INNV-28. CONNECTOMICS-GUIDED GLIOMA RESECTION: HOW CHANGES IN STRUCTURAL CONNECTIVITY CORRELATE WITH LANGUAGE FUNCTION

Abstract

Abstract Postoperative aphasia is a risk inherent to resections of brain masses in language eloquent areas. Neurosurgical strategies to minimize damage of functional language structures include awake craniotomies combined with stimulation mapping and intra-operative speech and language pathology (SLP) testing. Until now, consideration of white matter tracts involved in language processing as measured by diffusion tensor imaging (DTI) has been minimally incorporated into resection planning. In addition, there is limited understanding as to the association between specific tracts and aphasia risk. Quicktome™ by Omniscient Neurotechnology is clinically-oriented connectomics software that uses DTI sequences from MRIs to model connectivity between geographically distinct brain regions. This model can then be integrated with intraoperative navigation to avoid language connections during resection. Here, we investigate how language tract changes affect clinical aphasia. Patients with language-eloquent gliomas with available pre- and post-operative DTI and SLP evaluations were included in this retrospective study. Structural networks were quantified using Quicktome™ and compared using Spearman correlation. Changes in language function were evaluated using the Boston Naming Test and the Western Aphasia Battery. Patients with postoperative auditory verbal deficits showed a moderate correlation in connectivity changes (ρ=0.42), whereas patients with postoperative naming deficits showed a weak correlation (ρ=0.19). The inferior frontal junction, anterior portion (IFJa), and the superior temporal sulcus, ventral posterior portion (STSvp), in the right hemisphere demonstrated the most associated structural connectivity changes. To our knowledge, this is the first study which uses Quicktome™ to directly associate postoperative connectivity with aphasia outcomes. Understanding the interplay between structural connectivity and neurological symptoms can elucidate neural pathways underlying cortical function with the potential to reduce neurosurgical postoperative morbidity.