Language reorganization after resection of low-grade gliomas: an fMRI task based connectivity study
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ORIGINAL RESEARCH
Language reorganization after resection of low-grade gliomas: an fMRI task based connectivity study Jeremy Deverdun 1,2,3 & Liesjet E. H. van Dokkum 3 & Emmanuelle Le Bars 1,2,3 & Guillaume Herbet 4,5 & Thibault Mura 6 & Benedicte D’agata 6 & Marie-Christine Picot 6 & Nicolas Menjot 1,2,3 & Francois Molino 2,3 & Hugues Duffau 4,5 & Sylvie Moritz Gasser 4,5,7
# Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Few studies addressed the evolution of brain activity before and after brain tumor resection. Using a fMRI naming task, we evaluated possible underlying plasticity phenomena. Thirty-two patients with left low-grade gliomas (16 women; age = 38.6 ± 8.31 years) and 19 healthy controls (7 women; age = 42.4 ± 12.1) were included in the study. An overt picture-naming task (DO80) was performed pre and post (3 months) surgery, as well as within the MRI in a covert manner. Exams included an injected 3DT1, a T2FLAIR, a DTI and a GE-EPI (task) sequence. Activations maps were compared with picture naming score, FA and MD maps were estimated, a VLSM analysis was performed on tumor masks, and disconnectome maps were reconstructed. Pre-surgery, the left parahippocampal gyrus (LPH) was inversely associated with task performance. Increased pre-post surgery left lingual gyrus (LLG) activity was found related to decreased picture naming performance. The evolution of left lingual gyrus (LLG) activity was negatively associated with the evolution of picture naming performance. In controls, the LPH was functionally connected to the right precentral gyrus (RPCG) and slightly to the LLG. This was not clearly retrieved in the patient group. Preoperatively, the LLG was connected to the left planum temporale and to the right lingual gyrus. The same result was found for controls. Postoperatively, the LLG was only connected to the RPCG. No association was found between evolution of FA/MD and evolution of picture naming performance. There is not one unique pattern of pre- and postoperative plasticity concerning picture-naming performance in DLGG patients. Keywords Connectivity . fMRI . Glioma . Language . Neuronal plasticity
Introduction Post-lesional plasticity corresponds to the brain’s potential to reorganize itself in case of acute or slow-growing lesions. The neural mechanisms underlying adaptive plasticity seem very efficient in patients harboring a diffuse low-grade glioma
* Jeremy Deverdun [email protected] 1
Department of Neuroradiology, Montpellier University Hospital, Gui de Chauliac Hospital, Montpellier, France
2
I2FH, Institut d’Imagerie Fonctionnelle Humaine, Montpellier University Hospital, Gui de Chauliac Hospital, Montpellier, France
3
Laboratoire Charles Coulomb, University of Montpellier, 34095 Montpellier, France
(DLGG), a slow-growing premalignant brain tumor mainly occurring in young adults (Desmurget et al. 2007; Duffau 2005). Indeed, only limited cognitive disturbances (including language disorders) are found in DLGG patients, even in case of extensive les
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