Abstract BACKGROUND Patients with low-grade gliomas may have no obvious problems during hospitalization or their initial return to social life; however, social life difficulties may gradually become more apparent long after the surgery. We investigated factors associated with social disabilities in patients with low-grade gliomas in the postoperative chronic phase. METHODS The study included 114 patients with WHO grade 2 or 3 gliomas who underwent surgery (mean age, 44.3±13.2 years). Seventy-six patients underwent an initial surgery and 38 underwent a second surgery. All patients underwent various brain functional assessments and interviews about their social lives over 1 year after the surgery (median, 23 months). Factors associated with social disabilities were determined using logistic multiple regression analysis and chi-square tests. Voxel-based lesion symptom mapping was used to examine the brain regions associated with social disabilities. RESULTS Social disabilities were observed in 12.3% of the patients. Factors associated with social disabilities were the number of surgeries (first vs. second, p=0.0052) and tumor location (left vs. right, p=0.0091). Patients with recurrence and right cerebral hemispheric lesions had a higher probability of social disability (42.1%, p<0.0001) than that of other patients. The reasons for social disability after right hemispheric recurrence were social behavior disorder (62.5%) and neuropsychological dysfunctions (37.5%). Social behavioral disorders include interpersonal problems, such as job switching owing to problems with others, poor interpersonal relationships, and sexually deviant behavior. No other apparent neuropsychological abnormalities were found in patients with social behavior disorders. Surgical resection of the deep part of the right prefrontal area is associated with social behavior disorders and right supplementary motor cortex resection is associated with neuropsychological disorders. CONCLUSION In lower grade glioma, patients with right hemispheric recurrence were more likely to develop social disabilities in the chronic phase, which was caused by social behavioral disorders and neuropsychological dysfunctions.
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