Neurocognitive and resting-state functional MRI changes in patients with diffuse gliomas after chemoradiotherapy
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
This prospective observational study employed resting-state functional MRI (rs-fMRI) to investigate network-level disturbances associated with neurocognitive function (NCF) changes in patients with gliomas following radiation therapy (RT).
Methods
Adult patients with either IDH-wildtype or IDH-mutant gliomas underwent computerized NCF testing and rs-fMRI before and 6 months after RT. NCF changes were quantified by the percent change in age-normalized composite scores from baseline (ΔNCF comp ). rs-fMRI data underwent seed-based functional connectivity (FC) analysis. Whole-brain connectivity regression analysis assessed the association between network FC changes and NCF changes, using a split-sample approach with a 26-patient training set and a 6-patient validation set, iterated 200 times. Permutation tests evaluated the significance of network selection.
Results
Between September 2020 and December 2023, 43 patients were enrolled, with 32 completing both initial and follow-up evaluations. The mean ΔNCF comp was 2.9% (SD: 13.7%), with 38% experiencing a decline. Intra-hemispheric FC remained similar between ipsilateral and contralateral hemispheres for most patients at both time points. FC changes accounted for a moderate amount of variance in NCF changes (mean R 2 : 0.301, SD: 0.249), with intra-network FC of the Parietal Memory Network (PMN-PMN, P =0.001) and inter-network FC between the PMN and the Visual Network (PMN-VN, P =0.002) as the most significant factors. Similar findings were obtained by sensitivity analyses using only the FC data from the hemisphere contralateral to the tumor.
Conclusions
Post-RT rs-fMRI changes significantly predicted NCF decline, highlighting rs-fMRI as a promising imaging biomarker for neurocognitive decline after RT.
