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Zangrossi A, Silvestri E, Bisio M, Bertoldo A, De Pellegrin S, Vallesi A, Della Puppa A, D'Avella D, Denaro L, Scienza R, Mondini S, Semenza C, Corbetta M. Presurgical predictors of early cognitive outcome after brain tumor resection in glioma patients. Neuroimage Clin 2022; 36:103219. [PMID: 36209618 PMCID: PMC9668620 DOI: 10.1016/j.nicl.2022.103219] [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: 06/07/2022] [Revised: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022]
Abstract
Gliomas are commonly characterized by neurocognitive deficits that strongly impact patients' and caregivers' quality of life. Surgical resection is the mainstay of therapy, and it can also cause cognitive impairment. An important clinical problem is whether patients who undergo surgery will show post-surgical cognitive impairment above and beyond that present before surgery. The relevant rognostic factors are largely unknown. This study aims to quantify the cognitive impairment in glioma patients 1-week after surgery and to compare different pre-surgical information (i.e., cognitive performance, tumor volume, grading, and lesion topography) towards predicting early post-surgical cognitive outcome. We retrospectively recruited a sample of N = 47 patients affected by high-grade and low-grade glioma undergoing brain surgery for tumor resection. Cognitive performance was assessed before and immediately after (∼1 week) surgery with an extensive neurocognitive battery. Multivariate linear regression models highlighted the combination of predictors that best explained post-surgical cognitive impairment. The impact of surgery on cognitive functioning was relatively small (i.e., 85% of test scores across the whole sample indicated no decline), and pre-operative cognitive performance was the main predictor of early post-surgical cognitive outcome above and beyond information from tumor topography and volume. In fact, structural lesion information did not significantly improve the accuracy of prediction made from cognitive data before surgery. Our findings suggest that post-surgery neurocognitive deficits are only partially explained by preoperative brain damage. The present results suggest the possibility to make reliable, individualized, and clinically relevant predictions from relatively easy-to-obtain information.
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Affiliation(s)
- Andrea Zangrossi
- Department of Neuroscience, University of Padova, Italy,Padova Neuroscience Center (PNC), University of Padova, Italy,Corresponding author at: Padova Neuroscience Center (PNC), University of Padova, Italy.
| | - Erica Silvestri
- Padova Neuroscience Center (PNC), University of Padova, Italy,Department of Information Engineering, University of Padova, Italy
| | - Marta Bisio
- Padova Neuroscience Center (PNC), University of Padova, Italy,Department of Biomedical Sciences, University of Padova, Italy
| | - Alessandra Bertoldo
- Padova Neuroscience Center (PNC), University of Padova, Italy,Department of Information Engineering, University of Padova, Italy
| | | | | | - Alessandro Della Puppa
- Neurosurgery Clinical Unit, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital and University of Florence, Florence, Italy
| | - Domenico D'Avella
- Academic Neurosurgery, Department of Neuroscience, University of Padova, Italy
| | - Luca Denaro
- Academic Neurosurgery, Department of Neuroscience, University of Padova, Italy
| | - Renato Scienza
- Academic Neurosurgery, Department of Neuroscience, University of Padova, Italy
| | - Sara Mondini
- Department of Philosophy, Sociology, Pedagogy and Applied Psychology, University of Padova, Padova, Italy
| | - Carlo Semenza
- Padova Neuroscience Center (PNC), University of Padova, Italy
| | - Maurizio Corbetta
- Department of Neuroscience, University of Padova, Italy,Padova Neuroscience Center (PNC), University of Padova, Italy,Neurology Clinical Unit, University Hospital of Padova, Padova, Italy,Venetian Institute of Molecular Medicine, VIMM, Foundation for Advanced Biomedical Research, Padova, Italy
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Mitsuhashi T, Sonoda M, Firestone E, Sakakura K, Jeong JW, Luat AF, Sood S, Asano E. Temporally and functionally distinct large-scale brain network dynamics supporting task switching. Neuroimage 2022; 254:119126. [PMID: 35331870 PMCID: PMC9173207 DOI: 10.1016/j.neuroimage.2022.119126] [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: 11/12/2021] [Revised: 02/25/2022] [Accepted: 03/20/2022] [Indexed: 11/04/2022] Open
Abstract
Objective: Our daily activities require frequent switches among competing responses at the millisecond time scale. We determined the spatiotemporal characteristics and functional significance of rapid, large-scale brain network dynamics during task switching. Methods: This cross-sectional study investigated patients with drug-resistant focal epilepsy who played a Lumosity cognitive flexibility training game during intracranial electroencephalography (iEEG) recording. According to a given task rule, unpredictably switching across trials, participants had to swipe the screen in the direction the stimulus was pointing or moving. Using this data, we described the spatiotemporal characteristics of iEEG high-gamma augmentation occurring more intensely during switch than repeat trials, unattributable to the effect of task rule (pointing or moving), within-stimulus congruence (the direction of stimulus pointing and moving was same or different in a given trial), or accuracy of an immediately preceding response. Diffusion-weighted imaging (DWI) tractography determined whether distant cortical regions showing enhanced activation during task switch trials were directly connected by white matter tracts. Trial-by-trial iEEG analysis deduced whether the intensity of task switch-related high-gamma augmentation was altered through practice and whether high-gamma amplitude predicted the accuracy of an upcoming response among switch trials. Results: The average number of completed trials during five-minute gameplay was 221.4 per patient (range: 171–285). Task switch trials increased the response times, whereas later trials reduced them. Analysis of iEEG signals sampled from 860 brain sites effectively elucidated the distinct spatiotemporal characteristics of task switch, task rule, and post-error-specific high-gamma modulations. Post-cue, task switch-related high-gamma augmentation was initiated in the right calcarine cortex after 260 ms, right precuneus after 330 ms, right entorhinal after 420 ms, and bilateral anterior middle-frontal gyri after 450 ms. DWI tractography successfully showed the presence of direct white matter tracts connecting the right visual areas to the precuneus and anterior middle-frontal regions but not between the right precuneus and anterior middle-frontal regions. Task-related high-gamma amplitudes in later trials were reduced in the calcarine, entorhinal and anterior middle-frontal regions, but increased in the precuneus. Functionally, enhanced post-cue precuneus high-gamma augmentation improved the accuracy of subsequent responses among switch trials. Conclusions: Our multimodal analysis uncovered two temporally and functionally distinct network dynamics supporting task switching. High-gamma augmentation in the visual-precuneus pathway may reflect the neural process facilitating an attentional shift to a given updated task rule. High-gamma activity in the visual-dorsolateral prefrontal pathway, rapidly reduced through practice, may reflect the cost of executing appropriate stimulus-response translation.
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Affiliation(s)
- Takumi Mitsuhashi
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurosurgery, Juntendo University, Tokyo, 1138421, Japan
| | - Masaki Sonoda
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurosurgery, Yokohama City University, Yokohama, 2360004, Japan
| | - Ethan Firestone
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Physiology, Wayne State University, Detroit, MI 48201, USA
| | - Kazuki Sakakura
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurosurgery, University of Tsukuba, Tsukuba, 3058575, Japan
| | - Jeong-Won Jeong
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA
| | - Aimee F Luat
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Pediatrics, Central Michigan University, Mount Pleasant, MI, 48858, USA
| | - Sandeep Sood
- Department of Neurosurgery, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA
| | - Eishi Asano
- Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, 48201, USA.
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