Impact of resection location on depressive symptoms following glioma surgery

Glioma surgery aims to maximize tumor removal while preserving functional integrity. Functional outcome usually focuses on neurological and neurocognitive functions, but surgery may also affect mood regulation. We determined the occurrence of depressive symptoms after surgery and investigated associated factors, including preoperative depressive symptoms and the location of the resection.

We included a single-center retrospective cohort of patients with supratentorial diffuse glioma (WHO grade 2-4) who underwent first-time surgical resection between 2009 and 2021 and who completed the Center for Epidemiologic Studies Depression Scale (CES-D) before and one year after surgery. Resection cavities were segmented on postoperative MRI scans. White matter disconnections were computed, the so-called disconnectome, to examine distant effects. Multivariable regression analysis was used to relate patient, tumor, and treatment characteristics to postoperative depression scores and changes after surgery. Lesion-symptom mapping was used to relate resection and disconnectome locations to these scores and changes.

The study included 83 patients. Before surgery, 25% of patients had depressive symptoms and one year after surgery 34%, which was not statistically different. Resections of gliomas in the right hemisphere were significantly associated with increased depression scores after surgery. A resection involving the left anterior temporal region was significantly associated with low postoperative depression scores. Disconnectome locations were not associated with either postoperative or change in depression scores.

Resection locations affect depressive symptoms in glioma patients. This information may be useful for patient counseling.