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Role of interhemispheric connectivity in recovery from postoperative supplementary motor area syndrome in glioma patients.
- Source :
-
Journal of neurosurgery [J Neurosurg] 2022 Dec 02; Vol. 139 (2), pp. 324-333. Date of Electronic Publication: 2022 Dec 02 (Print Publication: 2023). - Publication Year :
- 2022
-
Abstract
- Objective: Surgical resection of gliomas involving the supplementary motor area (SMA) frequently results in SMA syndrome, a symptom complex characterized by transient akinesia and mutism. Because the factors influencing patient functional outcomes after surgery remain elusive, the authors investigated network-based predictors in a multicentric cohort of glioma patients.<br />Methods: The participants were 50 patients treated for glioma located in the SMA at one of the three centers participating in the study. Postoperative functional outcomes (motor deficits, mutism) and duration of symptoms were assessed during hospitalization. Long-term outcome was assessed 3 months after surgery. MRI-based lesion-symptom mapping was performed to estimate the severity of gray matter damage and white matter disconnection.<br />Results: The median duration of acute symptoms was 3 days (range 1-42 days). Long-term deficits involving fine motor movements and speech were found at follow-up in 27 patients (54%). Disconnection of the central callosal fibers was associated with prolonged acute symptoms (p < 0.05). Postoperative mutism was significantly related to disconnection severity of the left frontopontine tract, frontal aslant tract, cingulum, and corticostriatal tract (p < 0.05). Disconnection of midposterior callosal fibers and lesion loads within the left medial Brodmann area 4 were associated with long-term motor deficits (p < 0.05).<br />Conclusions: This study provides evidence for the pathophysiology and predictive factors of postoperative SMA syndrome by demonstrating the relation of the disconnection of callosal fibers with prolonged symptom duration (central segment) and long-term motor deficits (midposterior segment). These data may be useful for presurgical risk assessment and adequate consultation for patients prior to undergoing resection of glioma located within the SMA region.
- Subjects :
- Humans
Male
Female
Adult
Middle Aged
Young Adult
Aged
Corpus Callosum surgery
Corpus Callosum diagnostic imaging
Mutism etiology
Magnetic Resonance Imaging
Adolescent
Treatment Outcome
Syndrome
Glioma surgery
Glioma diagnostic imaging
Glioma complications
Brain Neoplasms surgery
Brain Neoplasms diagnostic imaging
Postoperative Complications etiology
Motor Cortex surgery
Motor Cortex diagnostic imaging
Motor Cortex physiopathology
Recovery of Function
Subjects
Details
- Language :
- English
- ISSN :
- 1933-0693
- Volume :
- 139
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 36461815
- Full Text :
- https://doi.org/10.3171/2022.10.JNS221303