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• W2955396516 abstract "Immunohistochemical data based on isocitrate-dehydrogenase mutation (IDH) status have redefined glioma as a whole brain disease, while occult tumor cell invasion along white matter fibers is inapparent in conventional MRI. The functional and prognostic impact of focal glioma may however relate to the extent of white matter involvement. We used diffusion tensor imaging (DTI) to investigate microstructural characteristics of whole brain normal appearing white matter (NAWM) in relation to cognitive functions as potential surrogates for occult white matter involvement in glioma. 20 patients (12 IDH-mutated) and 20 individually matched controls were preoperatively examined using DTI combined with a standardized neuropsychological examination. Tumor lesions including perifocal edema were masked, and fractional anisotropy (FA) as well as mean-, radial- and axial diffusivity (MD, RD, AD) were determined of the remaining whole brain NAWM by using Tract-based Spatial Statistics and histogram analyses. The relationship between extratumoral white matter integrity and cognitive performance was examined using partial correlation analyses controlling for age, education and lesion volumes. In patients, mean FA and AD was decreased as compared to controls, which agrees with the notion of microstructural impairment of NAWM in glioma patients. Patients performed worse in all cognitive domains tested, and higher anisotropy and lower MD and RD values of NAWM were associated with better cognitive performance. In additional analyses, IDH-mutated and IDH-wildtype patients were compared. Patients with IDH-mutation showed higher FA, but lower MD, AD and RD values as compared to IDH-wildtype patients, suggesting a better preserved microstructural integrity of NAWM, which may relate to a less infiltrative nature of IDH-mutated gliomas. Diffusion-based phenotyping and monitoring microstructural integrity of extratumoral whole brain NAWM may aid in estimating occult white matter involvement and should be considered as complementary biomarker in glioma." @default.
• W2955396516 created "2019-07-12" @default.
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• W2955396516 date "2019-06-26" @default.
• W2955396516 modified "2023-09-25" @default.
• W2955396516 title "Diffusion Tensor Imaging Reveals Microstructural Heterogeneity of Normal-Appearing White Matter and Related Cognitive Dysfunction in Glioma Patients" @default.
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• W2955396516 doi "https://doi.org/10.3389/fonc.2019.00536" @default.
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