Non-traditional cognitive brain network involvement in insulo-Sylvian gliomas: a case series study and clinical experience using Quicktome

Chinese Neurosurgical Journal

Research

Zhiqiang Wu¹  Xiefeng Wang¹  Xiao Fan¹  Qinyu Shi¹  Guanjie Hu¹  Xingdong Liu¹  Zhangchun Cheng¹  Zifeng Zhang¹  Bowen Cao¹  Yao Tang¹  Junxia Zhang²  Yongping You²  Xiaorong Hu³  Xia Zhang³  Nicholas B. Dadario⁴ 

[1] Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, China;Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, 210029, Nanjing, China;Institute for Brain Tumors, Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, 211166, Nanjing, China;International Joint Research Center On Precision Brain Medicine, XD Group Hospital, Shaanxi Province, 710077, Xi’an, China;Robert Wood Johnson Medical School, Rutgers University, 08901, Newark, NJ, USA;

关键词: Connectome;    Brain network;    Machine learning;    Insulo-Sylvian gliomas;    Cognitive function;   

DOI  :  10.1186/s41016-023-00325-4

 received in 2023-02-01, accepted in 2023-04-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPatients with insulo-Sylvian gliomas continue to present with severe morbidity in cognitive functions primarily due to neurosurgeons’ lack of familiarity with non-traditional brain networks. We sought to identify the frequency of invasion and proximity of gliomas to portions of these networks.MethodsWe retrospectively analyzed data from 45 patients undergoing glioma surgery centered in the insular lobe. Tumors were categorized based on their proximity and invasiveness of non-traditional cognitive networks and traditionally eloquent structures. Diffusion tensor imaging tractography was completed by creating a personalized brain atlas using Quicktome to determine eloquent and non-eloquent networks in each patient. Additionally, we prospectively collected neuropsychological data on 7 patients to compare tumor-network involvement with change in cognition. Lastly, 2 prospective patients had their surgical plan influenced by network mapping determined by Quicktome.ResultsForty-four of 45 patients demonstrated tumor involvement (< 1 cm proximity or invasion) with components of non-traditional brain networks involved in cognition such as the salience network (SN, 60%) and the central executive network (CEN, 56%). Of the seven prospective patients, all had tumors involved with the SN, CEN (5/7, 71%), and language network (5/7, 71%). The mean scores of MMSE and MOCA before surgery were 18.71 ± 6.94 and 17.29 ± 6.26, respectively. The two cases who received preoperative planning with Quicktome had a postoperative performance that was anticipated.ConclusionsNon-traditional brain networks involved in cognition are encountered during surgical resection of insulo-Sylvian gliomas. Quicktome can improve the understanding of the presence of these networks and allow for more informed surgical decisions based on patient functional goals.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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