Open Access

Xenia Hautmann, Carolin Weiss Lucas, Ralf-Ingo Ernestus, Roland Goldbrunner, Stefan Rückriegel

• Patients with high-grade gliomas frequently suffer from neurocognitive decline caused by damage to the connectome. The corpus callosum (CC) is the largest fiber bundle in the human brain. It qualifies to identify decline in white matter integrity (WMI) correlating with neuroginitive functioning. We hypothesize a deterioration of WMI and neuropsychological parameters (NP) after resection due to injury of fiber bundles. Methods 16 patients with high-grade gliomas underwent MRI with DTI within one week before and within 48 hours after resection. We used the software FSL (FMRIB Software Library, Oxford) to determine fractional anisotropy (FA) in three standardized volumes of the CC. NP testing was performed within one week before and after surgery. We conducted a Spearman's correlation between FA and NP parameters. Changes in FA and NP parameters after surgery were analyzed using a paired t-test. Results There was deterioration of WMI in the rostrum in 7 patients, in the truncus in 10Patients with high-grade gliomas frequently suffer from neurocognitive decline caused by damage to the connectome. The corpus callosum (CC) is the largest fiber bundle in the human brain. It qualifies to identify decline in white matter integrity (WMI) correlating with neuroginitive functioning. We hypothesize a deterioration of WMI and neuropsychological parameters (NP) after resection due to injury of fiber bundles. Methods 16 patients with high-grade gliomas underwent MRI with DTI within one week before and within 48 hours after resection. We used the software FSL (FMRIB Software Library, Oxford) to determine fractional anisotropy (FA) in three standardized volumes of the CC. NP testing was performed within one week before and after surgery. We conducted a Spearman's correlation between FA and NP parameters. Changes in FA and NP parameters after surgery were analyzed using a paired t-test. Results There was deterioration of WMI in the rostrum in 7 patients, in the truncus in 10 patients and in the splenium in 7 patients. In patients with edema but no infiltration of the CC (n=7) FA declined significantly in the rostrum (p=.005). There was significant decline in visuospatial reconstruction abilities (ROCF) (p=0.0253), Trail-Making-Test (TMT) (p=0.0.0298), 9-Hole-Pegboard Test (p=0.0179) and Hopkins Verbal Learning and Memory Test (HVLT) (p=0.0.0117) after surgery. Preoperatively, FA in the rostrum correlated with the TMT and lexical fluency test, FA in the truncus correlated with HVLT, and FA in the splenium with Digit Symbol Modality Test. Postoperatively, FA in the truncus correlated with HVLT and Stroop Color Word Test, and FA in the splenium with HVLT and ROCF. Conclusions We observed significant deteriorations in transcallosal fiber integrity during the short-term postoperative course, which correlated with declines in visuospatial/constructive abilities, learning and memory, as well as executive functions in this small patient cohort.…