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@ARTICLE{Kocher:877231,
author = {Kocher, Martin and Jockwitz, Christiane and Caspers, Svenja
and Schreiber, Jan and Farrher, Ezequiel and Stoffels,
Gabriele and Filss, Christian and Lohmann, Philipp and
Tscherpel, Caroline and Ruge, Maximilian I. and Fink, Gereon
R. and Shah, Nadim J. and Galldiks, Norbert and Langen,
Karl-Josef},
title = {{R}ole of the default mode resting-state network for
cognitive functioning in malignant glioma patients following
multimodal treatment},
journal = {NeuroImage: Clinical},
volume = {27},
issn = {2213-1582},
address = {[Amsterdam u.a.]},
publisher = {Elsevier},
reportid = {FZJ-2020-02058},
pages = {102287 -},
year = {2020},
abstract = {Progressive cognitive decline following multimodal
neurooncological treatment is a common observation in
patients suffering from malignant glioma. Alterations of the
default-mode network (DMN) represent a possible source of
impaired neurocognitive functioning and were analyzed in
these patients.Eighty patients (median age, 51 years) with
glioma (WHO grade IV glioblastoma, n=57; WHO grade III
anaplastic astrocytoma, n=13; WHO grade III anaplastic
oligodendroglioma, n=10) and ECOG performance score 0-1
underwent resting-state functional MRI (rs-fMRI) and
neuropsychological testing at a median interval of 13 months
(range, 1-114 months) after initiation of therapy. For
evaluation of structural and metabolic changes after
treatment, anatomical MRI and amino acid PET using
O-(2-[18F]fluoroethyl)-L-tyrosine (FET) were simultaneously
acquired to rs-fMRI on a hybrid MR/PET scanner. A cohort of
80 healthy subjects matched for gender, age, and educational
status served as controls.The connectivity pattern within
the DMN (12 nodes) of the glioma patients differed
significantly from that of the healthy subjects but did not
depend on age, tumor grade, time since treatment initiation,
presence of residual/recurrent tumor, number of chemotherapy
cycles received, or anticonvulsive medication. Small changes
in the connectivity pattern were observed in patients who
had more than one series of radiotherapy. In contrast,
structural tissue changes located at or near the tumor site
(including resection cavities, white matter lesions, edema,
and tumor tissue) had a strong negative impact on the
functional connectivity of the adjacent DMN nodes, resulting
in a marked dependence of the connectivity pattern on tumor
location. In the majority of neurocognitive domains, glioma
patients performed significantly worse than healthy
subjects. Correlation analysis revealed that reduced
connectivity in the left temporal and parietal DMN nodes was
associated with low performance in language processing and
verbal working memory. Furthermore, connectivity of the left
parietal DMN node also correlated with processing speed,
executive function, and verbal as well as visual working
memory. Overall DMN connectivity loss and cognitive decline
were less pronounced in patients with higher
education.Personalized treatment strategies for malignant
glioma patients should consider the left parietal and
temporal DMN nodes as vulnerable regions concerning
neurocognitive outcome.},
cin = {INM-4 / INM-1 / INM-3},
ddc = {610},
cid = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)INM-1-20090406 /
I:(DE-Juel1)INM-3-20090406},
pnm = {572 - (Dys-)function and Plasticity (POF3-572) / 571 -
Connectivity and Activity (POF3-571)},
pid = {G:(DE-HGF)POF3-572 / G:(DE-HGF)POF3-571},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:32540630},
UT = {WOS:000561851100004},
doi = {10.1016/j.nicl.2020.102287},
url = {https://juser.fz-juelich.de/record/877231},
}