Recovery of functional connectivity of the sensorimotor network after surgery for diffuse low-grade gliomas involving the supplementary motor area.
OBJECTIVE The supplementary motor area (SMA) syndrome is a well-studied lesional model of brain plasticity involving the sensorimotor network. Patients with diffuse low-grade gliomas in the SMA may exhibit this syndrome after resective surgery. They experience a temporary loss of motor function, which completely resolves within 3 months. The authors used functional MRI (fMRI) resting state analysis of the sensorimotor network to investigate large-scale brain plasticity between the immediate postoperative period and 3 months' follow-up. METHODS Resting state fMRI was performed preoperatively, during the immediate postoperative period, and 3 months postoperatively in 6 patients with diffuse low-grade gliomas who underwent partial surgical excision of the SMA. Correlation analysis within the sensorimotor network was carried out on those 3 time points to study modifications of its functional connectivity. RESULTS The results showed a large-scale reorganization of the sensorimotor network. Interhemispheric connectivity was decreased in the postoperative period, and increased again during the recovery process. Connectivity between the lesion side motor area and the contralateral SMA rose to higher values than in the preoperative period. Intrahemispheric connectivity was decreased during the immediate postoperative period and had returned to preoperative values at 3 months after surgery. CONCLUSIONS These results confirm the findings reported in the existing literature on the plasticity of the SMA, showing large-scale modifications of the sensorimotor network, at both inter- and intrahemispheric levels. They suggest that interhemispheric connectivity might be a correlate of SMA syndrome recovery.
Departments of 1 Neurosurgery and.|Neuroradiology.|Institut d'Imagerie Fonctionnelle Humaine, and.|Institut des Neurosciences de Montpellier, INSERM U1051, Centre Hospitalier Régional Universitaire de Montpellier; and.
Matthieu
M
Vassal
Neuroradiology.|Institut d'Imagerie Fonctionnelle Humaine, and.
Céline
C
Charroud
Neuroradiology.|Institut d'Imagerie Fonctionnelle Humaine, and.|Institut des Neurosciences de Montpellier, INSERM U1051, Centre Hospitalier Régional Universitaire de Montpellier; and.|Institut de Génomique Fonctionnelle, UMR 5203-INSERM U661.|Laboratoire Charles Coulomb, CNRS UMR 5221, and.
Jérémy
J
Deverdun
Neuroradiology.|Institut d'Imagerie Fonctionnelle Humaine, and.|Laboratoire Charles Coulomb, CNRS UMR 5221, and.
Emmanuelle
E
Le Bars
Institut de Génomique Fonctionnelle, UMR 5203-INSERM U661.|Laboratoire Charles Coulomb, CNRS UMR 5221, and.
François
F
Molino
Laboratoire d'Informatique, de Robotique et de Microélectronique de Montpellier, CNRS UMR5506, Université de Montpellier, Montpellier, France.
Francois
F
Bonnetblanc
Laboratoire d'Informatique, de Robotique et de Microélectronique de Montpellier, CNRS UMR5506, Université de Montpellier, Montpellier, France.
Anthony
A
Boyer
Laboratoire d'Informatique, de Robotique et de Microélectronique de Montpellier, CNRS UMR5506, Université de Montpellier, Montpellier, France.
Anirban
A
Dutta
Departments of 1 Neurosurgery and.|Institut des Neurosciences de Montpellier, INSERM U1051, Centre Hospitalier Régional Universitaire de Montpellier; and.
Guillaume
G
Herbet
Departments of 1 Neurosurgery and.|Institut des Neurosciences de Montpellier, INSERM U1051, Centre Hospitalier Régional Universitaire de Montpellier; and.
Sylvie
S
Moritz-Gasser
Neuroradiology.|Institut d'Imagerie Fonctionnelle Humaine, and.|Institut des Neurosciences de Montpellier, INSERM U1051, Centre Hospitalier Régional Universitaire de Montpellier; and.
Alain
A
Bonafé
Departments of 1 Neurosurgery and.|Institut des Neurosciences de Montpellier, INSERM U1051, Centre Hospitalier Régional Universitaire de Montpellier; and.
Hugues
H
Duffau
Neuroradiology.|Institut d'Imagerie Fonctionnelle Humaine, and.|Institut des Neurosciences de Montpellier, INSERM U1051, Centre Hospitalier Régional Universitaire de Montpellier; and.|Laboratoire Charles Coulomb, CNRS UMR 5221, and.
Nicolas Menjot
NM
de Champfleur
D000328:Adult; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D020127:Recovery of Function / Q000502:physiology*; D012146:Rest
BOLD = blood-oxygen-level dependent; DLGG = diffuse low-grade glioma; GRE-EPI = gradient echo–echo planar imaging; MNI = Montreal Neurological Institute; MP-RAGE = magnetization-prepared, rapid-acquisition gradient echo; SMA = supplementary motor area; brain mapping; fMRI = functional MRI; functional neuroimaging; glioma; magnetic resonance imaging; neuronal plasticity; oncology; paralysis