The impact of patient factors and tumor characteristics on language neuroplasticity in left hemispheric diffuse gliomas prior to surgical resection

Wei-Han Chang; Kuo-Chen Wei; Pin-Yuan Chen; Yi-Chun Chen; Yah-Yuan Wu; Hong-Chieh Tsai; Mei-Hui Chen; Yi-Ping Chao; Ko-Ting Chen

doi:10.1007/s11060-023-04311-9

The impact of patient factors and tumor characteristics on language neuroplasticity in left hemispheric diffuse gliomas prior to surgical resection

J Neurooncol. 2023 May;163(1):95-104. doi: 10.1007/s11060-023-04311-9. Epub 2023 Apr 24.

Authors

Wei-Han Chang^{1

2

3}, Kuo-Chen Wei^{4

5

6}, Pin-Yuan Chen^{5

7

6}, Yi-Chun Chen^{8

9}, Yah-Yuan Wu^{8

9}, Hong-Chieh Tsai¹⁰, Mei-Hui Chen¹¹, Yi-Ping Chao¹², Ko-Ting Chen^{13

14

15

16}

Affiliations

¹ School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.
² Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Keelung, New Taipei, Taiwan.
³ Department of Nutrition and Health Sciences, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
⁴ Department of Neurosurgery, New Taipei Municipal TuCheng Hospital, Chang Gung Medical Foundation, New Taipei, Taiwan.
⁵ School of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁶ Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
⁷ Department of Neurosurgery, Chang Gung Memorial Hospital at Keelung, New Taipei, Taiwan.
⁸ Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
⁹ Dementia Center, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.
¹⁰ Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan, 33305, Taiwan.
¹¹ Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
¹² Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan.
¹³ School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan. chenkoting@gmail.com.
¹⁴ School of Medicine, Chang Gung University, Taoyuan, Taiwan. chenkoting@gmail.com.
¹⁵ Department of Neurosurgery, Chang Gung Memorial Hospital at Linkou, No. 5, Fuxing Street, Guishan Dist., Taoyuan, 33305, Taiwan. chenkoting@gmail.com.
¹⁶ Neuroscience Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan. chenkoting@gmail.com.

PMID: 37093525
DOI: 10.1007/s11060-023-04311-9

Abstract

Purpose: Language networks are reorganized during glioma growth, leading to varying language performance in patients with gliomas located in or around language-eloquent areas. Therefore, pre-treated language performance reflects the neuroplasticity potential. Different domains of language processing, such as speech expression, repetition, and comprehension, involving different neural networks. We analyzed the effects of patient factors and tumor characteristics on the pre-treated performance to investigate neuroplastic potential of different language domains.

Methods: Patient age, sex, education level, tumor grade, language pathway involvement, T1 contrast enhanced (C+), and FLAIR (T2) volume were selected as variables. The correlation with abnormal language performance was verified using univariate and multivariate logistic regression.

Results: In total, 104 left hemispheric glioma patients were enrolled in this study. 44% of patients had repetitive abnormalities, 34.9% had comprehensive abnormalities, and 32.1% had expressive abnormalities. The proportion of normal language performance was 60% in grade 2 and 3 gliomas and 16% in grade 4 gliomas. Tumor grade (p = 0.006) and T2 volume (p = 0.008) were associated with abnormal performance in the expressive domain, education level (p = 0.004) and T1 C+ volume (p = 0.049) in the repetitive domain, and education level (p = 0.013), T2 volume (p = 0.011), and tumor grade (p = 0.089) in the comprehensive domain.

Conclusion: Different clinical and radiological factors affected the abnormal performance of the three language domains, indicating their functional connectivity and neuroplastic potential are inherently varied. The dynamic interactions between patient factors, tumor characteristics, and language processing should be considered when resecting left hemispheric gliomas.

Keywords: Arcuate fasciculus; Diffuse glioma; Language; Neuroplasticity; Superior longitudinal fasciculus.

MeSH terms

Brain Mapping
Brain Neoplasms* / pathology
Glioma* / pathology
Humans
Language
Neurosurgical Procedures
Speech