BOLD Coupling between Lesioned and Healthy Brain Is Associated with Glioma Patients’ Recovery
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MDPI
Materia
Global signal Brain tumours Functional MRI Neurosurgery Cognitive recovery
Date
2021Referencia bibliográfica
Romero-Garcia, R.; Hart, M.G.; Bethlehem, R.A.I.; Mandal, A.; Assem, M.; Crespo-Facorro, B.; Gorriz, J.M.; Burke, G.A.A.; Price, S.J.; Santarius, T.; et al. BOLD Coupling between Lesioned and Healthy Brain Is Associated with Glioma Patients’ Recovery. Cancers 2021, 13, 5008. https://doi.org/10.3390/ cancers13195008
Sponsorship
Guarantors of Brain, Cancer Research UK Cambridge Centre, The Brain Tumour Charity; EMERGIA Junta de Andalucia program; Royal Society Dorothy Hodgkin Research Fellowship (DHF130100); e Ciencia e Innovación (España)/FEDER under the RTI2018-098913-B100 project, by the Consejería de Economía, Innovación, Ciencia y Empleo (Junta de Andalucía) and FEDER under CV20-45250, A-TIC-080-UGR18, B-TIC-586-UGR20 and P20-00525 projects; Cambridge Trust—Yousef Jameel Scholarship; NIHR Cambridge Biomedical Research Centre (BRC-1215-20014); National Institute for Health Research (NIHR)Abstract
Glioma, a type of brain tumour, affects not only the function of immediately
adjacent brain tissue but also that in more distant areas, potentially impacting cognitive function after
its surgical removal. Here, 17 patients with glioma had brain scans and tests of cognitive function
during treatment and recovery. We investigated the effects of glioma on the brain, and what happens
during recovery, using the brain’s “global signal” detected with magnetic resonance imaging (MRI).
We found that the signal from gliomas was synchronised with the global signal in all patients and
that this synchronisation was associated with the recovery of cognition after surgery. Specifically,
patients with a greater reduction in glioma–global signal synchronisation following surgery were
more likely to have a larger number of newly acquired cognitive difficulties. Together, these results
suggest that the interaction between gliomas and the brain can predict how patients recover their
cognitive abilities, which is important for their quality of life. Predicting functional outcomes after surgery and early adjuvant treatment is difficult due
to the complex, extended, interlocking brain networks that underpin cognition. The aim of this
study was to test glioma functional interactions with the rest of the brain, thereby identifying the
risk factors of cognitive recovery or deterioration. Seventeen patients with diffuse non-enhancing
glioma (aged 22–56 years) were longitudinally MRI scanned and cognitively assessed before and
after surgery and during a 12-month recovery period (55 MRI scans in total after exclusions). We
initially found, and then replicated in an independent dataset, that the spatial correlation pattern
between regional and global BOLD signals (also known as global signal topography) was associated
with tumour occurrence. We then estimated the coupling between the BOLD signal from within
the tumour and the signal extracted from different brain tissues. We observed that the normative
global signal topography is reorganised in glioma patients during the recovery period. Moreover,
we found that the BOLD signal within the tumour and lesioned brain was coupled with the global signal and that this coupling was associated with cognitive recovery. Nevertheless, patients did
not show any apparent disruption of functional connectivity within canonical functional networks.
Understanding how tumour infiltration and coupling are related to patients’ recovery represents a
major step forward in prognostic development.