Correlation between brain functional connectivity and neurocognitive function in patients with left frontal glioma.

The association between neurocognitive function (NCF) impairment and brain cortical functional connectivity in glioma patients remains unclear. The correlations between brain oscillatory activity or functional connectivity and NCF measured by the Wechsler Adult Intelligence Scale full-scale intelligence quotient scores (WAIS FSIQ), the Wechsler Memory Scale-revised general memory scores (WMS-R GM), and the Western aphasia battery aphasia quotient scores (WAB AQ) were evaluated in 18 patients with left frontal glioma using resting-state electroencephalography (EEG). Current source density (CSD) and lagged phase synchronization (LPS) were analyzed using exact low-resolution electromagnetic tomography (eLORETA). Although 2 and 2 patients scored in the borderline range of WAIS FSIQ and WMS-R GM, respectively, the mean WAIS FSIQ, WMS-R GM, and WAB AQ values of all patients were within normal limits, and none had aphasia. In the correlation analysis, lower WMS-R GM was associated with a higher LPS value between the right anterior prefrontal cortex and the left superior parietal lobule in the beta1 band (13-20 Hz, R = - 0.802, P = 0.012). These findings suggest that LPS evaluated by scalp EEG is associated with memory function in patients with left frontal glioma and mild NCF disorders.

Intraoperative hand strength as an indicator of consciousness during awake craniotomy: a prospective, observational study.

Awake craniotomy enables mapping and monitoring of brain functions. For successful procedures, rapid awakening and the precise evaluation of consciousness are required. A prospective, observational study conducted to test whether intraoperative hand strength could be a sensitive indicator of consciousness during the awake phase of awake craniotomy. Twenty-three patients who underwent awake craniotomy were included. Subtle changes of the level of consciousness were assessed by the Japan Coma Scale (JCS). The associations of hand strength on the unaffected side with the predicted plasma concentration (Cp) of propofol, the bispectral index (BIS), and the JCS were analyzed. Hand strength relative to the preoperative maximum hand strength on the unaffected side showed significant correlations with the Cp of propofol (ρ = - 0.219, p = 0.007), the BIS (ρ = 0.259, p = 0.002), and the JCS (τ = - 0.508, p = 0.001). Receiver operating characteristic curve analysis for discriminating JCS 0-1 and JCS ≥ 2 demonstrated that the area under the curve was 0.76 for hand strength, 0.78 for Cp of propofol, and 0.66 for BIS. With a cutoff value of 75% for hand strength, the sensitivity was 0.76, and the specificity was 0.67. These data demonstrated that hand strength is a useful indicator for assessing the intraoperative level of consciousness during awake craniotomy.

Assessment of neurocognitive function in association with WHO grades in gliomas.

OBJECTIVE: High-grade gliomas are fast-growing and may exhibit more severe neurocognitive function (NCF) decline compared with low-grade gliomas. A comprehensive understanding of the NCF in patients with glioma may be critical for developing effective glioma treatments and rehabilitation interventions. This study evaluated NCF more comprehensively in patients with glioma using the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) and the Wechsler Memory Scale-Revised (WMS-R), and also determined the differences in NCF in relation with the WHO grades of gliomas. METHODS: Thirty-five patients with newly diagnosed glioma were reviewed in the present study. The patients were divided into three groups, Grade II, III, and IV, based on the World Health Organization's classification of tumors of the central nervous system. NCF was assessed using the WAIS-III and WMS-R. RESULTS: There were 14 (40.0%), 7 (20.0%), and 14 (40.0%) patients in the grade II, grade III, and grade IV groups, respectively. The results of the Kruskal-Wallis test showed significant differences in all the scores of the WAIS-III and WMS-R between grade II and grade IV. The scores of the WAIS-III and WMS-R in grade IV patients were borderline for NCF disorders, except in the attention/concentration domain. On the other hand, grade II and III groups had normal scores. CONCLUSION: Therefore, patients with a grade IV glioma presented NCF decline compared to grade II and III glioma. In contrast, the results of the WAIS-III and WMS-R indicated that the NCF of patients with grades II and III glioma was intact.

Finger sensory impairment after elbow flexion reconstruction using concomitant nerve transfer from the median and ulnar nerves.

PURPOSE: Single and double fascicular nerve transfer using the ulnar or median nerve is performed to restore elbow flexion following injuries to the brachial plexus or nerve root. However, little is known regarding the postoperative changes involved in the sensory alteration of the hand after a single and double fascicular nerve transfer. We evaluated the sensory alteration of the hand in patients who underwent single and double fascicular nerve transfer for two years. METHODS: A total of five patients that underwent single or double fascicular nerve transfer participated in this study. The injury mechanism was avulsion (n = 2), stretching (n = 1), open injury (n = 1), and compression (n = 1). The touch sensation of the index and the little fingers before surgery at 6 months, 1 year, and 2 years after nerve transfer was evaluated using the Semmes-Weinstein monofilaments test (SWM-t). Muscle strength of the elbow flexion and the wrist flexion was evaluated. RESULTS: The touch sensation of the index finger at 24 months was equal to the preoperative evaluation. On the other hand, the touch sensation of the little finger at 24 months slightly improved compared to what it had been at the preoperative evaluation. Moreover, the median of the SWM-t score in the index and little finger at 24 months after surgery was beyond 3.61 that mean diminished light touch level. CONCLUSIONS: The results of this study indicate that the touch sensory deficit of the index and little fingers persist for up to 2 years after nerve transfer.