Owen M, McDonald A, Woodberry E, Assem M, Coelho P, Morris RC, Price SJ, Santarius T, Suckling J, Manly T, Erez Y, Hart MG. Assessment of neuropsychological function in brain tumor treatment: a comparison of traditional neuropsychological assessment with app-based cognitive screening. Acta Neurochir (Wien) 2022; 164:2021-2034. [PMID: 35230551 PMCID: PMC9338148 DOI: 10.1007/s00701-022-05162-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/16/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Gliomas are typically considered to cause relatively few neurological impairments. However, cognitive difficulties can arise, for example during treatment, with potential detrimental effects on quality of life. Accurate, reproducible, and accessible cognitive assessment is therefore vital in understanding the effects of both tumor and treatments. Our aim is to compare traditional neuropsychological assessment with an app-based cognitive screening tool in patients with glioma before and after surgical resection. Our hypotheses were that cognitive impairments would be apparent, even in a young and high functioning cohort, and that app-based cognitive screening would complement traditional neuropsychological assessment. METHODS Seventeen patients with diffuse gliomas completed a traditional neuropsychological assessment and an app-based touchscreen tablet assessment pre- and post-operatively. The app assessment was also conducted at 3- and 12-month follow-up. Impairment rates, mean performance, and pre- and post-operative changes were compared using standardized Z-scores. RESULTS Approximately 2-3 h of traditional assessment indicated an average of 2.88 cognitive impairments per patient, while the 30-min screen indicated 1.18. As might be expected, traditional assessment using multiple items across the difficulty range proved more sensitive than brief screening measures in areas such as memory and attention. However, the capacity of the screening app to capture reaction times enhanced its sensitivity, relative to traditional assessment, in the area of non-verbal function. Where there was overlap between the two assessments, for example digit span tasks, the results were broadly equivalent. CONCLUSIONS Cognitive impairments were common in this sample and app-based screening complemented traditional neuropsychological assessment. Implications for clinical assessment and follow-up are discussed.
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Affiliation(s)
- Rafael Romero-Garcia
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, CB2 0SZ, UK.
- Dpto. de Fisiología Médica Y Biofísica, Instituto de Biomedicina de Sevilla (IBiS) HUVR/CSIC, Universidad de Sevilla, Seville, Spain.
| | - Mallory Owen
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, CB2 0SZ, UK
| | - Alexa McDonald
- Department of Neuropsychology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Emma Woodberry
- Department of Neuropsychology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Moataz Assem
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - Rob C Morris
- Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Stephen J Price
- Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Tom Santarius
- Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
- Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, CB2 0SZ, UK
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
- Cambridge and Peterborough NHS Foundation Trust, Cambridgeshire, UK
| | - Tom Manly
- Cambridge and Peterborough NHS Foundation Trust, Cambridgeshire, UK
| | - Yaara Erez
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Faculty of Engineering, Bar-Ilan University, Ramat-Gan, Israel
| | - Michael G Hart
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Robinson Way, Cambridge, CB2 0SZ, UK
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16
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Wang C, Cho NS, Dyk KV, Islam S, Raymond C, Choi J, Salamon N, Pope WB, Lai A, Cloughesy TF, Nghiemphu PL, Ellingson BM. Characterization of Cognitive Function in Survivors of Diffuse Gliomas Using Morphometric Correlation Networks. Tomography 2022; 8:1437-1452. [PMID: 35736864 PMCID: PMC9229761 DOI: 10.3390/tomography8030116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/13/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
This pilot study investigates structural alterations and their relationships with cognitive function in survivors of diffuse gliomas. Twenty-four survivors of diffuse gliomas (mean age 44.5 ± 11.5), from whom high-resolution T1-weighted images, neuropsychological tests, and self-report questionnaires were obtained, were analyzed. Patients were grouped by degree of cognitive impairment, and interregional correlations of cortical thickness were computed to generate morphometric correlation networks (MCNs). The results show that the cortical thickness of the right insula (R2 = 0.3025, p = 0.0054) was negatively associated with time since the last treatment, and the cortical thickness of the left superior temporal gyrus (R2 = 0.2839, p = 0.0107) was positively associated with cognitive performance. Multiple cortical regions in the default mode, salience, and language networks were identified as predominant nodes in the MCNs of survivors of diffuse gliomas. Compared to cognitively impaired patients, cognitively non-impaired patients tended to have higher network stability in network nodes removal analysis, especially when the fraction of removed nodes (among 66 nodes in total) exceeded 55%. These findings suggest that structural networks are altered in survivors of diffuse gliomas and that their cortical structures may also be adapting to support cognitive function during survivorship.
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Affiliation(s)
- Chencai Wang
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (C.W.); (N.S.C.); (S.I.); (C.R.)
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (N.S.); (W.B.P.)
| | - Nicholas S. Cho
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (C.W.); (N.S.C.); (S.I.); (C.R.)
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (N.S.); (W.B.P.)
- Medical Scientist Training Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Kathleen Van Dyk
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute, University of California Los Angeles, Los Angeles, CA 90095, USA;
| | - Sabah Islam
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (C.W.); (N.S.C.); (S.I.); (C.R.)
- Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (C.W.); (N.S.C.); (S.I.); (C.R.)
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (N.S.); (W.B.P.)
| | - Justin Choi
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (J.C.); (A.L.); (T.F.C.); (P.L.N.)
| | - Noriko Salamon
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (N.S.); (W.B.P.)
| | - Whitney B. Pope
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (N.S.); (W.B.P.)
| | - Albert Lai
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (J.C.); (A.L.); (T.F.C.); (P.L.N.)
| | - Timothy F. Cloughesy
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (J.C.); (A.L.); (T.F.C.); (P.L.N.)
| | - Phioanh L. Nghiemphu
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (J.C.); (A.L.); (T.F.C.); (P.L.N.)
| | - Benjamin M. Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (C.W.); (N.S.C.); (S.I.); (C.R.)
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90024, USA; (N.S.); (W.B.P.)
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California Los Angeles, Los Angeles, CA 90095, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute, University of California Los Angeles, Los Angeles, CA 90095, USA;
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA 90095, USA
- Correspondence: ; Tel.: +1-(310)-481-7572
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17
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The role of the default mode network in longitudinal functional brain reorganization of brain gliomas. Brain Struct Funct 2022; 227:2923-2937. [PMID: 35460446 PMCID: PMC9653323 DOI: 10.1007/s00429-022-02490-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
Abstract
The study of patients after glioma resection offers a unique opportunity to investigate brain reorganization. It is currently unknown how the whole-brain connectomic profile evolves longitudinally after surgical resection of a glioma and how this may be associated with tumor characteristics and cognitive outcome. In this longitudinal study, we investigate the impact of tumor lateralization and grade on functional connectivity (FC) in highly connected networks, or hubs, and cognitive performance. Twenty-eight patients (17 high-grade, 11 low-grade gliomas) underwent longitudinal pre/post-surgery resting-state fMRI scans and neuropsychological assessments (73 total measures). FC matrices were constructed considering as functional hubs the default mode (DMN) and fronto-parietal networks. No-hubs included primary sensory functional networks and any other no-hubs nodes. Both tumor hemisphere and grade affected brain reorganization post-resection. In right-hemisphere tumor patients, regardless of grade and relative to left-hemisphere gliomas, FC increased longitudinally after the intervention, both in terms of FC within hubs (phubs = 0.0004) and FC between hubs and no-hubs (phubs-no-hubs = 0.005). Regardless of tumor side, only lower-grade gliomas showed longitudinal FC increases relative to high-grade tumors within a precise hub network, the DMN. The neurocognitive profile was longitudinally associated with spatial features of the connectome, mainly within the DMN. We provide evidence that clinical glioma features, such as lateralization and grade, affect post-surgical longitudinal functional reorganization and cognitive recovery. The data suggest a possible role of the DMN in supporting cognition, providing useful information for prognostic prediction and surgical planning.
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18
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Chen Z, Ye N, Teng C, Li X. Alternations and Applications of the Structural and Functional Connectome in Gliomas: A Mini-Review. Front Neurosci 2022; 16:856808. [PMID: 35478847 PMCID: PMC9035851 DOI: 10.3389/fnins.2022.856808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/28/2022] [Indexed: 12/12/2022] Open
Abstract
In the central nervous system, gliomas are the most common, but complex primary tumors. Genome-based molecular and clinical studies have revealed different classifications and subtypes of gliomas. Neuroradiological approaches have non-invasively provided a macroscopic view for surgical resection and therapeutic effects. The connectome is a structural map of a physical object, the brain, which raises issues of spatial scale and definition, and it is calculated through diffusion magnetic resonance imaging (MRI) and functional MRI. In this study, we reviewed the basic principles and attributes of the structural and functional connectome, followed by the alternations of connectomes and their influences on glioma. To extend the applications of connectome, we demonstrated that a series of multi-center projects still need to be conducted to systemically investigate the connectome and the structural-functional coupling of glioma. Additionally, the brain-computer interface based on accurate connectome could provide more precise structural and functional data, which are significant for surgery and postoperative recovery. Besides, integrating the data from different sources, including connectome and other omics information, and their processing with artificial intelligence, together with validated biological and clinical findings will be significant for the development of a personalized surgical strategy.
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Affiliation(s)
- Ziyan Chen
- Department of Neurosurgery, Xiangya Hospital, Central South University, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Brain Tumor Research, Xiangya Hospital, Central South University, Changsha, China
| | - Ningrong Ye
- Department of Neurosurgery, Xiangya Hospital, Central South University, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Brain Tumor Research, Xiangya Hospital, Central South University, Changsha, China
| | - Chubei Teng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Brain Tumor Research, Xiangya Hospital, Central South University, Changsha, China
- Department of Neurosurgery, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Xuejun Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, Hunan, China
- Hunan International Scientific and Technological Cooperation Base of Brain Tumor Research, Xiangya Hospital, Central South University, Changsha, China
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19
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Silvestri E, Moretto M, Facchini S, Castellaro M, Anglani M, Monai E, D’Avella D, Della Puppa A, Cecchin D, Bertoldo A, Corbetta M. Widespread cortical functional disconnection in gliomas: an individual network mapping approach. Brain Commun 2022; 4:fcac082. [PMID: 35474856 PMCID: PMC9034119 DOI: 10.1093/braincomms/fcac082] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 02/04/2022] [Accepted: 04/04/2022] [Indexed: 11/14/2022] Open
Abstract
Abstract
Assessment of impaired/preserved cortical regions in brain tumours is typically performed via intraoperative direct brain stimulation of eloquent areas or task-based functional MRI. One main limitation is that they overlook distal brain regions or networks that could be functionally impaired by the tumour.
