Early recovery of cognition and brain plasticity after surgery in children with low-grade frontal lobe tumors

• Published in: Frontiers in pediatrics Vol. 11; p. 1127098
• Main Authors: Zheng, Wenjian, Guan, Xueyi, Zhang, Xianchang, Gong, Jian
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 10.03.2023
• Subjects: Brain plasticity; Brain tumor; Cognition; DTI; Pediatrics; rsfMRI; Brain tumor; DTI; Brain plasticity; Cognition; rsfMRI
• ISSN: 2296-2360; 2296-2360
• DOI: 10.3389/fped.2023.1127098

Low-grade frontal lobe tumors (LGFLT) can be cured through total resection, but surgical trauma could impair higher-order cognitive function. We aim to characterize the short-term natural cognitive recovery and brain plasticity in surgically-treated pediatric patients with LGFLT. Ten pediatric patients with LGFLT were enrolled. Their cognitive function was assessed before the surgery (S0), in the first month post-surgery (S1), and 3-6 months post-surgery (S2), using the CNS Vital Signs battery. DTI and rs-fMRI were performed during the same time periods. Changes of cognition and image metrics between S1>S0 and S2>S1 were analyzed. The Motor Speed (MotSp) and Reaction Time (RT) scores significantly decreased in S1 and recovered in S2. Rs-fMRI showed decreased functional connectivity (FC) between the bilateral frontal lobes and bilateral caudates, putamina, and pallidi in S1>S0 (voxel threshold , cluster threshold ). In S2>S1, FC recovery was observed in the neighboring frontal cortex areas ( , ). Among them, the FC in the caudates-right inferior frontal gyri was positively correlated to the RT ( ). A DTI Tract-based spatial statistics (TBSS) analysis showed decreased fractional anisotropy and axial diffusivity mainly in the corticospinal tracts, cingulum, internal capsule, and external capsule at 0-6 months post-surgery (TFCE- ). The DTI metrics were not associated with the cognitive data. Processing speed impairment after an LGFLT resection can recover naturally within 3-6 months in school-age children. Rs-fMRI is more sensitive to short-term brain plasticity than DTI TBSS analysis. "Map expansion" plasticity in the frontal-basal ganglia circuit may contribute to the recovery.