Abstract

BackgroundGlioma-related epilepsy (GRE) is a common symptom in patients with prefrontal glioma. Epilepsy onset is associated with functional network alterations. This study investigated alterations of functional networks in patients with prefrontal glioma and GRE.MethodsSixty-five patients with prefrontal lobe gliomas were retrospectively assessed and classified into GRE and non-GRE groups. Additionally, 25 healthy participants were enrolled after matching for general information. Imaging data were acquired within 72 h in pre-operation. The sensorimotor network was used to delineate alterations in functional connectivity (FC) and topological properties. One-way analysis of variance and post-hoc analysis with Bonferroni correction were used to calculate differences of FC and topological properties.ResultsAll significant alterations were solely found in the sensorimotor network. Irrespective of gliomas located in the left or right prefrontal lobes, the edge between medial Brodmann area 6 and caudal ventrolateral Brodmann area 6 decreased FC in the GRE group compared with the non-GRE group [p < 0.0001 (left glioma), p = 0.0002 (right glioma)]. Moreover, the shortest path length decrease was found in the GRE group compared with the non-GRE group [p = 0.0292 (left glioma) and p = 0.0129 (right glioma)].ConclusionsThe reduction of FC between the medial BA 6 (supplementary motor area) and caudal ventrolateral BA 6 in the ipsilateral hemisphere and the shortening of the path length of the sensorimotor network were characteristics alterations in patients with GRE onset. These findings fill in the gap which is the relationship between GRE onset and the alterations of functional networks in patients with prefrontal glioma.Significance StatementGlioma related epilepsy is the most common symptom of prefrontal glioma. It is important to identify characteristic alterations in functional networks in patients with GRE. We found that all significant alterations occurred in the sensorimotor network. Moreover, a decreased FC in the supplementary motor area and a shortening of the path’s length are additional characteristics of glioma-related epilepsy. We believe that our findings indicate new directions of research that will contribute to future investigations of glioma-related epilepsy onset.

Highlights

  • Tumor locations and low-grade glioma are susceptible factors for patients with glioma-related epilepsy (GRE) [1, 2]

  • Based on whether patients had preoperative GRE, 29 patients were included in the GRE group (15 and 14 patients with prefrontal gliomas in the left and right hemisphere, respectively)

  • Our postoperative follow-up data showed that no patient with preoperative GRE experienced epilepsy at 1 year after tumor resection

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Summary

Introduction

Tumor locations and low-grade glioma are susceptible factors for patients with glioma-related epilepsy (GRE) [1, 2]. Extensive disruption of functional connectivity (FC) was thought to be related to patients with idiopathic epilepsy [3,4,5]. Based on those studies, the investigation of epilepsy by analyzing the alterations in brain functional networks was proposed, which gives a new insight into the inspection of epilepsy. Different from idiopathic epilepsy only impairing functional networks, glioma was disrupted and was able to reorganize functional networks [12, 13]. Glioma-related epilepsy (GRE) is a common symptom in patients with prefrontal glioma. This study investigated alterations of functional networks in patients with prefrontal glioma and GRE

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