This study aims: 1) to investigate the impact of brain tumours on the cortical synchronization of brain networks measured with resting-state functional magnetic resonance imaging (resting-state networks) both near the lesion and remotely; 2) to test whether potential changes in resting state networks correlate with cognitive status.
The sample included twenty-four glioma patients (mean age 58.1 ± 16.4y) with different pathological staging. We developed a new method for single subject localization of resting state networks abnormalities. First, we derived the spatial pattern of the main resting state networks by means of the group guided independent component analysis. This was informed by a high-resolution resting state networks template derived from an independent sample of healthy controls. Second, we developed a spatial similarity index to measure differences in network topography and strength between healthy controls and individual brain tumour patients. Next, we investigated the spatial relationship between altered networks and tumour location. Finally, multivariate analyses related cognitive scores across multiple cognitive domains (attention, language, memory, decision making) with patterns of multi-network abnormality.
We found that brain gliomas cause broad alterations of resting state networks topography that occurred mainly in structurally normal regions outside the tumour and oedema region. Cortical regions near the tumour often showed normal synchronization. Finally, multi-network abnormalities predicted attention deficits.
Overall, we present a novel method for the functional localization of resting state networks abnormalities in individual glioma patients. These abnormalities partially explain cognitive disabilities and shall be carefully navigated during surgery.
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Affiliation(s)
- Erica Silvestri
- Department of Information Engineering, University of Padova, 35131 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Manuela Moretto
- Department of Information Engineering, University of Padova, 35131 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Silvia Facchini
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Marco Castellaro
- Department of Information Engineering, University of Padova, 35131 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | | | - Elena Monai
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Domenico D’Avella
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
| | - Alessandro Della Puppa
- Neurosurgery, Department of NEUROFARBA, University Hospital of Careggi, University of Florence, 50139 Florence, Italy
| | - Diego Cecchin
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
- Department of Medicine, Unit of Nuclear Medicine, University of Padova, 35128 Padova, Italy
| | - Alessandra Bertoldo
- Department of Information Engineering, University of Padova, 35131 Padova, Italy
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
| | - Maurizio Corbetta
- Padova Neuroscience Center, University of Padova, 35129 Padova, Italy
- Department of Neuroscience, University of Padova, 35128 Padova, Italy
- Venetian Institute of Molecular Medicine, 35129 Padova, Italy
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20
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Functional reorganization of contralesional networks varies according to isocitrate dehydrogenase 1 mutation status in patients with left frontal lobe glioma. Neuroradiology 2022; 64:1819-1828. [PMID: 35348814 DOI: 10.1007/s00234-022-02932-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/12/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE The study aimed to assess how isocitrate dehydrogenase 1 (IDH1) mutation status in patients with glioma may alter functional connectivity (FC) in the default mode network (DMN) and fronto-parietal network (FPN). METHODS Using resting-state functional magnetic resonance imaging, a seed-based FC analysis was employed to investigate connectivity within and between networks in seventeen patients with IDH1-mutant glioma (IDH1-M), eleven patients with IDH1-wildtype glioma (IDH1-WT), and nineteen healthy controls (HC). RESULTS For FC within the DMN, compared to HC, both IDH1-M and IDH1-WT exhibited significantly increased FC between the posterior cingulate cortex (PCC) and the right retrosplenial cortex, right precuneus/cuneus, and right middle cingulate cortex and between the right lateral parietal cortex (LP_R) and the right middle temporal gyrus. For FC within the FPN, compared with HC, IDH1-M showed significantly greater FC between the right posterior parietal cortex (PPC_R) and the right inferior, right medial, and right middle frontal gyrus, and IDH1-WT showed significantly increased FC between the PPC_R and the right middle frontal gyrus. For FC between the DMN and FPN, relative to IDH1-WT and HC, IDH1-M exhibited significantly increased FC between the LP_R and the right superior frontal gyrus and between the PPC_R and the right precuneus/cuneus. In contrast, compared to IDH1-M and HC, IDH1-WT showed significantly reduced FC between the PPC_R and the right angular gyrus. CONCLUSION The preliminary findings revealed that there should be differences in the patterns of network reorganization between IDH1-M and IDH1-WT with different growth kinetics.
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21
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Douw L, Nissen IA, Fitzsimmons SMDD, Santos FAN, Hillebrand A, van Straaten ECW, Stam CJ, De Witt Hamer PC, Baayen JC, Klein M, Reijneveld JC, Heyer DB, Verhoog MB, Wilbers R, Hunt S, Mansvelder HD, Geurts JJG, de Kock CPJ, Goriounova NA. Cellular Substrates of Functional Network Integration and Memory in Temporal Lobe Epilepsy. Cereb Cortex 2021; 32:2424-2436. [PMID: 34564728 PMCID: PMC9157285 DOI: 10.1093/cercor/bhab349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/19/2021] [Accepted: 08/22/2021] [Indexed: 11/12/2022] Open
Abstract
Temporal lobe epilepsy (TLE) patients are at risk of memory deficits, which have been linked to functional network disturbances, particularly of integration of the default mode network (DMN). However, the cellular substrates of functional network integration are unknown. We leverage a unique cross-scale dataset of drug-resistant TLE patients (n = 31), who underwent pseudo resting-state functional magnetic resonance imaging (fMRI), resting-state magnetoencephalography (MEG) and/or neuropsychological testing before neurosurgery. fMRI and MEG underwent atlas-based connectivity analyses. Functional network centrality of the lateral middle temporal gyrus, part of the DMN, was used as a measure of local network integration. Subsequently, non-pathological cortical tissue from this region was used for single cell morphological and electrophysiological patch-clamp analysis, assessing integration in terms of total dendritic length and action potential rise speed. As could be hypothesized, greater network centrality related to better memory performance. Moreover, greater network centrality correlated with more integrative properties at the cellular level across patients. We conclude that individual differences in cognitively relevant functional network integration of a DMN region are mirrored by differences in cellular integrative properties of this region in TLE patients. These findings connect previously separate scales of investigation, increasing translational insight into focal pathology and large-scale network disturbances in TLE.
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Affiliation(s)
- Linda Douw
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands.,Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 02129 MA, Charlestown, USA
| | - Ida A Nissen
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Sophie M D D Fitzsimmons
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Fernando A N Santos
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Elisabeth C W van Straaten
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Philip C De Witt Hamer
- Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, VUmc Cancer Center Amsterdam Brain Tumor Center Amsterdam, 1081 HV, Amsterdam, the Netherlands
| | - Johannes C Baayen
- Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, VUmc Cancer Center Amsterdam Brain Tumor Center Amsterdam, 1081 HV, Amsterdam, the Netherlands
| | - Martin Klein
- Department of Medical Psychology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, VUmc Cancer Center Amsterdam Brain Tumor Center Amsterdam, 1081 HV, Amsterdam, the Netherlands
| | - Jaap C Reijneveld
- Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, VUmc Cancer Center Amsterdam Brain Tumor Center Amsterdam, 1081 HV, Amsterdam, the Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede 2103 SW, Heemstede, the Netherlands
| | - Djai B Heyer
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Matthijs B Verhoog
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands.,Department of Human Biology, Division of Cell Biology, Neuroscience Institute, University of Cape Town, 7935, Cape Town, South Africa
| | - René Wilbers
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Sarah Hunt
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Huibert D Mansvelder
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Jeroen J G Geurts
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Christiaan P J de Kock
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
| | - Natalia A Goriounova
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research (CNCR), Vrije Universiteit Amsterdam, Amsterdam Neuroscience, 1081 HV, Amsterdam, the Netherlands
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22
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Jütten K, Weninger L, Mainz V, Gauggel S, Binkofski F, Wiesmann M, Merhof D, Clusmann H, Na CH. Dissociation of structural and functional connectomic coherence in glioma patients. Sci Rep 2021; 11:16790. [PMID: 34408195 PMCID: PMC8373888 DOI: 10.1038/s41598-021-95932-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023] Open
Abstract
With diffuse infiltrative glioma being increasingly recognized as a systemic brain disorder, the macroscopically apparent tumor lesion is suggested to impact on cerebral functional and structural integrity beyond the apparent lesion site. We investigated resting-state functional connectivity (FC) and diffusion-MRI-based structural connectivity (SC) (comprising edge-weight (EW) and fractional anisotropy (FA)) in isodehydrogenase mutated (IDHmut) and wildtype (IDHwt) patients and healthy controls. SC and FC were determined for whole-brain and the Default-Mode Network (DMN), mean intra- and interhemispheric SC and FC were compared across groups, and partial correlations were analyzed intra- and intermodally. With interhemispheric EW being reduced in both patient groups, IDHwt patients showed FA decreases in the ipsi- and contralesional hemisphere, whereas IDHmut patients revealed FA increases in the contralesional hemisphere. Healthy controls showed strong intramodal connectivity, each within the structural and functional connectome. Patients however showed a loss in structural and reductions in functional connectomic coherence, which appeared to be more pronounced in IDHwt glioma patients. Findings suggest a relative dissociation of structural and functional connectomic coherence in glioma patients at the time of diagnosis, with more structural connectomic aberrations being encountered in IDHwt glioma patients. Connectomic profiling may aid in phenotyping and monitoring prognostically differing tumor types.
