A Longitudinal Multimodal Imaging Study in Patients with Temporo-Insular Diffuse Low-Grade Tumors: How the Inferior Fronto-Occipital Fasciculus Provides Information on Cognitive Outcomes
Background: Tractography allows the in vivo study of subcortical white matter, and it is a potential tool for providing predictive indices on post-operative outcomes. We aim at establishing whether there is a relation between cognitive outcome and the status of the inferior fronto-occipital fascicul...
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| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-12-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/31/12/595 |
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| Summary: | Background: Tractography allows the in vivo study of subcortical white matter, and it is a potential tool for providing predictive indices on post-operative outcomes. We aim at establishing whether there is a relation between cognitive outcome and the status of the inferior fronto-occipital fasciculus’s (IFOF’s) microstructure. Methods: The longitudinal neuropsychological data of thirty young (median age: 35 years) patients operated on for DLGG in the left temporo-insular cortex along with pre-surgery tractography data were processed. Results: A degraded integrity of the left (vs. right) IFOF (lower fractional anisotropy and length, <i>p</i> < 0.001; higher mean and axial diffusivity, <i>p</i> < 0.01) was found, with lower microstructural variables in the infiltration (vs. dislocation) group. Significant decreases immediately post-surgery vs. pre-surgery mainly occurred in lexico-semantics (<i>p</i> < 0.001), with significant improvements at follow-up in all the tests (<i>p</i> < 0.01 to <i>p</i> < 0.001), despite values in the range of 44% to 47.82% of patients with below cut-off scores regarding naming verbs and making visual lexical decisions. The status of left and right IFOFs is predictive of a decrease in immediate post-surgery performance for several tests (<i>p</i> < 0.05); similarly, it is predictive of better recovery in the follow-up performance for naming nouns, naming verbs, making phonological fluency lexical decisions, and the token test (<i>p</i> < −0.05). For the ROC analysis, a significant result was obtained for the verb-naming test, with a cut-off of 79%. Conclusions: This study supports the role of the predictive value of pre-operative tractography for assessing the immediate post-operative result and at follow-up the risk of developing a cognitive deficit. |
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| ISSN: | 1198-0052 1718-7729 |