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Functional connectivity of the sensorimotor network before and after surgery in the supplementary motor area
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.ORCID iD: 0000-0002-9877-2417
Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Medical and Translational Biology.ORCID iD: 0000-0002-1407-9288
Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Wallenberg Centre for Molecular Medicine at Umeå University (WCMM). Umeå University, Faculty of Medicine, Department of Medical and Translational Biology. Aging Research Center, Karolinska Institutet, Sweden; Stockholm University, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Medical and Translational Biology.ORCID iD: 0000-0003-4743-6365
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2024 (English)In: Neuropsychologia, ISSN 0028-3932, E-ISSN 1873-3514, Vol. 204, article id 109004Article in journal (Refereed) Published
Abstract [en]

After resective glioma surgery in the Supplementary Motor Area (SMA), patients often experience a transient disturbance of the ability to initiate speech and voluntary motor actions, known as the SMA syndrome (SMAS). It has been proposed that enhanced interhemispheric functional connectivity (FC) within the sensorimotor system may serve as a potential mechanism for recovery, enabling the non-resected SMA to assume the function of the resected region. The purpose of the present study was to investigate the extent to which changes in FC can be observed in patients after resolution of the SMAS.

Eight patients underwent resection of left SMA due to suspected gliomas, resulting in various levels of the SMA syndrome. Resting-state functional MR images were acquired prior to the surgery and after resolution of the syndrome.

At the group level we found an increased connectivity between the unaffected (right) SMA and the primary motor cortex on the same side following surgery. However, no significant increase in interhemispheric connectivity was observed.

These findings challenge the prevailing notion that increased interhemispheric FC serves as the only mechanism underlying recovery from SMA syndrome and suggest the presence of one or more alternative mechanisms.

Place, publisher, year, edition, pages
Elsevier, 2024. Vol. 204, article id 109004
Keywords [en]
Glioma, Supplementary motor area, SMA, Interhemispheric connectivity, Functional imaging
National Category
Neurosciences
Research subject
Neurosurgery
Identifiers
URN: urn:nbn:se:umu:diva-206849DOI: 10.1016/j.neuropsychologia.2024.109004ISI: 001325130500001PubMedID: 39299453Scopus ID: 2-s2.0-85204550323OAI: oai:DiVA.org:umu-206849DiVA, id: diva2:1751564
Funder
Region VästerbottenSjöberg FoundationCancerforskningsfonden i NorrlandAvailable from: 2023-04-18 Created: 2023-04-18 Last updated: 2024-10-14Bibliographically approved
In thesis
1. Cognitive function, quality of life and functional brain networks: before and after glioma surgery
Open this publication in new window or tab >>Cognitive function, quality of life and functional brain networks: before and after glioma surgery
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Kognitiv funktion, livskvalitet och funktionella nätverk i hjärnan : före och efter gliomkirurgi
Abstract [en]

The aim of this thesis was to investigate how cognitive function and quality of life are affected by glioma surgery in the supplementary motor area (SMA) and the lower primary motor cortex (M1), as well as to explore possible changes in functional network connectivity after surgery in the SMA.

Sixteen patients subject to resective neurosurgical procedures due to gliomas in either the SMA or the M1 were studied. Neuropsychological tests, Quality of Life (QoL) questionnaires and resting state functional magnetic imaging sequences were administered before surgery and at follow-up. Neuropsychological testing was also performed 1-2 days after SMA resection.

SMA resections were associated with significant but transient impairments of cognitive control. However, subjective sense of volition and long-term perception of QoL remained intact. Changes in interhemispheric connectivity in the sensorimotor network after SMA resections were variable between patients and non-significant at the group level. Resections of the lower M1 were associated with a slight impairment of maximal speech speed but not with clinically significant declines in QoL or cognitive function. 

Glioma resections in the SMA and lower M1 may affect aspects of cognitive and motor function. However, thanks to the brain’s capacity for functional reorganization and compensation this will typically not cause permanent and significant negative effects on cognitive function or QoL.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2023. p. 66
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2243
Keywords
Glioma, Neuropsychology, Neurosurgery, Quality of life, Supplementary Motor Area, Primary motor area. rsfMRI, fMRI
National Category
Neurology Neurosciences
Research subject
Neurosurgery; Oncology
Identifiers
urn:nbn:se:umu:diva-206831 (URN)978-91-8070-018-4 (ISBN)978-91-8070-019-1 (ISBN)
Public defence
2023-05-15, R -1, Hörsal E04, Byggnad 6E, Umeå Universitetssjukhus, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2023-04-24 Created: 2023-04-18 Last updated: 2023-04-24Bibliographically approved

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Stålnacke, MattiasEriksson, JohanSalami, AlirezaAndersson, MicaelNyberg, LarsSjöberg, Rickard L

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Stålnacke, MattiasEriksson, JohanSalami, AlirezaAndersson, MicaelNyberg, LarsSjöberg, Rickard L
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NeurosciencesUmeå Centre for Functional Brain Imaging (UFBI)Department of Medical and Translational BiologyWallenberg Centre for Molecular Medicine at Umeå University (WCMM)Department of Diagnostics and Intervention
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Neuropsychologia
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