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Affiliation(s)
- Kerstin Jütten
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Leon Weninger
- Imaging and Computer Vision, RWTH Aachen University, Templergraben 55, 52074, Aachen, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany
| | - Siegfried Gauggel
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Pauwelsstraße 19, 52074, Aachen, Germany
| | - Ferdinand Binkofski
- Division of Clinical Cognitive Sciences, RWTH Aachen University, Pauwelsstraße 17, 52074, Aachen, Germany
| | - Martin Wiesmann
- Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Dorit Merhof
- Imaging and Computer Vision, RWTH Aachen University, Templergraben 55, 52074, Aachen, Germany
| | - Hans Clusmann
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
| | - Chuh-Hyoun Na
- Department of Neurosurgery, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.,Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Aachen, Germany
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23
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Wang C, Van Dyk K, Cho N, Raymond C, Choi J, Salamon N, Pope WB, Lai A, Cloughesy TF, Nghiemphu PL, Ellingson BM. Characterization of cognitive function in survivors of diffuse gliomas using resting-state functional MRI (rs-fMRI). Brain Imaging Behav 2021; 16:239-251. [PMID: 34350525 PMCID: PMC8825610 DOI: 10.1007/s11682-021-00497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 11/29/2022]
Abstract
As treatments for diffuse gliomas have advanced, survival for patients with gliomas has also increased. However, there remains limited knowledge on the relationships between brain connectivity and the lasting changes to cognitive function that glioma survivors often experience long after completing treatment. This resting-state functional magnetic resonance imaging (rs-fMRI) study explored functional connectivity (FC) alterations associated with cognitive function in survivors of gliomas. In this pilot study, 22 patients (mean age 43.8 ± 11.9) with diffuse gliomas who completed treatment within the past 10 years were evaluated using rs-fMRI and neuropsychological measures. Novel rs-fMRI analysis methods were used to account for missing brain in the resection cavity. FC relationships were assessed between cognitively impaired and non-impaired glioma patients, along with self-reported cognitive impairment, non-work daily functioning, and time with surgery. In the cognitively non-impaired patients, FC was stronger in the medial prefrontal cortex, rostral prefrontal cortex, and intraparietal sulcus compared to the impaired survivors. When examining non-work daily functioning, a positive correlation with FC was observed between the accumbens and the intracalcarine cortices, while a negative correlation with FC was observed between the parietal operculum cortex and the cerebellum. Additionally, worse self-reported cognitive impairment and worse non-work daily functioning were associated with increased FC between regions involved in cognition and sensorimotor processing. These preliminary findings suggest that neural correlates for cognitive and daily functioning in glioma patients can be revealed using rs-fMRI. Resting-state network alterations may serve as a biomarker for patients’ cognition and functioning.
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Affiliation(s)
- Chencai Wang
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Kathleen Van Dyk
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Nicholas Cho
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.,Medical Scientist Training Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Catalina Raymond
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA.,Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Justin Choi
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Noriko Salamon
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Whitney B Pope
- Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Albert Lai
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Timothy F Cloughesy
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Phioanh L Nghiemphu
- Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Benjamin M Ellingson
- UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 615, Los Angeles, CA, 90024, USA. .,Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. .,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Semel Institute, University of California Los Angeles, Los Angeles, CA, USA.
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24
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Maniar YM, Peck KK, Jenabi M, Gene M, Holodny AI. Functional MRI Shows Altered Deactivation and a Corresponding Decrease in Functional Connectivity of the Default Mode Network in Patients with Gliomas. AJNR Am J Neuroradiol 2021; 42:1505-1512. [PMID: 33985945 DOI: 10.3174/ajnr.a7138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/19/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE The default mode network normally decreases in activity during externally directed tasks. Although default mode network connectivity is disrupted in numerous brain pathologies, default mode network deactivation has not been studied in patients with brain tumors. We investigated default mode network deactivation with language task-based fMRI by measuring the anticorrelation of a critical default mode network node, the posterior cingulate cortex, in patients with gliomas and controls; furthermore, we examined default mode network functional connectivity in these patients with task-based and resting-state fMRI. MATERIALS AND METHODS In 10 healthy controls and 30 patients with gliomas, the posterior cingulate cortex was identified on task-based fMRI and was used as an ROI to create connectivity maps from task-based and resting-state fMRI data. We compared the average correlation in each default mode network region between patients and controls for each correlation map and stratified patients by tumor location, hemisphere, and grade. RESULTS Patients with gliomas (P = .001) and, in particular, patients with tumors near the posterior default mode network (P < .001) showed less posterior cingulate cortex anticorrelation in task-based fMRI than controls. Patients with both left- and right-hemisphere tumors, as well as those with grade IV tumors, showed significantly lower posterior cingulate cortex anticorrelation than controls (P = .02, .03, and <.001, respectively). Functional connectivity in each default mode network region was not significantly different between task-based and resting-state maps. CONCLUSIONS Task-based fMRI showed impaired deactivation of the default mode network in patients with gliomas. The functional connectivity of the default mode network in both task-based and resting-state fMRI in patients with gliomas using the posterior cingulate cortex identified in task-based fMRI as an ROI for seed-based correlation analysis has strong overlap.
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Affiliation(s)
- Y M Maniar
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - K K Peck
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Medical Physics (K.K.P.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M Jenabi
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - M Gene
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - A I Holodny
- From the Department of Radiology (Y.M.M., K.K.P., M.J., M.G., A.I.H.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (A.I.H.), Weill Medical College of Cornell University, New York, New York
- Department of Neuroscience (A.I.H.), Weill-Cornell Graduate School of the Medical Sciences, New York, New York
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25
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Fox ME, Turner JA, Crosson B, Morris RD, King TZ. Functional Connectivity Networks and Their Recruitment During Working Memory Tasks in Adult Survivors of Childhood Brain Tumors. Brain Connect 2021; 11:822-837. [PMID: 33858201 DOI: 10.1089/brain.2020.0800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Assessments of functional connectivity of default mode network (DMN) and positive task-related networks (TRNs) using independent component analysis (ICA) may help describe long-term effects of childhood brain tumors and adjuvant treatments. Methods: Aiming to identify potential neuronal markers that may aid in prognosis and inform interventions to optimize outcomes, this study used ICA to evaluate the presence of functional connectivity networks and their recruitment during a letter n-back task in 23 adult survivors of childhood posterior fossa tumors (9 low grade, 14 high grade) at least 5 years past diagnosis compared with 40 age- and sex-matched healthy peers. Results: DMN components generally demonstrated increasing disengagement as task difficulty increased, and relationships between effective DMN disengagement and improved performance were observed in healthy controls (HCs). Low-grade brain tumor survivors (LGS) demonstrated unique patterns in DMN recruitment that suggested increased involvement of the medial prefrontal cortex in LGS during tasks. TRN components generally demonstrated increasing engagement, which was related to improved task performance in HCs for one executive control network (ECN) component. High-grade brain tumor survivors (HGS) demonstrated distinct challenges recruiting an ECN component at more difficult task levels and showed a relationship between recruitment of another ECN component and task performance, indicating a potential compensatory mechanism for some HGS. Conclusions: Findings suggest the importance of cognitive intervention in both survivor groups and the necessity to track LGS despite their cognitive abilities often resembling those of their healthy peers. Impact statement Distinct functional connectivity patterns were identified between both adult survivor of childhood brain tumor groups and peers during attention and working memory tasks, reflecting different damage and recovery from treatment. Survivors of low-grade tumors demonstrated unique patterns of recruitment of default mode network components in the context of similar cognitive abilities, whereas survivors of high-grade tumors demonstrated poorer cognitive abilities and may be utilizing compensatory executive control network components in the face of challenging tasks. Long-term clinical follow-up and cognitive remediation is warranted for both groups, including low grade cerebellar tumor patients who have traditionally not been monitored as closely.
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Affiliation(s)
- Michelle E Fox
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Jessica A Turner
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
| | - Bruce Crosson
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA.,Departments of Neurology and of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Atlanta VA Center of Excellence for Visual and Neurocognitive Rehabilitation, Decatur, Georgia, USA
| | - Robin D Morris
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
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26
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fMRI Retinotopic Mapping in Patients with Brain Tumors and Space-Occupying Brain Lesions in the Area of the Occipital Lobe. Cancers (Basel) 2021; 13:cancers13102439. [PMID: 34069930 PMCID: PMC8157607 DOI: 10.3390/cancers13102439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 11/26/2022] Open
Abstract
Simple Summary Functional magnetic resonance imaging (fMRI) in patients with brain tumors enables the visualization of eloquent cortical areas and can be used for planning surgical interventions and assessing the risk of postoperative functional deficits. While preoperative fMRI paradigms used to determine the localization of speech-critical or motor areas dominate the literature, there are hardly any studies that investigate the retinotopic organization of the visual field in patients with occipital lesions or tumors. The aim of this study was to evaluate the effect of a brain tumor or space-occupying brain lesions on the retinotopic organization of the occipital cortex, the activation of and the functional connectivity between cortical areas involved in visual processing. We found a high degree of similarity in the activation profiles of patients and healthy controls, indicating that the retinotopic organization of the visual cortex can reliably be described by fMRI retinotopic mapping as part of the preoperative examination of patients with tumors and space-occupying brain lesions. Abstract Functional magnetic resonance imaging (fMRI) is a valuable tool in the clinical routine of neurosurgery when planning surgical interventions and assessing the risk of postoperative functional deficits. Here, we examined how the presence of a brain tumor or lesion in the area of the occipital lobe affects the results of fMRI retinotopic mapping. fMRI data were evaluated on a retrospectively selected sample of 12 patients with occipital brain tumors, 7 patients with brain lesions and 19 control subjects. Analyses of the cortical activation, percent signal change, cluster size of the activated voxels and functional connectivity were carried out using Statistical Parametric Mapping (SPM12) and the CONN and Marsbar toolboxes. We found similar but reduced patterns of cortical activation and functional connectivity between the two patient groups compared to a healthy control group. Here, we found that retinotopic organization was well-preserved in the patients and was comparable to that of the age-matched controls. The results also showed that, compared to the tumor patients, the lesion patients showed higher percent signal changes but lower values in the cluster sizes of the activated voxels in the calcarine fissure region. Our results suggest that the lesion patients exhibited results that were more similar to those of the control subjects in terms of the BOLD signal, whereas the extent of the activation was comparable to that of the tumor patients.
