Predicting attention deficits and functional recovery after glioma resection through functional executive networks:...

Postoperative short-term attentional and executive dysfunctions are common after brain tumor resection, significantly impacting patients' quality of life and functional recovery. This longitudinal cross-sectional study investigated whether presurgical functional dynamics of key brain networks supporting executive functioning could predict postoperative neuropsychological outcomes, providing insights into temporary deficits and recovery trajectories.

Twenty-two patients with gliomas underwent resting-state fMRI scans before and three-months after surgery, along with neuropsychological assessments conducted before, one week and three months after surgery. Co-activation pattern analysis (CAPs) characterized functional dynamic properties of executive networks, including the Fronto-parietal (FPN). Temporal network properties - stability, integration, and centrality- were examined longitudinally. Descriptive and predictive multivariate analysis explored associations between network dynamics and cognitive functioning.

Immediate post-surgical attentional deficits were associated with pre-surgical FPN properties, revealing dynamic activation patterns predictive of short-term deficits. These temporal properties not only predicted the severity and persistence of early deficits, but also offered valuable insights in the longitudinal progression of attentional performance otherwise neglected. Importantly, by three months post-surgery, neuropsychological profiles and network dynamics returned to pre-surgical baseline, highlighting the transient nature of the deficits beyond treatment strategies.

Our study demonstrates that presurgical dynamic properties of intrinsic executive networks alone can predict short-term postoperative neuropsychological outcomes. This predictive ability offers critical value for patients, families and clinical teams by emphasizing the temporary nature of the deficits and enabling early, personalized interventions. These findings emphasize the potential for using intrinsic brain activity dynamics as a tool for guiding postoperative recovery planning and alleviating concerns about temporary postoperative cognitive impairments.