A Longitudinal Multimodal Imaging Study in Patients with Temporo-Insular Diffuse Low-Grade Tumors: How the Inferior Fronto-Occipital Fasciculus Provides Information on Cognitive Outcomes

Abstract

Background: Tractography allows the in vivo study of subcortical white matter, and it is a potential tool for providing predictive indices on post-operative outcomes. We aim at establishing whether there is a relation between cognitive outcome and the status of the inferior fronto-occipital fasciculus’s (IFOF’s) microstructure. Methods: The longitudinal neuropsychological data of thirty young (median age: 35 years) patients operated on for DLGG in the left temporo-insular cortex along with pre-surgery tractography data were processed. Results: A degraded integrity of the left (vs. right) IFOF (lower fractional anisotropy and length, p p p p p p p < −0.05). For the ROC analysis, a significant result was obtained for the verb-naming test, with a cut-off of 79%. Conclusions: This study supports the role of the predictive value of pre-operative tractography for assessing the immediate post-operative result and at follow-up the risk of developing a cognitive deficit.

Keywords

• predictive value
• lower-grade gliomas
• inferior fronto-occipital fasciculus
• microstructure analysis
• fiber tracking
• neuropsychology