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27
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Weyer-Jamora C, Brie MS, Luks TL, Smith EM, Braunstein SE, Villanueva-Meyer JE, Bracci PM, Chang S, Hervey-Jumper SL, Taylor JW. Cognitive impact of lower-grade gliomas and strategies for rehabilitation. Neurooncol Pract 2021; 8:117-128. [PMID: 33898046 PMCID: PMC8049427 DOI: 10.1093/nop/npaa072] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Outcomes for patients with lower-grade gliomas (LrGGs) continue to improve with advances in molecular characterization and treatment. However, cognitive sequela from the tumor and its treatment leave a significant impact on health-related quality of life for these patients. Several factors affect each patient's cognition, such as tumor location, treatment, medication, and comorbidities. However, impairments of processing speed, attention, concentration, working memory, and executive function are common across LrGG patients. Cognitive rehabilitation strategies, well established in traumatic brain injury and stroke populations, are based on neural plasticity and functional reorganization. Adapting these strategies for implementation in patients with brain tumors is an active area of research. This article provides an overview of cognitive domains commonly impaired in LrGG patients and evidence for the use of cognitive rehabilitation strategies to address these impairments with the goal of improving health-related quality of life in this patient population.
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Affiliation(s)
- Christina Weyer-Jamora
- Department of Neurological Surgery, University of California San Francisco
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, California
| | - Melissa S Brie
- Department of Neurological Surgery, University of California San Francisco
- Department of Psychiatry and Behavioral Sciences, Zuckerberg San Francisco General Hospital, California
| | - Tracy L Luks
- Department of Radiology and Biomedical Imaging, University of California San Francisco
| | - Ellen M Smith
- Department of Neurological Surgery, University of California San Francisco
| | - Steve E Braunstein
- Department of Radiation Oncology, University of California San Francisco
| | | | - Paige M Bracci
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Susan Chang
- Department of Neurological Surgery, University of California San Francisco
| | | | - Jennie W Taylor
- Department of Neurological Surgery, University of California San Francisco
- Department of Neurology, University of California San Francisco
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28
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Yang J, Gohel S, Zhang Z, Hatzoglou V, Holodny AI, Vachha BA. Glioma-Induced Disruption of Resting-State Functional Connectivity and Amplitude of Low-Frequency Fluctuations in the Salience Network. AJNR Am J Neuroradiol 2021; 42:551-558. [PMID: 33384293 DOI: 10.3174/ajnr.a6929] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 10/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive challenges are prevalent in survivors of glioma, but their neurobiology is incompletely understood. The purpose of this study was to investigate the effect of glioma presence and tumor characteristics on resting-state functional connectivity and amplitude of low-frequency fluctuations of the salience network, a key neural network associated with cognition. MATERIALS AND METHODS Sixty-nine patients with glioma (mean age, 48.74 [SD, 14.32] years) who underwent resting-state fMRI were compared with 31 healthy controls (mean age, 49.68 [SD, 15.54] years). We identified 4 salience network ROIs: left/right dorsal anterior cingulate cortex and left/right anterior insula. Average salience network resting-state functional connectivity and amplitude of low-frequency fluctuations within the 4 salience network ROIs were computed. RESULTS Patients with gliomas showed decreased overall salience network resting-state functional connectivity (P = .001) and increased amplitude of low-frequency fluctuations in all salience network ROIs (P < .01) except in the left dorsal anterior cingulate cortex. Compared with controls, patients with left-sided gliomas showed increased amplitude of low-frequency fluctuations in the right dorsal anterior cingulate cortex (P = .002) and right anterior insula (P < .001), and patients with right-sided gliomas showed increased amplitude of low-frequency fluctuations in the left anterior insula (P = .002). Anterior tumors were associated with decreased salience network resting-state functional connectivity (P < .001) and increased amplitude of low-frequency fluctuations in the right anterior insula, left anterior insula, and right dorsal anterior cingulate cortex. Patients with high-grade gliomas had decreased salience network resting-state functional connectivity compared with healthy controls (P < .05). The right anterior insula showed increased amplitude of low-frequency fluctuations in patients with grade II and IV gliomas compared with controls (P < .01). CONCLUSIONS By demonstrating decreased resting-state functional connectivity and an increased amplitude of low-frequency fluctuations related to the salience network in patients with glioma, this study adds to our understanding of the neurobiology underpinning observable cognitive deficits in these patients. In addition to more conventional functional connectivity, amplitude of low-frequency fluctuations is a promising functional-imaging biomarker of tumor-induced vascular and neural pathology.
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Affiliation(s)
- J Yang
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- New York University Grossman School of Medicine (J.Y.), New York University, New York, New York
| | - S Gohel
- Department of Health Informatics (S.G.), Rutgers University School of Health Professions, Newark, New Jersey
| | - Z Zhang
- Epidemiology and Biostatistics (Z.Z.)
| | - V Hatzoglou
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- Brain Tumor Center (V.H., A.I.H., B.A.V.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (V.H., A.I.H., B.A.V.), Weill Medical College of Cornell University, New York, New York
| | - A I Holodny
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- Brain Tumor Center (V.H., A.I.H., B.A.V.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (V.H., A.I.H., B.A.V.), Weill Medical College of Cornell University, New York, New York
- Department of Neuroscience (A.I.H.), Weill-Cornell Graduate School of the Medical Sciences, New York, New York
| | - B A Vachha
- From the Departments of Radiology (J.Y., V.H., A.I.H., B.A.V.)
- Brain Tumor Center (V.H., A.I.H., B.A.V.), Memorial Sloan Kettering Cancer Center, New York, New York
- Department of Radiology (V.H., A.I.H., B.A.V.), Weill Medical College of Cornell University, New York, New York
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29
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Manan HA, Franz EA, Yahya N. The utilisation of resting-state fMRI as a pre-operative mapping tool in patients with brain tumours in comparison to task-based fMRI and intraoperative mapping: A systematic review. Eur J Cancer Care (Engl) 2021; 30:e13428. [PMID: 33592671 DOI: 10.1111/ecc.13428] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE Resting-state functional Magnetic Resonance Imaging (rs-fMRI) is suggested to be a viable option for pre-operative mapping for patients with brain tumours. However, it remains an open issue whether the tool is useful in the clinical setting compared to task-based fMRI (T-fMRI) and intraoperative mapping. Thus, a systematic review was conducted to investigate the usefulness of this technique. METHODS A systematic literature search of rs-fMRI methods applied as a pre-operative mapping tool was conducted using the PubMed/MEDLINE and Cochrane Library electronic databases following PRISMA guidelines. RESULTS Results demonstrated that 50% (six out of twelve) of the studies comparing rs-fMRI and T-fMRI showed good concordance for both language and sensorimotor networks. In comparison to intraoperative mapping, 86% (six out of seven) studies found a good agreement to rs-fMRI. Finally, 87% (twenty out of twenty-three) studies agreed that rs-fMRI is a suitable and useful pre-operative mapping tool. CONCLUSIONS rs-fMRI is a promising technique for pre-operative mapping in assessing the functional brain areas. However, the agreement between rs-fMRI with other techniques, including T-fMRI and intraoperative maps, is not yet optimal. Studies to ascertain and improve the sophistication in pre-processing of rs-fMRI imaging data are needed.
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Affiliation(s)
- Hanani Abdul Manan
- Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory, Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Elizabeth A Franz
- Department of Psychology and fMRIotago, University of Otago, Dunedin, New Zealand
| | - Noorazrul Yahya
- Diagnostic Imaging & Radiotherapy Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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30
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Tordjman M, Madelin G, Gupta PK, Cordova C, Kurz SC, Orringer D, Golfinos J, Kondziolka D, Ge Y, Wang RL, Lazar M, Jain R. Functional connectivity of the default mode, dorsal attention and fronto-parietal executive control networks in glial tumor patients. J Neurooncol 2021; 152:347-355. [PMID: 33528739 DOI: 10.1007/s11060-021-03706-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/20/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Resting state functional magnetic resonance imaging (rsfMRI) is an emerging tool to explore the functional connectivity of different brain regions. We aimed to assess the disruption of functional connectivity of the Default Mode Network (DMN), Dorsal Attention Network(DAN) and Fronto-Parietal Network (FPN) in patients with glial tumors. METHODS rsfMRI data acquired on 3T-MR of treatment-naive glioma patients prospectively recruited (2015-2019) and matched controls from the 1000 functional-connectomes-project were analyzed using the CONN functional toolbox. Seed-Based Connectivity Analysis (SBCA) and Independent Component Analysis (ICA, with 10 to 100 components) were performed to study reliably the three networks of interest. RESULTS 35 patients with gliomas (17 WHO grade I-II, 18 grade III-IV) and 70 controls were included. Global increased DMN connectivity was consistently found with SBCA and ICA in patients compared to controls (Cluster1: Precuneus, height: p < 10-6; Cluster2: subcallosum; height: p < 10-5). However, an area of decreased connectivity was found in the posterior corpus callosum, particularly in high-grade gliomas (height: p < 10-5). The DAN demonstrated small areas of increased connectivity in frontal and occipital regions (height: p < 10-6). For the FPN, increased connectivity was noted in the precuneus, posterior cingulate gyrus, and frontal cortex. No difference in the connectivity of the networks of interest was demonstrated between low- and high-grade gliomas, as well as when stratified by their IDH1-R132H (isocitrate dehydrogenase) mutation status. CONCLUSION Altered functional connectivity is reliably found with SBCA and ICA in the DMN, DAN, and FPN in glioma patients, possibly explained by decreased connectivity between the cerebral hemispheres across the corpus callosum due to disruption of the connections.
