Universität zu Köln

Kocher, Martin, Jockwitz, Christiane, Caspers, Svenja, Schreiber, Jan, Farrher, Ezequiel, Stoffels, Gabriele, Filss, Christian, Lohmann, Philipp ORCID: 0000-0002-5360-046X, Tscherpel, Caroline, Ruge, Maximilian, I, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Shah, Nadim J., Galldiks, Norbert ORCID: 0000-0002-2485-1796 and Langen, Karl-Josef (2020). Role of the default mode resting-state network for cognitive functioning in malignant glioma patients following multimodal treatment. NeuroImage-Clin., 27. OXFORD: ELSEVIER SCI LTD. ISSN 2213-1582

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Abstract

Background: Progressive cognitive decline following multimodal neurooncological treatment is a common observation in patients suffering from malignant glioma. Alterations of the default-mode network (DMN) represent a possible source of impaired neurocognitive functioning and were analyzed in these patients. Methods: Eighty patients (median age, 51 years) with glioma (WHO grade IV glioblastoma, n = 57; WHO grade III anaplastic astrocytoma, n = 13; WHO grade III anaplastic oligodendroglioma, n = 10) and ECOG performance score 0-1 underwent resting-state functional MRI (rs-fMRI) and neuropsychological testing at a median interval of 13 months (range, 1-114 months) after initiation of therapy. For evaluation of structural and metabolic changes after treatment, anatomical MRI and amino acid PET using O-(2-[F-18]fluoroethyl)-L-tyrosine (FET) were simultaneously acquired to rs-fMRI on a hybrid MR/PET scanner. A cohort of 80 healthy subjects matched for gender, age, and educational status served as controls. Results: The connectivity pattern within the DMN (12 nodes) of the glioma patients differed significantly from that of the healthy subjects but did not depend on age, tumor grade, time since treatment initiation, presence of residual/recurrent tumor, number of chemotherapy cycles received, or anticonvulsive medication. Small changes in the connectivity pattern were observed in patients who had more than one series of radiotherapy. In contrast, structural tissue changes located at or near the tumor site (including resection cavities, white matter lesions, edema, and tumor tissue) had a strong negative impact on the functional connectivity of the adjacent DMN nodes, resulting in a marked dependence of the connectivity pattern on tumor location. In the majority of neurocognitive domains, glioma patients performed significantly worse than healthy subjects. Correlation analysis revealed that reduced connectivity in the left temporal and parietal DMN nodes was associated with low performance in language processing and verbal working memory. Furthermore, connectivity of the left parietal DMN node also correlated with processing speed, executive function, and verbal as well as visual working memory. Overall DMN connectivity loss and cognitive decline were less pronounced in patients with higher education. Conclusion: Personalized treatment strategies for malignant glioma patients should consider the left parietal and temporal DMN nodes as vulnerable regions concerning neurocognitive outcome.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kocher, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Jockwitz, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Caspers, Svenja UNSPECIFIED UNSPECIFIED UNSPECIFIED Schreiber, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Farrher, Ezequiel UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoffels, Gabriele UNSPECIFIED UNSPECIFIED UNSPECIFIED Filss, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohmann, Philipp UNSPECIFIED orcid.org/0000-0002-5360-046X UNSPECIFIED Tscherpel, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruge, Maximilian, I UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon R. UNSPECIFIED orcid.org/0000-0002-8230-1856 UNSPECIFIED Shah, Nadim J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Galldiks, Norbert UNSPECIFIED orcid.org/0000-0002-2485-1796 UNSPECIFIED Langen, Karl-Josef UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-350323
DOI:	10.1016/j.nicl.2020.102287
Journal or Publication Title:	NeuroImage-Clin.
Volume:	27
Date:	2020
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	2213-1582
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NEUROCOGNITIVE FUNCTION; BRAIN-TUMORS; CONNECTIVITY; GRADE; CORTEX; OPTIMIZATION; RADIOTHERAPY; REGISTRATION; PERFORMANCE; IMPAIRMENT Multiple languages Neuroimaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/35032