Preoperative language tract integrity is a limiting factor in recovery from aphasia after glioma surgery

Prasse, Gordian; Meyer, Hans‐Jonas; Scherlach, Cordula; Maybaum, Jens; Hoffmann, Anastasia; Kasper, Johannes; Fehrenbach, Michael Karl; Wilhelmy, Florian; Meixensberger, Jürgen; Hoffmann, Karl‐Titus; Wende, Tim

doi:10.1016/j.nicl.2022.103310

Cited by 7 publications

(6 citation statements)

References 60 publications

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“…Prediction of cognitive de cits from the affection of individual ber tracts Studies regarding the relationship between white matter alterations and neurologic or cognitive de cits in glioma patients have, so far, focused on the perioperative setting and single, anatomically de ned tracts and their impact on motor function, speech and selected higher cognitive functions. These include central callosal bers (supplementary motor area syndrome) [33], left inferior fronto-occipital/inferior longitudinal/uncinate fascicles (aphasia) [34,35], right frontal aslant tract (executive functions, attention shift, verbal uency) [36], right superior longitudinal fascicle/fronto-striatal tract/orbitofrontal cortex (mentalizing/visuospatial function) [37][38][39][40], and right inferior fronto-striatal tract/inferior frontal gyrus (inference control processes) [41]. Regarding radiation therapy, it was observed that radiation-induced changes in the hippocampus, parahippocampal cingulate, and other structures of the medial temporal lobe were associated with decreases in verbal memory, verbal uency and visuospatial memory [42,43].…”

Section: Discussionmentioning

confidence: 99%

Whole-brain structural connectivity predicts cognitive deficits in pretreated glioma patients

Friedrich

Filß

Lohmann

et al. 2023

Preprint

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Purpose Glioma patients frequently suffer from cognitive dysfunction potentially caused by tumor invasion or treatment effects. We hypothesized that cognitive functioning in pretreated glioma patients critically depends on the maintained structural connectivity of multiple brain networks. Methods The study included 121 pretreated glioma patients (median age, 52 years; median ECOG score 1; CNS WHO grade 3 or 4) who had biopsy or resection plus chemoradiation. Cognitive performance was assessed by ten tests in five main cognitive domains 14 (1-214) months after therapy initiation. Hybrid amino acid PET/MRI using the tracer O-(2-[18F]fluoroethyl)-L-tyrosine, a network-based cortical parcellation, and advanced tractography methods were used to generate whole-brain fiber count-weighted connectivity matrices. The matrices were applied to cross-validated machine learning-based models to identify fiber connections and underlying networks predictive for cognitive performance in the evaluated domains. Results Compared to healthy controls (n = 121), the cognitive scores were significantly lower in nine cognitive tests. The models well predicted 7/10 scores (median correlation coefficient, 0.47; range, 0.39–0.57) from 24–230 (0.5–4.6%) of the possible connections/edges, 84% were between nodes of different networks. Critically involved cortical regions/nodes (≥ 10 adjacent predictive edges) included predominantly left-sided nodes of the visual, somatomotor, dorsal/ventral attention, and default mode networks. Highly critical nodes (≥ 15–20 edges) included the default-mode network’s left temporal and bilateral posterior cingulate cortex. Conclusions These results suggest that the cognitive performance of pretreated glioma patients is strongly related to structural connectivity between multiple brain networks and depends on the integrity of known network hubs also involved in other neurological disorders.