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Affiliation(s)
- Mickael Tordjman
- Department of Radiology, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA.
| | - Guillaume Madelin
- Department of Radiology, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - Pradeep Kumar Gupta
- Department of Radiology, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - Christine Cordova
- Perlmutter Cancer Center, Brain and Spine Tumor Center, NYU Langone Health, 240 E 38th Street, New York, NY, 10016, USA
| | - Sylvia C Kurz
- Perlmutter Cancer Center, Brain and Spine Tumor Center, NYU Langone Health, 240 E 38th Street, New York, NY, 10016, USA
| | - Daniel Orringer
- Department of Neurosurgery, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - John Golfinos
- Department of Neurosurgery, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - Douglas Kondziolka
- Department of Neurosurgery, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - Yulin Ge
- Department of Radiology, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - Ruoyu Luie Wang
- Department of Radiology, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - Mariana Lazar
- Department of Radiology, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
| | - Rajan Jain
- Department of Radiology, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA.,Department of Neurosurgery, New York University Grossman School of Medicine, 650 First Avenue, New York, NY, 10022, USA
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31
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Fang S, Zhou C, Wang Y, Jiang T. Contralesional functional network reorganization of the insular cortex in diffuse low-grade glioma patients. Sci Rep 2021; 11:623. [PMID: 33436741 PMCID: PMC7804949 DOI: 10.1038/s41598-020-79845-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/14/2020] [Indexed: 12/15/2022] Open
Abstract
Diffuse low-grade gliomas (DLGGs) growing on the insular lobe induce contralesional hemispheric insular lobe compensation of damaged functioning by increasing cortical volumes. However, it remains unclear how functional networks are altered in patients with insular lobe DLGGs during functional compensation. Thirty-five patients with insular DLGGs were classified into the left (insL, n = 16) and right groups (insR, n = 19), and 33 healthy subjects were included in the control group. Resting state functional magnetic resonance imaging was used to generate functional connectivity (FC), and network topological properties were evaluated using graph theoretical analysis based on FC matrices. Network-based statistics were applied to compare differences in the FC matrices. A false discovery rate was applied to correct the topological properties. There was no difference in the FC of edges between the control and insL groups; however, the nodal shortest path length of the right insular lobe was significantly increased in the insL group compared to the control group. Additionally, FC was increased in the functional edges originating from the left insular lobe in the insR group compared to the control group. Moreover, there were no differences in topological properties between the insR and control groups. The contralesional insular lobe is crucial for network alterations. The detailed patterns of network alterations were different depending on the affected hemisphere. The observed network alterations might be associated with functional network reorganization and functional compensation.
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Affiliation(s)
- Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China
| | - Chunyao Zhou
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China
| | - Yinyan Wang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. .,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China.
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China. .,Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the southern 4th Ring Road, Beijing, 100070, China. .,Research Unit of Accurate Diagnosis, Treatment, and Translational Medicine of Brain Tumors Chinese (2019RU11), Chinese Academy of Medical Sciences, Beijing, China.
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32
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Nenning KH, Furtner J, Kiesel B, Schwartz E, Roetzer T, Fortelny N, Bock C, Grisold A, Marko M, Leutmezer F, Liu H, Golland P, Stoecklein S, Hainfellner JA, Kasprian G, Prayer D, Marosi C, Widhalm G, Woehrer A, Langs G. Distributed changes of the functional connectome in patients with glioblastoma. Sci Rep 2020; 10:18312. [PMID: 33110138 PMCID: PMC7591862 DOI: 10.1038/s41598-020-74726-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 09/09/2020] [Indexed: 12/22/2022] Open
Abstract
Glioblastoma might have widespread effects on the neural organization and cognitive function, and even focal lesions may be associated with distributed functional alterations. However, functional changes do not necessarily follow obvious anatomical patterns and the current understanding of this interrelation is limited. In this study, we used resting-state functional magnetic resonance imaging to evaluate changes in global functional connectivity patterns in 15 patients with glioblastoma. For six patients we followed longitudinal trajectories of their functional connectome and structural tumour evolution using bi-monthly follow-up scans throughout treatment and disease progression. In all patients, unilateral tumour lesions were associated with inter-hemispherically symmetric network alterations, and functional proximity of tumour location was stronger linked to distributed network deterioration than anatomical distance. In the longitudinal subcohort of six patients, we observed patterns of network alterations with initial transient deterioration followed by recovery at first follow-up, and local network deterioration to precede structural tumour recurrence by two months. In summary, the impact of focal glioblastoma lesions on the functional connectome is global and linked to functional proximity rather than anatomical distance to tumour regions. Our findings further suggest a relevance for functional network trajectories as a possible means supporting early detection of tumour recurrence.
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Affiliation(s)
- Karl-Heinz Nenning
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
| | - Julia Furtner
- Department of Biomedical Imaging and Image-Guided Therapy, Division for Neuro- and Musculo-Skeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Barbara Kiesel
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Ernst Schwartz
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Thomas Roetzer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Nikolaus Fortelny
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Christoph Bock
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.,Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Anna Grisold
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Martha Marko
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Fritz Leutmezer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Hesheng Liu
- A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Cambridge, USA
| | - Polina Golland
- Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Cambridge, USA
| | - Sophia Stoecklein
- Department of Radiology, Ludwig-Maximilians-University, Munich, Germany
| | - Johannes A Hainfellner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Gregor Kasprian
- Department of Biomedical Imaging and Image-Guided Therapy, Division for Neuro- and Musculo-Skeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Daniela Prayer
- Department of Biomedical Imaging and Image-Guided Therapy, Division for Neuro- and Musculo-Skeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Christine Marosi
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Adelheid Woehrer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Georg Langs
- Computational Imaging Research Lab, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria. .,Computer Science and Artificial Intelligence Lab, Massachusetts Institute of Technology, Cambridge, USA.
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33
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Duffau H. Functional Mapping before and after Low-Grade Glioma Surgery: A New Way to Decipher Various Spatiotemporal Patterns of Individual Neuroplastic Potential in Brain Tumor Patients. Cancers (Basel) 2020; 12:E2611. [PMID: 32933174 PMCID: PMC7565450 DOI: 10.3390/cancers12092611] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/07/2020] [Accepted: 09/11/2020] [Indexed: 12/21/2022] Open
Abstract
Intraoperative direct electrostimulation mapping (DEM) is currently the gold-standard for glioma surgery, since functional-based resection allows an optimization of the onco-functional balance (increased resection with preserved quality of life). Besides intrasurgical awake mapping of conation, cognition, and behavior, preoperative mapping by means of functional neuroimaging (FNI) and transcranial magnetic stimulation (TMS) has increasingly been utilized for surgical selection and planning. However, because these techniques suffer from several limitations, particularly for direct functional mapping of subcortical white matter pathways, DEM remains crucial to map neural connectivity. On the other hand, non-invasive FNI and TMS can be repeated before and after surgical resection(s), enabling longitudinal investigation of brain reorganization, especially in slow-growing tumors like low-grade gliomas. Indeed, these neoplasms generate neuroplastic phenomena in patients with usually no or only slight neurological deficits at diagnosis, despite gliomas involving the so-called "eloquent" structures. Here, data gained from perioperative FNI/TMS mapping methods are reviewed, in order to decipher mechanisms underpinning functional cerebral reshaping induced by the tumor and its possible relapse, (re)operation(s), and postoperative rehabilitation. Heterogeneous spatiotemporal patterns of rearrangement across patients and in a single patient over time have been evidenced, with structural changes as well as modifications of intra-hemispheric (in the ipsi-lesional and/or contra-lesional hemisphere) and inter-hemispheric functional connectivity. Such various fingerprints of neural reconfiguration were correlated to different levels of cognitive compensation. Serial multimodal studies exploring neuroplasticity might lead to new management strategies based upon multistage therapeutic approaches adapted to the individual profile of functional reallocation.
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Affiliation(s)
- Hugues Duffau
- Department of Neurosurgery, Montpellier University Medical Center, 34295 Montpellier, France; ; Tel.: +33-4-67-33-66-12; Fax: +33-4-67-33-69-12
- Institute of Functional Genomics, INSERM U-1191, University of Montpellier, 34298 Montpellier, France
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34
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Mitchell TJ, Seitzman BA, Ballard N, Petersen SE, Shimony JS, Leuthardt EC. Human Brain Functional Network Organization Is Disrupted After Whole-Brain Radiation Therapy. Brain Connect 2020; 10:29-38. [PMID: 31964163 DOI: 10.1089/brain.2019.0713] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Radiation therapy (RT) plays a vital role in the treatment of brain cancers, but it frequently results in cognitive decline in the patients who receive it. Because the underlying mechanisms for this decline remain poorly understood, the brain is typically treated as a single, uniform volume when evaluating the toxic effects of RT plans. This ignorance represents a significant deficit in the field of radiation oncology, as the technology exists to manipulate dose distributions to spare regions of the brain, but there exists no body of knowledge regarding what is critical to spare. This deficit exists due to the numerous confounding factors that are frequently associated with radiotherapy, including the tumors themselves, other treatments such as surgery and chemotherapy, and dose gradients across the brain. Here, we present a case in which a 57-year-old male patient received a uniform dose of radiation across the whole brain, did not receive concurrent chemotherapy, had minimal surgical intervention and a small tumor burden, and received resting-state functional magnetic resonance imaging (fMRI) scans both before and after RT. To our knowledge, this is the first study on the effects of whole-brain radiotherapy on functional network organization, and this patient's treatment regimen represents a rare and non-replicable opportunity to isolate the effects of radiation on functional connectivity. We observed substantial changes in the subject's behavior and functional network organization over a 12-month timeframe. Interestingly, the homogenous radiation dose to the brain had a heterogeneous effect on cortical networks, and the functional networks most affected correspond with observed cognitive behavioral deficits. This novel study suggests that the cognitive decline that occurs after whole-brain radiation therapy may be network specific and related to the disruption of large-scale distributed functional systems, and it indicates that fMRI is a promising avenue of study for optimizing cognitive outcomes after RT.
