Abstract
Simple SummaryStudies on pre-surgery effects of high-grade glioma on cognition are few, and investigations mainly used general test batteries without specifically addressing selective neuropsychological functions. We studied the pre-surgery neuropsychological status of 85 patients with high-grade glioma, by administering several cognitive tasks to assess language, memory, executive functions, and praxis. We analyzed their lesion volumes to test anatomo-functional correlations. We found that high-grade glioma involving different sub-areas of the left temporal lobe selectively impacts cognitive functions, especially within the language domain. There was one small overlapping lesion area that was shared by all the tasks we examined, localized in the superior temporal cortex.(1) Background: The literature on the effects of high-grade glioma (HGG) growth on cognition is still scarce. (2) Method: A consecutive series of 85 patients with HGG involving the left hemisphere underwent an extended neuropsychological evaluation prior to surgery. Voxel-based lesion-symptom mapping (VLSM) was used to identify regions related to cognitive performance. (3) Results: The patients’ mean level of pre-surgery accuracy was overall high. They showed the greatest difficulties in language with tasks such as naming (42.1% of patients impaired on nouns and 61.4% on verbs), reading (36.3% on words and 32.7% on pseudo-words), auditory lexical decisions (43.9%) and writing (41.3%) being most frequently impaired. VLSM analysis revealed anatomically separated areas along the temporal cortex and the white matter related to impairments on the different tasks, with voxels commonly shared by all tasks restricted to a small region in the ventral superior and middle temporal gyrus. (4) Conclusions: High-grade glioma affects cognition; nonetheless, lesions do not cause diffuse deficits but selectively impact the different language sub-domains along the ventral stream and the dorsal stream for language processing.
Highlights
High-grade gliomas (HGGs) are astrocytic- or oligodendrocytic-derived (WHO gradeIII and IV) tumors [1] with a highly malignant pattern and poor prognosis
Voxel-based lesion-symptom mapping (VLSM) performed for noun naming revealed 24% of the voxels damaged in the middle temporal cortex and, to a lesser extent, in the inferior and superior temporal gyrus, the hippocampus/parahippocampal area and the fusiform gyrus (Figure 1A)
VLSM analyses performed for the Token Test revealed 26% of the voxels damaged in the middle temporal cortex and, to a lesser extent, in the inferior and superior temporal gyrus, and the hippocampus (Figure 1B)
Summary
High-grade gliomas (HGGs) are astrocytic- or oligodendrocytic-derived (WHO gradeIII and IV) tumors [1] with a highly malignant pattern and poor prognosis. High-grade gliomas (HGGs) are astrocytic- or oligodendrocytic-derived Among all primary tumors of the central nervous system (CNS), glioblastoma multiforme is considered one of the most common and most aggressive tumor subtypes in the adult population. It has a global incidence of about 3–4 cases per 100,000 people per year [2], is more frequent in men than in women and occurs mainly in the 55–75 age group, with no particular territorial 4.0/). The literature on cognition in HGG is limited [3]. Cognitive deficits can have consequences upon the daily life of patients [5,6]. Patients’ complaints of symptoms occur in the weeks or months before they are admitted to a neurological or neurosurgical ward for their first examinations
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