Abstract
Introduction: Preservation of language functioning in patients undergoing brain tumor surgery is essential because language impairments negatively impact the quality of life. Brain tumor patients have alterations in functional connectivity (FC), the extent to which brain areas functionally interact. We studied FC networks in relation to language functioning in glioma and meningioma patients.Method: Patients with a low-grade glioma (N = 15) or meningioma (N = 10) infiltrating into/pressing on the language-dominant hemisphere underwent extensive language testing before and 1 year after surgery. Resting-state EEG was registered preoperatively, postoperatively (glioma patients only), and once in healthy individuals. After analyzing FC in theta and alpha frequency bands, weighted networks and Minimum Spanning Trees were quantified by various network measures.Results: Pre-operative FC network characteristics did not differ between glioma patients and healthy individuals. However, hub presence and higher local and global FC are associated with poorer language functioning before surgery in glioma patients and predict worse language performance at 1 year after surgery. For meningioma patients, a greater small worldness was related to worse language performance and hub presence; better average clustering and global integration were predictive of worse outcome on language function 1 year after surgery. The average eccentricity, diameter and tree hierarchy seem to be the network metrics with the more pronounced relation to language performance.Discussion: In this exploratory study, we demonstrated that preoperative FC networks are informative for pre- and postoperative language functioning in glioma patients and to a lesser extent in meningioma patients.
Highlights
Preservation of language functioning in patients undergoing brain tumor surgery is essential because language impairments negatively impact the quality of life
At T2, there was a drop-out of two glioma patients, due to severe side effects of adjuvant treatment, and two meningioma patients, because they were no longer motivated to participate in the study
Glioma and Meningioma Patients The results indicate that in glioma patients, those with language impairments in the preoperative setting show hub presence, a more global integration and more starlike configuration compared to patients without a language impairment in the theta band
Summary
Preservation of language functioning in patients undergoing brain tumor surgery is essential because language impairments negatively impact the quality of life. Gliomas are infiltrative tumors whereas the meningioma are extra-axially located Patients with a low-grade glioma involving eloquent brain areas generally undergo surgical resection by an awake procedure, to maximize the extent of resection while preventing additional impairment by surgical injury to eloquent brain areas. Patients of both groups have a relatively long life expectancy after surgery (Van Alkemade et al, 2012; Ho et al, 2014). It is important to gain more insight into the underlying mechanisms of language impairments in this group of patients, to identify at-risk patients and potentially prevent postoperative language decline
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