Alterations of white matter integrity associated with cognitive deficits in patients with glioma

Abstract

Objective This study aimed to investigate the characteristic of brain structural connections in glioma patients and further evaluate the relationship between changes in the white matter tracts and cognitive decline. Methods This retrospective study included a total of 35 subjects with glioma and 14 demographically matched healthy controls, who underwent diffusion tensor imaging scans and formal neuropsychological assessment tests. Fractional anisotropy (FA) values of white matter tracts were derived from atlas‐based analysis to compare group differences. Furthermore, subgroup‐level analysis was performed to differentiate the effects of tumor location on white matter tracts. Partial correlation analysis was used to examine the associations between neurocognitive assessments and the integrity of tracts. Region of interest‐based network analysis was performed to validate the alteration of structural brain network in subjects with glioma. Results Compared with controls, subjects with glioma exhibited reduced FA values in the right uncinate fasciculus. Besides, subjects with glioma exhibited worse performance in several cognitive assessments. Partial correlation analysis indicated that the FA value in the right superior longitudinal fasciculus temporal part was significantly positively correlated with scores of visual–spatial abilities in subjects with glioma in the right temporal lobe ( r = .932, p = .002). Region of interest‐based network analysis revealed that subjects with glioma exhibited reduced FA, fiber length (FL), and fiber number (FN) between specific brain regions compared with controls. Conclusion The present study demonstrated the reduced integrity of white matter tracts and altered structural connectivity in brain networks in patients with glioma. Notably, white matter tracts in the right hemisphere might be vulnerable to the effects of a frontal or temporal lesion and might be associated with deficient cognitive function.

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

“…This insult of the structural connectivity is correlated with a decline of cognitive functions, confirming that axonal bundles represent a major limitation of neuroplasticity. For example, invasion of the right superior longitudinal fasciculus is correlated to a visuo-spatial deficit [ 37 ], invasion of the left inferior fronto-occipital fasciculus to a semantic deficit [ 38 ], or invasion of the right cingulate to a mentalization deficit [ 39 ]. This low potential of structural reconfiguration and rewiring within the function-specific WM pathways [ 40 ] may indirectly participate in the compensatory changes of the intra- and inter-system functional connectivity at the level of the whole meta-networking brain.…”

White Matter Tracts and Diffuse Lower-Grade Gliomas: The Pivotal Role of Myelin Plasticity in the Tumor Pathogenesis, Infiltration Patterns, Functional Consequences and Therapeutic Management

“…Typically, LGG patients with involvement of the left IFOF may exhibit a decline of semantic fluency at diagnosis ( 78 ) ( Figure 1A ). Using each patients’ DTI, reduced fractional anisotropy values in the right superior longitudinal fasciculus (SLF) affected by the glioma were associated to visuospatial impairments ( 82 ).…”

Perspectives on (A)symmetry of Arcuate Fasciculus. A Short Review About Anatomy, Tractography and TMS for Arcuate Fasciculus Reconstruction in Planning Surgery for Gliomas in Language Areas

“…An example of AF asymmetry in one patient treated at our hospital can be seen in Figure 1 , whereas Table 1 reports the main studies including AF tractography for surgical planning on patients with gliomas. Only few of them took into account contralesional WM bundles ( 19 , 69 , 70 ). In 2018, Jehna et al demonstrated that, at presentation, language functions were worse in patients in whom the AF was left-lateralized, whereas patients with symmetric or right-lateralized AF reconstructions showed better language performance ( 19 ).…”