Assessment of Network Integrity in Right-Hemispheric Glioma Patients Using Function-Based Tractography and...

Area of Science:

• Neuroscience
• Neurosurgery
• Cognitive Science

Background:

• Gliomas can disrupt brain networks and neurological function.
• Right-hemispheric gliomas' impact on higher cognitive functions is less understood than left-hemispheric ones.
• Assessing cognitive changes and their structural correlates is crucial for patient outcomes.

Purpose of the Study:

• To evaluate pre- and postoperative neurocognitive performance in patients with right-hemispheric gliomas.
• To correlate cognitive outcomes with structural brain findings using function-based tractography.
• To understand the impact of right-sided gliomas on cognitive functions.

Main Methods:

• Prospective observational study of glioma patients.
• Administered a neurocognitive test battery preoperatively, postoperatively, and at 3-month follow-up.
• Utilized navigated transcranial magnetic stimulation (nTMS) for cortical mapping and diffusion tensor imaging (DTI) for function-based fiber tracking.

Main Results:

• Preoperatively, 88.8% of patients had cognitive impairments, notably in fine motor skills, executive function, and processing speed.
• Cognitive performance improved at follow-up.
• Involvement of superior longitudinal fasciculi I-III and inferior frontooccipital fasciculus correlated with specific cognitive deficits, including attention, executive function, visuospatial processing, and memory.

Conclusions:

• Preoperative neurocognitive deficits are common in right-hemispheric gliomas.
• Maximal safe resection that spares critical white matter tracts is linked to cognitive recovery.
• Function-based tractography highlights the association between specific fiber tract involvement and cognitive impairments.