Baseline neurocognitive dysfunction is ubiquitous in intrinsic brain tumors– results from a large Indian cohort of patients and analysis of factors associated with domain-specific dysfunction

Moiyadi, Aliasgar; Jain, Kanchi; Shetty, Prakash; Singh, Vikas; Radhakrishnan, Keerthi; Rane, Pallavi; Velayutham, Parthiban

doi:10.1016/j.wnsx.2023.100210

Cited by 2 publications

(2 citation statements)

References 29 publications

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“…Of the grade 4 tumors observed in 15 (22.7%) patients, 13 had glioblastomas, and 2 had Grade 4 IDH mutant astrocytomas. Similar to our previous observation [ 21 ] severe baseline neurocognitive deficits were seen in 90% of the patients and the most commonly affected domains were attention and memory.…”

Section: Resultssupporting

confidence: 91%

“…A detailed neuropsychological assessment was conducted by a trained neuropsychologist (KS) prior to surgery and during the follow-up period prior to the start of adjuvant therapy wherever possible as part of routine practice. Specific neurocognitive tests pertaining to the domains of attention/executive functions, memory, language, visuospatial function and visuomotor function were conducted as per a protocol we previously published [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

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Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Biswas,

Shetty,

Sahu

et al. 2024

Acta Neurochir

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Background Surgical resection of insular gliomas is a challenge. TO resection is considered more versatile and has lower risk of vascular damage. In this study, we aimed to understand the factors that affect resection rates, ischemic changes and neurological outcomes and studied the utility of IONM in patients who underwent TO resection for IGs. Methods Retrospective analysis of 66 patients with IG who underwent TO resection was performed. Results Radical resection was possible in 39% patients. Involvement of zone II and the absence of contrast enhancement predicted lower resection rate. Persistent deficit rate was 10.9%. Although dominant lobe tumors increased immediate deficit and fronto-orbital operculum involvement reduced prolonged deficit rate, no tumor related factor showed significant association with persistent deficits. 45% of patients developed a postoperative infarct, 53% of whom developed deficits. Most affected vascular territory was lenticulostriate (39%). MEP changes were observed in 9/57 patients. 67% of stable TcMEPs and 74.5% of stable strip MEPs did not develop any postoperative motor deficits. Long-term deficits were seen in 3 and 6% patients with stable TcMEP and strip MEPs respectively. In contrast, 25% and 50% of patients with reversible strip MEP and Tc MEP changes respectively had persistent motor deficits. DWI changes were clinically more relevant when accompanied by MEP changes intraoperatively, with persistent deficit rates three times greater when MEP changes occurred than when MEPs were stable. Conclusion Radical resection can be achieved in large, multizone IGs, with reasonable outcomes using TO approach and multimodal intraoperative strategy with IONM.

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Section: Resultssupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Biswas,

Shetty,

Sahu

et al. 2024

Acta Neurochir

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Tumor location and neurocognitive function—Unravelling the association and identifying relevant anatomical substrates in intra-axial brain tumors

Shah,

Bhartia,

Biswas

et al. 2024

Neuro-Oncology Advances

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Background Neurocognitive function is a key outcome indicator of therapy in brain tumors. Understanding the underlying anatomical substrates involved in domain function and the pathophysiological basis of dysfunction can help ameliorate the effects of therapy and tailor directed rehabilitative strategies. Methods 100 adult diffuse gliomas were co-registered onto a common demographic-specific brain template to create Tumor localization maps (TLMs). Voxel-based lesion symptom (VLSM) technique was used to assign an association between individual voxels and neuropsychological dysfunction in various domains (attention and executive function (A & EF), language, memory, visuospatial/ constructive abilities, and visuomotor speed). The probability maps thus generated were further co-registered to cortical and subcortical atlases. A permutation-based statistical testing method was used to evaluate the statistically and clinically significant anatomical parcels associated with domain dysfunction and to create heat maps. Results Neurocognition was affected in a high proportion of subjects (93%), with A & EF and memory being the most affected domains. Left-sided networks were implicated in patients with A & EF, memory, and language deficits with the perisylvian white matter tracts being the most common across domains. Visuospatial dysfunction was associated with lesions involving the right perisylvian cortical regions, whereas deficits in visuomotor speed were associated with lesions involving primary visual and motor output pathways. Conclusions Significant baseline neurocognitive deficits are prevalent in gliomas. These are multi-domain and the perisylvian network especially on the left side seems to be very important, being implicated in dysfunction of many domains.

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Baseline neurocognitive dysfunction is ubiquitous in intrinsic brain tumors– results from a large Indian cohort of patients and analysis of factors associated with domain-specific dysfunction

Cited by 2 publications

References 29 publications

Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Factors affecting the extent of resection and neurological outcomes following transopercular resection of insular gliomas

Tumor location and neurocognitive function—Unravelling the association and identifying relevant anatomical substrates in intra-axial brain tumors

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