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Affiliation(s)
- Timothy J Mitchell
- Department of Radiation Oncology and Washington University in St. Louis-School of Medicine, St. Louis, Missouri
| | - Benjamin A Seitzman
- Department of Neurology, Washington University in St. Louis-School of Medicine, St. Louis, Missouri
| | - Nicholas Ballard
- Department of Radiation Oncology and Washington University in St. Louis-School of Medicine, St. Louis, Missouri
| | - Steven E Petersen
- Department of Neurology, Washington University in St. Louis-School of Medicine, St. Louis, Missouri.,Mallinckrodt Institute of Radiology, Washington University in St. Louis-School of Medicine, St. Louis, Missouri.,Department of Neuroscience, Washington University in St. Louis-School of Medicine, St. Louis, Missouri.,Department of Biomedical Engineering, Washington University in St. Louis-School of Engineering and Applied Science, St. Louis, Missouri.,Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University in St. Louis-School of Medicine, St. Louis, Missouri
| | - Eric C Leuthardt
- Department of Neuroscience, Washington University in St. Louis-School of Medicine, St. Louis, Missouri.,Department of Biomedical Engineering, Washington University in St. Louis-School of Engineering and Applied Science, St. Louis, Missouri.,Department of Mechanical Engineering and Materials Science, Washington University in St. Louis-School of Engineering and Applied Science, St. Louis, Missouri.,Center for Innovation in Neuroscience and Technology and Washington University in St. Louis-School of Medicine, St. Louis, Missouri.,Brain Laser Center, Washington University in St. Louis-School of Medicine, St. Louis, Missouri.,Department of Neurological Surgery, Washington University in St. Louis-School of Medicine, St. Louis, Missouri
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35
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Jütten K, Mainz V, Delev D, Gauggel S, Binkofski F, Wiesmann M, Clusmann H, Na CH. Asymmetric tumor-related alterations of network-specific intrinsic functional connectivity in glioma patients. Hum Brain Mapp 2020; 41:4549-4561. [PMID: 32716597 PMCID: PMC7555062 DOI: 10.1002/hbm.25140] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/05/2020] [Accepted: 07/09/2020] [Indexed: 12/12/2022] Open
Abstract
Resting-state functional MRI (rs-fMRI) allows mapping temporally coherent brain networks, and intra- and inter-network alterations have been described in different diseases. This prospective study investigated hemispheric resting-state functional connectivity (RSFC) differences in the default-mode network (DMN) and fronto-parietal network (FPN) between patients with left- and right-hemispheric gliomas (LH PAT, RH PAT), addressing asymmetry effects the tumor might have on network-specific intrinsic functional connectivity under consideration of the prognostically relevant isocitrate-dehydrogenase (IDH) mutation status. Twenty-seven patients (16 LH PAT, 12 IDH-wildtype) and 27 healthy controls underwent anatomical and rs-fMRI as well as neuropsychological assessment. Independent component analyses were performed to identify the DMN and FPN. Hemispheric DMN- and FPN-RSFC were computed, compared across groups, and correlated with cognitive performance. Patient groups did not differ in tumor volume, grade or location. RH PAT showed higher contra-tumoral DMN-RSFC than controls and LH PAT. With regard to the FPN, contra-tumoral RSFC was increased in both patient groups as compared to controls. Higher contra-tumoral RSFC was associated with worse cognitive performance in patients, which, however, seemed to apply mainly to IDH-wildtype patients. The benefit of RSFC alterations for cognitive performance varied depending on the affected hemisphere, cognitive demand, and seemed to be altered by IDH-mutation status. At the time of study initiation, a clinical trial registration was not mandatory at our faculty, but it can be applied for if requested.
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Affiliation(s)
- Kerstin Jütten
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Verena Mainz
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Aachen, Germany
| | - Daniel Delev
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Siegfried Gauggel
- Institute of Medical Psychology and Medical Sociology, RWTH Aachen University, Aachen, Germany
| | - Ferdinand Binkofski
- Division of Clinical Cognitive Sciences, RWTH Aachen University, Aachen, Germany
| | - Martin Wiesmann
- Department of Diagnostic and Interventional Neuroradiology, RWTH Aachen University, Aachen, Germany
| | - Hans Clusmann
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
| | - Chuh-Hyoun Na
- Department of Neurosurgery, RWTH Aachen University, Aachen, Germany
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36
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Inter-Network Functional Connectivity Changes in Patients With Brain Tumors: A Resting-State Functional Magnetic Resonance Imaging Study. World Neurosurg 2020; 138:e66-e71. [DOI: 10.1016/j.wneu.2020.01.177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/19/2022]
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37
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Kocher M, Jockwitz C, Caspers S, Schreiber J, Farrher E, Stoffels G, Filss C, Lohmann P, Tscherpel C, Ruge MI, Fink GR, Shah NJ, Galldiks N, Langen KJ. Role of the default mode resting-state network for cognitive functioning in malignant glioma patients following multimodal treatment. Neuroimage Clin 2020; 27:102287. [PMID: 32540630 PMCID: PMC7298724 DOI: 10.1016/j.nicl.2020.102287] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/31/2020] [Accepted: 04/27/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Progressive cognitive decline following multimodal neurooncological treatment is a common observation in patients suffering from malignant glioma. Alterations of the default-mode network (DMN) represent a possible source of impaired neurocognitive functioning and were analyzed in these patients. METHODS Eighty patients (median age, 51 years) with glioma (WHO grade IV glioblastoma, n = 57; WHO grade III anaplastic astrocytoma, n = 13; WHO grade III anaplastic oligodendroglioma, n = 10) and ECOG performance score 0-1 underwent resting-state functional MRI (rs-fMRI) and neuropsychological testing at a median interval of 13 months (range, 1-114 months) after initiation of therapy. For evaluation of structural and metabolic changes after treatment, anatomical MRI and amino acid PET using O-(2-[18F]fluoroethyl)-L-tyrosine (FET) were simultaneously acquired to rs-fMRI on a hybrid MR/PET scanner. A cohort of 80 healthy subjects matched for gender, age, and educational status served as controls. RESULTS The connectivity pattern within the DMN (12 nodes) of the glioma patients differed significantly from that of the healthy subjects but did not depend on age, tumor grade, time since treatment initiation, presence of residual/recurrent tumor, number of chemotherapy cycles received, or anticonvulsive medication. Small changes in the connectivity pattern were observed in patients who had more than one series of radiotherapy. In contrast, structural tissue changes located at or near the tumor site (including resection cavities, white matter lesions, edema, and tumor tissue) had a strong negative impact on the functional connectivity of the adjacent DMN nodes, resulting in a marked dependence of the connectivity pattern on tumor location. In the majority of neurocognitive domains, glioma patients performed significantly worse than healthy subjects. Correlation analysis revealed that reduced connectivity in the left temporal and parietal DMN nodes was associated with low performance in language processing and verbal working memory. Furthermore, connectivity of the left parietal DMN node also correlated with processing speed, executive function, and verbal as well as visual working memory. Overall DMN connectivity loss and cognitive decline were less pronounced in patients with higher education. CONCLUSION Personalized treatment strategies for malignant glioma patients should consider the left parietal and temporal DMN nodes as vulnerable regions concerning neurocognitive outcome.
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Affiliation(s)
- Martin Kocher
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne and Duesseldorf, Kerpener Str. 62, 50937 Cologne, Germany.
| | - Christiane Jockwitz
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Svenja Caspers
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Juelich-Aachen Research Alliance (JARA)-Section JARA-Brain, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Institute for Anatomy I, Medical Faculty, Heinrich Heine University Duesseldorf, Universitaetsstr. 1, 40225 Duesseldorf, Germany
| | - Jan Schreiber
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany
| | - Ezequiel Farrher
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany
| | - Gabriele Stoffels
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany
| | - Christian Filss
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany
| | - Philipp Lohmann
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Caroline Tscherpel
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne and Duesseldorf, Kerpener Str. 62, 50937 Cologne, Germany
| | - Maximilian I Ruge
- Department of Stereotaxy and Functional Neurosurgery, Center for Neurosurgery, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne and Duesseldorf, Kerpener Str. 62, 50937 Cologne, Germany
| | - Gereon R Fink
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany
| | - Nadim J Shah
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Institute of Neuroscience and Medicine 11, JARA, Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Juelich-Aachen Research Alliance (JARA)-Section JARA-Brain, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Neurology, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
| | - Norbert Galldiks
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Center of Integrated Oncology (CIO), Universities of Aachen, Bonn, Cologne and Duesseldorf, Kerpener Str. 62, 50937 Cologne, Germany
| | - Karl-Josef Langen
- Institute of Neuroscience and Medicine (INM-1, -3, -4), Research Center Juelich, Wilhelm-Johnen-Str., 52428 Juelich, Germany; Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Pauwelsstr. 30, 52074 Aachen, Germany
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Sparacia G, Parla G, Lo Re V, Cannella R, Mamone G, Carollo V, Midiri M, Grasso G. Resting-State Functional Connectome in Patients with Brain Tumors Before and After Surgical Resection. World Neurosurg 2020; 141:e182-e194. [PMID: 32428723 DOI: 10.1016/j.wneu.2020.05.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE High-grade glioma surgery has evolved around the principal belief that a safe maximal tumor resection improves symptoms, quality of life, and survival. Mapping brain function has been recently improved by resting-state functional magnetic resonance imaging (rest-fMRI), a novel imaging technique that explores networks connectivity at "rest." METHODS This prospective study analyzed 10 patients with high-grade glioma in whom rest-fMRI connectivity was assessed both in single-subject and in group analysis before and after surgery. Seed-based functional connectivity analysis was performed with CONN toolbox. Network identification focused on 8 major functional connectivity networks. A voxel-wise region of interest (ROI) to ROI correlation map to assess functional connectivity throughout the whole brain was computed from a priori seeds ROI in specific resting-state networks before and after surgical resection in each patient. RESULTS Reliable topography of all 8 resting-state networks was successfully identified in each participant before surgical resection. Single-subject functional connectivity analysis showed functional disconnection for dorsal attention and salience networks, whereas the language network demonstrated functional connection either in the case of left temporal glioblastoma. Functional connectivity in group analysis showed wide variations of functional connectivity in the default mode, salience, and sensorimotor networks. However, salience and language networks, salience and default mode networks, and salience and sensorimotor networks showed a significant correlation (P uncorrected <0.0025; P false discovery rate <0.077) in comparison before and after surgery confirming non-disconnection of these networks. CONCLUSIONS Resting-state fMRI can reliably detect common functional connectivity networks in patients with glioma and has the potential to anticipate network alterations after surgical resection.