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Section: Discussionmentioning

confidence: 99%

Whole-brain structural connectivity predicts cognitive deficits in pretreated glioma patients

Friedrich

Filß

Lohmann

et al. 2023

Preprint

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“…As discussed previously, a number of studies have demonstrated language deficits resulting from the disconnection of cortical regions due to damage to underlying white matter tracts, even if language eloquent cortical areas are spared [ 47 , 81 , 120 ]. Indeed, preoperative white matter integrity within major language tracts is a predictor of postoperative recovery from aphasia [ 143 ]. These findings stress the importance of increasing attention toward the white matter tracts connecting these regions and to the integrity of language networks more broadly for the prediction of postoperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

Beyond Broca’s and Wernicke’s: Functional Mapping of Ancillary Language Centers Prior to Brain Tumor Surgery

2023

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Functional MRI is a well-established tool used for pre-surgical planning to help the neurosurgeon have a roadmap of critical functional areas that should be avoided, if possible, during surgery to minimize morbidity for patients with brain tumors (though this also has applications for surgical resection of epileptogenic tissue and vascular lesions). This article reviews the locations of secondary language centers within the brain along with imaging findings to help improve our confidence in our knowledge on language lateralization. Brief overviews of these language centers and their contributions to the language networks will be discussed. These language centers include primary language centers of “Broca’s Area” and “Wernicke’s Area”. However, there are multiple secondary language centers such as the dorsal lateral prefrontal cortex (DLPFC), frontal eye fields, pre- supplemental motor area (pre-SMA), Basal Temporal Language Area (BTLA), along with other areas of activation. Knowing these foci helps to increase self-assurance when discussing the nature of laterality with the neurosurgeon. By knowing secondary language centers for language lateralization, via fMRI, one can feel confident on providing neurosurgeon colleagues with appropriate information on the laterality of language in preparation for surgery.

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“…CST tractography was performed first manually with MRtrix3 17 , and also automatically in TractSeg. 15 Tractography parameters included an FA cutoff of 0.15, a maximum length of 250 mm, a minimum length of 60 mm, and 10 6 seeds. The seed region was placed in the mesencephalon, and the target region in the internal capsule.…”

Section: Imagingmentioning

confidence: 99%

“…Tractograms usually consist of streamlines, describing the probability that a white matter tract is present along their coordinates 12 . This spatial information can then be used to define volumes of the depicted tracts 15 . While a great number of connectomic studies use streamline count or its derivates to measure structural connectivity, its biological relevance has not yet been proven 16 .…”

Section: Introductionmentioning

confidence: 99%

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Radiomic white matter parameters of functional integrity of the corticospinal tract in high-grade glioma

Wende,

Güresir,

Wach

et al. 2024

Sci Rep

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Tractography has become a widely available tool for the planning of neurosurgical operations as well as for neuroscientific research. The absence of patient interaction makes it easily applicable. However, it leaves uncertainty about the functional relevance of the identified bundles. We retrospectively analyzed the correlation of white matter markers with their clinical function in 24 right-handed patients who underwent first surgery for high-grade glioma. Morphological affection of the corticospinal tract (CST) and grade of paresis were assessed before surgery. Tractography was performed manually with MRTrix3 and automatically with TractSeg. Median and mean fractional anisotropy (FA) from manual tractography showed a significant correlation with CST affection (p = 0.008) and paresis (p = 0.015, p = 0.026). CST affection correlated further most with energy, and surface-volume ratio (p = 0.014) from radiomic analysis. Paresis correlated most with maximum 2D column diameter (p = 0.005), minor axis length (p = 0.006), and kurtosis (p = 0.008) from radiomic analysis. Streamline count yielded no significant correlations. In conclusion, mean or median FA can be used for the assessment of CST integrity in high-grade glioma. Also, several radiomic parameters are suited to describe tract integrity and may be used to quantitatively analyze white matter in the future.

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Preoperative language tract integrity is a limiting factor in recovery from aphasia after glioma surgery

Cited by 7 publications

References 60 publications

Whole-brain structural connectivity predicts cognitive deficits in pretreated glioma patients

Whole-brain structural connectivity predicts cognitive deficits in pretreated glioma patients

Beyond Broca’s and Wernicke’s: Functional Mapping of Ancillary Language Centers Prior to Brain Tumor Surgery

Radiomic white matter parameters of functional integrity of the corticospinal tract in high-grade glioma

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