• Kyle R Noll, Henry S Chen, Jeffrey S Wefel, Vinodh A Kumar, Ping Hou, Sherise D Ferguson, Ganesh Rao, Jason M Johnson, Donald F Schomer, Dima Suki, Sujit S Prabhu, and Ho-Ling Liu.
• Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
• Neurosurgery. 2021 Feb 16; 88 (3): 544551544-551.

BackgroundDecline in neurocognitive functioning (NCF) often occurs following brain tumor resection. Functional connectomics have shown how neurologic insults disrupt cerebral networks underlying NCF, though studies involving patients with brain tumors are lacking.ObjectiveTo investigate the impact of brain tumor resection upon the connectome and relationships with NCF outcome in the early postoperative period.MethodsA total of 15 right-handed adults with left perisylvian glioma underwent resting-state functional magnetic resonance imaging (rs-fMRI) and neuropsychological assessment before and after awake tumor resection. Graph theoretical analysis was applied to rs-fMRI connectivity matrices to calculate network properties. Network properties and NCF measures were compared across the pre- to postoperative periods with matched pairs Wilcoxon signed-rank tests. Associations between pre- to postoperative change in network and NCF measures were determined with Spearman rank-order correlations (ρ).ResultsA majority of the sample showed postoperative decline on 1 or more NCF measures. Significant postoperative NCF decline was found across measures of verbal memory, processing speed, executive functioning, receptive language, and a composite index. Regarding connectomic properties, betweenness centrality and assortativity were significantly smaller postoperatively, and reductions in these measures were associated with better NCF outcomes. Significant inverse associations (ρ = -.51 to -.78, all P < .05) were observed between change in language, executive functioning, and learning and memory, and alterations in segregation, centrality, and resilience network properties.ConclusionDecline in NCF was common shortly following resection of glioma involving eloquent brain regions, most frequently in verbal learning/memory and executive functioning. Better postoperative outcomes accompanied reductions in centrality and resilience connectomic measures.Copyright © 2020 by the Congress of Neurological Surgeons.

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