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Affiliation(s)
- Gianvincenzo Sparacia
- Radiology Service, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy; Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy.
| | - Giuseppe Parla
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Vincenzina Lo Re
- Neurology Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Roberto Cannella
- Radiology Service, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Giuseppe Mamone
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Vincenzo Carollo
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo, Italy
| | - Massimo Midiri
- Radiology Service, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Giovanni Grasso
- Neurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
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Tumor grade-related language and control network reorganization in patients with left cerebral glioma. Cortex 2020; 129:141-157. [PMID: 32473401 DOI: 10.1016/j.cortex.2020.04.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/17/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022]
Abstract
Language processing relies on both a functionally specialized language network and a domain-general cognitive control network. Yet, how the two networks reorganize after damage resulting from diffuse and progressive glioma remains largely unknown. To address this issue, 130 patients with left cerebral gliomas, including 77 patients with low-grade glioma (LGG, WHO grade Ⅰ/II), 53 patients with high-grade glioma (HGG, WHO grade III/IV) and 38 healthy controls (HC) were adopted. The changes in resting-state functional connectivity (rsFC) of the language network and the cingulo-opercular/fronto-parietal (CO-FP) network were examined using network-based statistics. We found that tumor grade negatively correlated with language scores and language network integrity. Compared with HCs, patients with LGGs exhibited slight language deficits, both decreased and increased changes in rsFC of language network, and nearly normal CO-FP network. Patients with HGGs had significantly lower language scores than those with LGG and exhibited more severe language and CO-FP network disruptions than HCs or patients with LGGs. Moreover, we found that in patients with HGGs, the decreased rsFCs of language network were positively correlated with language scores. Together, our findings suggest tumor grade-related network reorganization of both language and control networks underlie the different levels of language impairments observed in patients with gliomas.
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Liu Y, Yang K, Hu X, Xiao C, Rao J, Li Z, Liu D, Zou Y, Chen J, Liu H. Altered Rich-Club Organization and Regional Topology Are Associated With Cognitive Decline in Patients With Frontal and Temporal Gliomas. Front Hum Neurosci 2020; 14:23. [PMID: 32153374 PMCID: PMC7047345 DOI: 10.3389/fnhum.2020.00023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 01/20/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives Gliomas are widely considered to be related to the altered topological organization of functional networks before operations. Tumors are usually thought to cause multimodal cognitive impairments. The structure is thought to form the basics of function, and the aim of this study was to reveal the rich-club organization and topological patterns of white matter (WM) structural networks associated with cognitive impairments in patients with frontal and temporal gliomas. Methods Graph theory approaches were utilized to reveal the global and regional topological organization and rich-club organization of WM structural networks of 14 controls (CN), 13 frontal tumors (FTumor), and 18 temporal tumors (TTumor). Linear regression was used to assess the relationship between cognitive performances and altered topological parameters. Results When compared with CN, both FTumor and TTumor showed no alterations in small-world properties and global network efficiency, but instead showed altered local network efficiency. Second, FTumor and TTumor patients showed similar deficits in the nodal shortest path in the left rolandic operculum and degree centrality (DC) of the right dorsolateral and medial superior frontal gyrus (SFGmed). Third, compared to FTumor patients, TTumor patients showed a significantly higher DC in the right dorsolateral and SFGmed, a higher level of betweenness in the right SFGmed, and higher nodal efficiency in the left middle frontal gyrus and right SFGmed. Finally, rich-club organization was disrupted, with increased structural connectivity among rich-club nodes and reduced structural connectivity among peripheral nodes in FTumor and TTumor patients. Altered local efficiency in TTumor correlated with memory function, while altered local efficiency in FTumor correlated with the information processing speed. Conclusion Both FTumor and TTumor presented an intact global topology and altered regional topology related to cognitive impairment and may also share the convergent and divergent regional topological organization of WM structural networks. This suggested that a compensatory mechanism plays a key role in global topology formation in both FTumor and TTumor patients, and as such, development of a structural connectome for patients with brain tumors would be an invaluable medical resource and allow clinicians to make comprehensive preoperative planning.
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Affiliation(s)
- Yong Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Kun Yang
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Xinhua Hu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Chaoyong Xiao
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China.,Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Rao
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China.,Department of Rehabilitation Medicine, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zonghong Li
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China.,Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Dongming Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yuanjie Zou
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China.,Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Fourth Clinical College of Nanjing Medical University, Nanjing, China
| | - Hongyi Liu
- Department of Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
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Sun H, Vachha B, Laino ME, Jenabi M, Flynn JR, Zhang Z, Holodny AI, Peck KK. Decreased Hand Motor Resting-State Functional Connectivity in Patients with Glioma: Analysis of Factors including Neurovascular Uncoupling. Radiology 2020; 294:610-621. [PMID: 31934827 DOI: 10.1148/radiol.2019190089] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Resting-state functional MRI holds substantial potential for clinical application, but limitations exist in current understanding of how tumors exert local effects on resting-state functional MRI readings. Purpose To investigate the association between tumors, tumor characteristics, and changes in resting-state connectivity, to explore neurovascular uncoupling as a mechanism underlying these changes, and to evaluate seeding methodologies as a clinical tool. Materials and Methods Institutional review board approval was obtained for this HIPAA-compliant observational retrospective study of patients with glioma who underwent MRI and resting-state functional MRI between January 2016 and July 2017. Interhemispheric symmetry of connectivity was assessed in the hand motor region, incorporating tumor position, perfusion, grade, and connectivity generated from seed-based correlation. Statistical analysis was performed by using one-tailed t tests, Wilcoxon rank sum tests, one-way analysis of variance, Pearson correlation, and Spearman rank correlation, with significance at P < .05. Results Data in a total of 45 patients with glioma (mean age, 51.3 years ± 14.3 [standard deviation]) were compared with those in 10 healthy control subjects (mean age, 50.3 years ± 17.2). Patients showed loss of symmetry in measures of hand motor resting-state connectivity compared with control subjects (P < .05). Tumor distance from the ipsilateral hand motor (IHM) region correlated with the degree (R = 0.38, P = .01) and strength (R = 0.33, P = .03) of resting-state connectivity. In patients with World Health Organization grade IV glioblastomas 40 mm or less from the IHM region, loss of symmetry in strength of resting-state connectivity was correlated with tumor perfusion (R = 0.74, P < .01). In patients with gliomas 40 mm or less from the IHM region, seeding the nontumor hemisphere yielded less asymmetric hand motor resting-state connectivity than seeding the tumor hemisphere (connectivity seeded:contralateral = 1.34 nontumor vs 1.38 tumor hemisphere seeded; P = .03, false discovery rate threshold = 0.01). Conclusion Hand motor resting-state connectivity was less symmetrical in a tumor distance-dependent manner in patients with glioma. Differences in resting-state connectivity may be false-negative results driven by a neurovascular uncoupling mechanism. Seeding from the nontumor hemisphere may attenuate asymmetry in patients with tumors near ipsilateral hand motor cortices. © RSNA, 2020 Online supplemental material is available for this article.
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Affiliation(s)
- Herie Sun
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Behroze Vachha
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Maria E Laino
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Mehrnaz Jenabi
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Jessica R Flynn
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Zhigang Zhang
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Andrei I Holodny
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
| | - Kyung K Peck
- From the Departments of Radiology (H.S., B.V., M.E.L., M.J., A.I.H., K.K.P.), Medical Physics (K.K.P.), and Epidemiology-Biostatistics (J.R.F., Z.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; Department of Radiology, Catholic University of the Sacred Heart-A. Gemelli Hospital, Rome, Italy (M.E.L.); Department of Neuroscience, Weill Cornell Graduate School of the Medical Sciences, New York, NY (A.I.H.); and Department of Radiology, Weill Medical College of Cornell University, New York, NY (A.I.H.)
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Metwali H, Raemaekers M, Kniese K, Samii A. Intraoperative Resting-State Functional Connectivity and Resting-State Networks in Patients with Intracerebral Lesions: Detectability and Variations Between Sessions. World Neurosurg 2020; 133:e197-e204. [DOI: 10.1016/j.wneu.2019.08.188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 01/04/2023]
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Orukari IE, Siegel JS, Warrington NM, Baxter GA, Bauer AQ, Shimony JS, Rubin JB, Culver JP. Altered hemodynamics contribute to local but not remote functional connectivity disruption due to glioma growth. J Cereb Blood Flow Metab 2020; 40:100-115. [PMID: 30334672 PMCID: PMC6928560 DOI: 10.1177/0271678x18803948] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Glioma growth can cause pervasive changes in the functional connectivity (FC) of brain networks, which has been associated with re-organization of brain functions and development of functional deficits in patients. Mechanisms underlying functional re-organization in brain networks are not understood and efforts to utilize functional imaging for surgical planning, or as a biomarker of functional outcomes are confounded by the heterogeneity in available human data. Here we apply multiple imaging modalities in a well-controlled murine model of glioma with extensive validation using human data to explore mechanisms of FC disruption due to glioma growth. We find gliomas cause both local and distal changes in FC. FC changes in networks proximal to the tumor occur secondary to hemodynamic alterations but surprisingly, remote FC changes are independent of hemodynamic mechanisms. Our data strongly implicate hemodynamic alterations as the main driver of local changes in measurements of FC in patients with glioma.
