Preoperative function‐specific connectome analysis predicts surgery‐related aphasia after glioma resection

Ille, Sebastian; Zhang, Haosu; Sogerer, Lisa; Schwendner, Maximilian; Schöder, Axel; Meyer, Bernhard; Wiestler, Benedikt; Krieg, Sandro M.

doi:10.1002/hbm.26014

Cited by 7 publications

(7 citation statements)

References 36 publications

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“…Multiple previous studies have predicted language outcomes with preoperative imaging while others have documented associations between resections and postoperative language decline. [19][20][21][22][23][24][25] However, in our view, this study has unique clinical value. Here we report novel data that can directly inform operative decisions by predicting the long-term functional impact of individual tumor-removal strategies with strong accuracy (>90%).…”

Section: Discussionmentioning

confidence: 84%

Non-Invasive Brain Mapping Localizes Essential Language Function in Surgical Glioma Patients

Muir,

Noll,

Prinsloo

et al. 2024

Preprint

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The essential neuroanatomical structure of language processing remains unclear. Here we show in a cohort of 79 consecutive glioma patients undergoing surgery in the dominant hemisphere that postoperative language deficits result from subcortical damage to individualized ROIs within normative white matter tracts. We integrate these findings into a data-driven, non-invasive brain mapping approach capable of using cortical transcranial magnetic stimulation (TMS) mappings and diffusion imaging to localize language-essential regions and predict the long-term functional outcome of personalized surgical strategies with an accuracy of 94%. We use this technique to create a group-level probabilistic atlas of functional white matter in glioma patients, revealing evidence for a novel, disease-specific pattern of subcortical connectivity deep to the temporo-parietal-occipital (TPO) junction that anatomically correlates with regional vulnerability to aphasic damage. This study provides novel insight into the functional anatomy of language processing while defining a reproducible approach for non-invasively mapping essential language function.

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Section: Discussionmentioning

confidence: 84%

Non-Invasive Brain Mapping Localizes Essential Language Function in Surgical Glioma Patients

Muir,

Noll,

Prinsloo

et al. 2024

Preprint

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“…Traditional preoperative mapping methods focus on eloquent areas such as language, visual, and sensorimotor networks. However, these techniques, including diffusion tensor imaging (DTI), navigated transcranial magnetic stimulation (rTMS), and functional MRI, present logistical challenges and require specialized personnel ( 27 ). Beyond traditional eloquent areas, non-traditional regions affecting personality, executive function, visuospatial abilities, metacognition, semantic memory, and other cognitive functions also impact patients’ quality of life.…”

Section: Resultsmentioning

confidence: 99%

“…Ille et al ( 27 ) enrolled 60 non-aphasic patients with left hemispheric perisylvian gliomas to investigate the prediction of surgery-related aphasia (SRA) based on function-specific connectome network properties under different fractional anisotropy thresholds combining navigated transcranial magnetic stimulation. Preoperative connectome analysis helped predict SRA development with an accuracy of 73.3% and sensitivity of 78.3%.…”

Section: Resultsmentioning

confidence: 99%

Augmented surgical decision-making for glioblastoma: integrating AI tools into education and practice

Mut,

Zhang,

Gupta

et al. 2024

Front. Neurol.

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Surgical decision-making for glioblastoma poses significant challenges due to its complexity and variability. This study investigates the potential of artificial intelligence (AI) tools in improving “decision-making processes” for glioblastoma surgery. A systematic review of literature identified 10 relevant studies, primarily focused on predicting resectability and surgery-related neurological outcomes. AI tools, especially rooted in radiomics and connectomics, exhibited promise in predicting resection extent through precise tumor segmentation and tumor-network relationships. However, they demonstrated limited effectiveness in predicting postoperative neurological due to dynamic and less quantifiable nature of patient-related factors. Recognizing these challenges, including limited datasets and the interpretability requirement in medical applications, underscores the need for standardization, algorithm optimization, and addressing variability in model performance and then further validation in clinical settings. While AI holds potential, it currently does not possess the capacity to emulate the nuanced decision-making process utilized by experienced neurosurgeons in the comprehensive approach to glioblastoma surgery.

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“…It should also be noted that other epidemiological factors, apart from those assessed in our study, could potentially influence neurological deterioration as a measured outcome. It is especially possible that other fiber bundles, for example in the language network, may be associated with neurological outcome [30].…”

Section: Limitationsmentioning

confidence: 99%

White Matter Integrity of the Corticospinal Tract for Estimation of Individual Patient Risk for Postoperative Neurological Deterioration after Glioma Surgery

Wende¹,

Hoffmann²,

Fehrenbach³

et al. 2022

J. Integr. Neurosci.

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Background: Tractography has become a standard tool for planning neurosurgical operations and has been proven to be useful for risk stratification. In various conditions, tractography-derived white matter integrity has been shown to be associated with neurological outcome. Postoperative performance has been shown to be a prognostic marker in glioma. We aimed to assess the relation of preoperative corticospinal tract (CST) integrity with postoperative neurological deterioration in patients with malignant glioma. Methods: We retrospectively analyzed a cohort of 24 right-handed patients (41.7% female) for perioperative neurological performance score (NPS) and applied our anatomical tractography workflow to extract the median fractional anisotropy (FA) of the CST in preoperative magnetic resonance imaging (MRI). Results: Median FA of the CST ipsilateral to the tumor correlated significantly with preoperative NPS (p = 0.025). After rank order correlation and multivariate linear regression, we found that the preoperative median FA of the right CST correlates with preoperative NPS, independently from epidemiological data (p = 0.019). In patients with lesions of the right hemisphere, median FA of the right CST was associated with a declining NPS in multivariate linear regression (p = 0.024). Receiver operating characteristic (ROC) analysis revealed an optimal FA cutoff at 0.3946 in this subgroup (area under the curve 0.83). Patients below that cutoff suffered from a decline in neurological performance significantly more often (p = 0.020). Conclusions: Assessment of preoperative white matter integrity may be a promising biomarker for risk estimation of patients undergoing craniotomy for resection of malignant glioma.

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Preoperative function‐specific connectome analysis predicts surgery‐related aphasia after glioma resection

Cited by 7 publications

References 36 publications

Non-Invasive Brain Mapping Localizes Essential Language Function in Surgical Glioma Patients

Non-Invasive Brain Mapping Localizes Essential Language Function in Surgical Glioma Patients

Augmented surgical decision-making for glioblastoma: integrating AI tools into education and practice

White Matter Integrity of the Corticospinal Tract for Estimation of Individual Patient Risk for Postoperative Neurological Deterioration after Glioma Surgery

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