Cognitive function, quality of life and functional brain networks : before and after glioma surgery

Sammanfattning: 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.