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Affiliation(s)
- Inema E Orukari
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Joshua S Siegel
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nicole M Warrington
- Department of Pediatrics, Washington University in St. Louis, St Louis, MO, USA
| | - Grant A Baxter
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St Louis, MO, USA
| | - Adam Q Bauer
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St Louis, MO, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St Louis, MO, USA
| | - Joshua B Rubin
- Department of Pediatrics, Washington University in St. Louis, St Louis, MO, USA.,Department of Neuroscience, Washington University in St. Louis, St Louis, MO, USA
| | - Joseph P Culver
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA.,Mallinckrodt Institute of Radiology, Washington University in St. Louis, St Louis, MO, USA.,Department of Physics, Washington University in St. Louis, St. Louis, MO, USA
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De Baene W, Rutten GJM, Sitskoorn MM. Cognitive functioning in glioma patients is related to functional connectivity measures of the non-tumoural hemisphere. Eur J Neurosci 2019; 50:3921-3933. [PMID: 31370107 PMCID: PMC6972640 DOI: 10.1111/ejn.14535] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/04/2019] [Accepted: 07/22/2019] [Indexed: 01/19/2023]
Abstract
Previous studies have shown that cognitive functioning in patients with brain tumour is associated with the functional network characteristics of specific resting‐state networks or with whole‐brain network characteristics. These studies, however, did not acknowledge the functional contribution of areas in the contralesional, non‐tumoural hemisphere, even though these healthy remote areas likely play a critical role in compensating for the loss of function in damaged tissue. In the current study, we examined whether there is an association between cognitive performance and functional network features of the contralesional hemisphere of patients with glioma. We found that local efficiency of the contralesional hemisphere was associated with performance on the reaction time domain, whereas contralesional assortativity was associated with complex attention and cognitive flexibility scores. Our results suggest that a less segregated organization of the contralesional hemisphere is associated with better reaction time scores, whereas a better spread of information over the contralesional hemisphere through mutually interconnected contralesional hubs is associated with better cognitive flexibility and better complex attention scores. These findings urge researchers to recognize the functional contribution of remote, undamaged regions and to focus more on the graph metrics of the contralesional hemisphere in the search for predictors of cognitive functioning in patients with brain tumour.
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Affiliation(s)
- Wouter De Baene
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Geert-Jan M Rutten
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Margriet M Sitskoorn
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
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Metwali H, Samii A. Seed-Based Connectivity Analysis of Resting-State fMRI in Patients with Brain Tumors: A Feasibility Study. World Neurosurg 2019; 128:e165-e176. [DOI: 10.1016/j.wneu.2019.04.073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/07/2019] [Accepted: 04/08/2019] [Indexed: 11/24/2022]
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Fox ME, King TZ. Functional Connectivity in Adult Brain Tumor Patients: A Systematic Review. Brain Connect 2019; 8:381-397. [PMID: 30141339 DOI: 10.1089/brain.2018.0623] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Brain tumor (BT) patients often experience reduced cognitive abilities and disrupted adaptive functioning before and after treatment. An innovative approach to understanding the underlying brain networks associated with these outcomes has been to study the brain's functional connectivity (FC), the spatially distributed and temporally correlated activity throughout the brain, and how it can be affected by a tumor. The present review synthesized the extant BT FC literature that utilizes functional magnetic resonance imaging to study FC strength of commonly observed networks during rest and task. A systematic review of English articles using PubMed was conducted. Search terms included brain tumor OR glioma AND functional connectivity, independent component analysis, ICA, psychophysiological interaction, OR PPI. Studies in which participants were diagnosed with BTs as adults that evaluated specific networks of interest using independent component analysis or seed-based component analysis were included. Twenty-five studies met inclusion criteria. BT patients often presented with decreases in FC strength within well-established networks and increases in atypical FC patterns. Network differences were tumor adjacent and distal, and left hemisphere tumors generally had a greater impact on FC. FC alterations often correlated with behavioral or cognitive outcomes when assessed. Overall, BTs appear to lead to various alterations in FC across different functional networks, and the most common change is a decrease in expected FC strength. More longitudinal studies are needed to determine the time course of network alterations across treatment and recovery, the role of medical treatments in BT survivors' FC, and the potential of FC patterns as biomarkers of cognitive outcomes.
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Affiliation(s)
- Michelle E Fox
- 1 Department of Psychology, Georgia State University , Atlanta, Georgia
| | - Tricia Z King
- 1 Department of Psychology, Georgia State University , Atlanta, Georgia .,2 Neuroscience Institute, Georgia State University , Atlanta, Georgia
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Potential Intra- or Cross-Network Functional Reorganization of the Triple Unifying Networks in Patients with Frontal Glioma. World Neurosurg 2019; 128:e732-e743. [PMID: 31077892 DOI: 10.1016/j.wneu.2019.04.248] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/28/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Patients with frontal glioma might experience cognition alterations together with potential dysfunction of resting-state networks (RSNs). To understand the altered patterns of the intrinsic activity and underlying network interactions between the cognitive-related RSNs is of great importance. OBJECTIVE This study aimed to investigate the characteristics of the altered RSNs, including default mode network, executive control network, and salience network and further elucidate the possible functional reorganization of RSNs in patients with frontal glioma. METHODS Thirteen patients with frontal glioma and 10 healthy controls (HCs) were enrolled in this study. Independent component analysis was performed to identify the characteristics of the selected RSNs activity. Further, functional connectivity analysis was applied to investigate the relationship between the altered regions. Subsequently, partial correlation analysis was performed to examine associations between the neural activity of RSNs and neurocognitive characteristics. RESULTS Compared with the HCs group, the patient group exhibited significant differences in functional connectivity among default mode network, executive control network, and salience network. In addition, the number of the significant functional connectivities between the paired seeds observed in the patients was greater than that in HCs and significantly increased functional connectivity was detected between left posterior cingulate cortex and right angular gyrus. Furthermore, altered neural activities in the RSNs of patients with frontal glioma were positively associated with certain aspects of cognitive function. CONCLUSIONS Our results suggested underlying network functional reorganization of the triple unifying RSNs in patients with frontal glioma, providing novel insights for improving understanding of brain function.
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Metwali H, Raemaekers M, Kniese K, Samii A. Resting-State Functional Connectivity in Neurosurgical Patients Under Propofol Anesthesia: Detectability and Variability Between Patients and Between Sessions. World Neurosurg 2019; 125:e1160-e1169. [DOI: 10.1016/j.wneu.2019.01.266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 01/26/2019] [Accepted: 01/28/2019] [Indexed: 01/03/2023]
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Briggs RG, Conner AK, Baker CM, Burks JD, Glenn CA, Sali G, Battiste JD, O’Donoghue DL, Sughrue ME. A Connectomic Atlas of the Human Cerebrum-Chapter 18: The Connectional Anatomy of Human Brain Networks. Oper Neurosurg (Hagerstown) 2018; 15:S470-S480. [PMID: 30260432 PMCID: PMC6890524 DOI: 10.1093/ons/opy272] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/18/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is widely understood that cortical functions are mediated by complex, interdependent brain networks. These networks have been identified and studied using novel technologies such as functional magnetic resonance imaging under both resting-state and task-based conditions. However, no one has attempted to describe these networks in terms of their cortical parcellations. OBJECTIVE To describe our approach to network modeling and discuss its significance for the future of neuronavigation in brain surgery using the cortical parcellation scheme detailed within this supplement. METHODS Using network models previously elucidated by our group using coordinate-based meta-analytic techniques, we show the anatomic position and underlying white matter tracts of the cortical regions comprising 8 functional networks of the human cerebrum. These network models are displayed using Synaptive's clinically available BrightMatter tractography software (Synaptive Medical, Toronto, Canada). RESULTS The relevant cortical parcellations of 8 different cerebral networks have been identified. The fiber tracts between these regions were used to construct anatomically precise models of the networks. Models are described for the dorsal attention, ventral attention, semantic, auditory, supplementary motor, ventral premotor, default mode, and salience networks. CONCLUSION Our goal is to move towards more precise, anatomically specific models of brain networks that can be constructed for individual patients and utilized in navigational platforms during brain surgery. We believe network modeling and future advances in navigation technology can provide a foundation for improving neurosurgical outcomes by allowing us to preserve complex brain networks.
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Affiliation(s)
- Robert G Briggs
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Andrew K Conner
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Cordell M Baker
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Joshua D Burks
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Chad A Glenn
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Goksel Sali
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - James D Battiste
- Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Daniel L O’Donoghue
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Michael E Sughrue
- Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Department of Neurosurgery, Prince of Wales Private Hospital, Sydney, Australia
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Cognitive functioning and functional brain networks in postoperative WHO grade I meningioma patients. J Neurooncol 2018; 140:605-613. [PMID: 30219943 PMCID: PMC6267232 DOI: 10.1007/s11060-018-2987-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/21/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Meningioma patients often have subtle cognitive deficits that might be attributed to the tumor itself, to surgical treatment, or to the occurrence of seizures and their treatment. Magnetoencephalography (MEG) analysis of resting-state functional networks (RSNs) could help to understand the neurophysiological basis of cognitive impairment in these patients. We explored the correlation between RSN functional connectivity and topology of functional networks on the one hand, and cognition on the other hand in WHO grade I meningioma patients. METHODS Twenty adult WHO grade I meningioma patients who had undergone tumor resection, as well as 20 healthy matched controls, were included. Neuropsychological assessment was done through a standardized test battery. MEG data were recorded, and projected to the anatomical space of the Automated Anatomical Labeling atlas. Functional connectivity (PLI), within the default mode network (DMN) and the bilateral frontoparietal networks were correlated to cognitive performance. Minimum spanning tree (MST) characteristics were correlated with cognitive functioning. RESULTS Compared to healthy controls, meningioma patients had lower working memory capacity (p = 0.037). Within the patient group, lower working memory performance was associated with lower DMN connectivity and a lower maximum MST degree in the theta band (resp. p = 0.044 and p = 0.003). CONCLUSIONS This study shows that cognitive functioning is correlated with functional connectivity in the default mode network and hub-pathology in WHO grade I meningioma patients. Future longitudinal studies are needed to corroborate these findings and to further investigate the pathophysiology of cognitive deficits and possible changes in functional brain networks in meningioma patients.
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