Introduction: This study investigates whether the middle frontal gyrus (MFG) can be used as an indicator for language hemispheric dominance in brain tumor patients using task-free resting state fMRI (rsfMRI). We hypothesize no significant difference in language lateralization between the MFG and Broca’s Area (BA) and that the MFG can serve as a simple and reliable means of measuring language laterality. Methods: 51 patients with glial neoplasms. Using rsfMRI, the MFG was compared to BA for voxel activation, language laterality index (LI) and the effect of tumor grade on LI. LI derived by rsfMRI and task-based fMRI was compared in a subset of 40 patients. Results: Voxel activations in the left MFG and left BA were positively correlated (r = 0.47, p<0.001). Positive correlations were seen between the LI of BA and LI of MFG regions (r = 0.56, p < 0.0005). 27/40 patients (67.5%) showed concordance of LI based on BA using rsfMRI with LI based on a language task. 30/40 patients (75%) showed concordance of LI based on the MFG using rsfMRI with LI based on a language task. Conclusion: MFG is comparable to BA in its ability to determine hemispheric dominance for language using rsfMRI. Our results suggest the addition of rsfMRI of MFG to the list of noninvasive modalities that could be used in glioma patients to evaluate hemispheric dominance of language prior to tumor resection. In patients who cannot participate in traditional task-based fMRI, rsfMRI offers a task-free alternate to presurgically map eloquent cortex.

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PurposeSubstantial research exists on the physical toxicities from radiation therapy (RT) for oropharyngeal cancers, but emotional quality of life is understudied. The purpose of this study is to map the effects and time course of radiation-related changes in mood and anxiety and to investigate the physical factors that drive these changes.Methods and materialsWe prospectively collected University of Washington Quality of Life questionnaires and identified patients with oropharyngeal cancer who were treated with curative-intent RT between 2013 and 2016 and had completed questionnaires within 12 months after RT (n = 69). We analyzed swallow, saliva, taste, chewing, speech, pain, mood, and anxiety scores, using a scale from 0 to 100. We conducted a multivariate regression analysis to identify physical functioning predictors of worse emotional scores.ResultsPhysical functioning scores declined from before RT to 3 months after RT and then began improving but did not rebound to baseline levels within 12 months. Patient mood slightly declined, but anxiety improved immediately after RT, with both generally improving such that scores were higher at the 12-month follow-up than at initial consult. Analysis showed that longer duration of treatment is associated with a higher likelihood of worse mood scores at 12 months (odds ratio [OR], 1.446; P < .01). Worse swallow score is associated with a greater likelihood of worse mood score at 3 months (OR, 0.971; P < .01) and 12 months (OR, 0.975; P < .01). A worse taste score is associated with a greater likelihood of worse anxiety score at 3 months (OR, 0.979; P < .05) and 12 months (OR, 0.982; P < .05).ConclusionsEmotional changes are associated with certain treatment-associated toxicities. A patient's emotional health is complex and likely multifactorial in nature. Our study identified key associations and time points to potentially intervene upon.

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