Transient immediate postoperative homotopic functional disconnectivity in low-grade glioma patients

Abstract

Background and purposeThe aim of this longitudinal study is to evaluate large-scale perioperative resting state networks reorganization in patients with diffuse low-grade gliomas following awake surgery.Materials and methodsEighty-two patients with diffuse low-grade gliomas were prospectively enrolled and underwent awake surgical resection. Resting-state functional images were acquired at three time points: preoperative (MRI-1), immediate postoperative (MRI-2) and three months after surgery (MRI-3). We simultaneously performed perfusion-weighted imaging.ResultsComparing functional connectivity between MRI-1 and MRI-2, we observed a statistically significant functional homotopy decrease in cortical and subcortical supratentorial structures (P < 0.05). A functional homotopy increase was observed between MRI-2 and MRI-3 in parietal lobes, cingulum and putamen (P < 0.05). No significant functional connectivity modification was noticed between MRI-1 and MRI-3. Regional cerebral blood flow appeared transiently reduced on MRI-2 (P < 0.05). No correlation between neurological deficit and interhemispheric connectivity results was found.Conclusion/interpretationWe found a supratentorial widely distributed functional homotopy disruption between preoperative and immediate postoperative time points with a complete restitution three months after surgery with simultaneous variation of regional cerebral blood flow.

Resting state network plasticity related to picture naming in low-grade glioma patients before and after resection

“…A larger effective is required to fully address this question. Nevertheless, previously we have shown that restingstate connectivity between homotopic regions was generally disturbed independent of the resection area (Coget et al., 2018) and task-based fMRI analysis showed that the functional plasticity during picture naming could not be explained by tumor location and volume (Deverdun et al., 2019). In both cases, the importance of pre-surgical plasticity has been highlighted as well as surgery procedures allowing the preservation of eloquent areas.…”

Homotopic redistribution of functional connectivity in insula-centered diffuse low-grade glioma

“…The use of different scanners was not related to the purpose of the study but was due to the renewal of the previous scanner in our medical center. However, to account for its potential effects on resting-state functional connectivity, we included the between-scanner difference as a covariate in the analyses ( Coget et al, 2018 ).…”

“…Despite the highly integrative feature of the insular cortex, its injury does not necessarily result in the range of neuropsychological or neurological impairments one would expect, especially in the event of graded damage as in diffuse low-grade glioma (DLGG) ( Duffau, 2005 , Duffau et al, 2006 , Herbet et al, 2016 ). Different neuroplasticity strategies may account for such an efficient functional compensation, including loco-regional, intra-hemispheric and inter-hemispheric functional redistributions ( Coget et al, 2018 , Desmurget et al, 2007 ). Furthermore, recent studies indicate that the contralesional, homotopic structures may play a strategic role ( Gauthier et al, 2008 , Voytek et al, 2010 ), especially in the context of bi-lateralized networks ( Rice et al, 2018 ).…”

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

“…Such data emphasize the importance of a whole-brain approach during resting-state investigation in glioma patients, in a meta-networking account of neural functions. To examine longitudinal large-scale resting-state networks’ reallocation in LGG, rsfMRI was achieved in 82 patients before, immediately after awake surgery, and 3 months later, without a priori [ 108 ]. A transitory immediate postsurgical homotopic FC decrease was observed in cortico-subcortical supratentorial structures, with a functional homotopy increase at 3 months, especially in parietal lobes, cingulum, and putamen ( Figure 1 C).…”

“…( C ). (from [ 108 ]) FC variations in 82 patients who underwent awake DEM surgery for an LGG. Patients were scanned using rsfMRI successively before surgery (MRI-1), immediately after surgery, within 36 h following surgery (MRI-2), and three months after surgery (MRI-3).…”