Brain Lesions Associated with Communication-Related Quality of Life Following Surgical Removal of Primary Left-Hemisphere Tumours

ABSTRACT

Background

Long-term health-related quality of life (HRQoL) is an important consideration in planning treatment for individuals with brain tumours.

Aim

The current study examined relationships between HRQoL and anatomical location of the lesion in patients 6-24 months post-surgery.

Methods

Following left-hemisphere tumour resection, 37 individuals underwent behavioural testing and MRI. A principal component analysis across 10 HRQoL measures identified two components explaining ~62% of the variance: a communication-related and a mood-related component. Three lesion maps were generated per participant capturing (1) the primary resection, (2) the resection plus residual tumour, oedema, and peri-resection treatment effect (resection+), and (3) residual tumour, oedema, and peri-resection treatment effect alone (residual). Relationships between HRQoL components and lesion maps were examined using voxel-wise lesion symptom-mapping as well as general linear models predicting tract- and voxel-wise disconnection severities.

Results

Communication-related quality of life was significantly associated with lesions comprising both the resection+ and residual tumour in the left medial inferior parietal lobe. Voxel-wise analyses of white matter disconnection severities revealed significant associations between communication-related quality of life and thalamostriatal fibres for the residual tumour lesions. None of the analyses involving mood-related quality of life or the primary resection lesion maps were significant.

Conclusions

The findings highlight the role of the residual tumour, oedema, and peri-resection treatment effects and associated white matter disconnection in communication-related quality of life following treatment.

KEYWORDS:

• brain tumours
• surgery
• quality of life
• aphasia
• neuroimaging
• white matter

Acknowledgements

We are grateful to Kori Ramajoo, Meg Brear and Trish Joseph for their assistance with data acquisition.

Disclosure of Interest

The authors report there are no competing interests to declare.

Author Contributions

Katie McMahon and Greig de Zubicaray contributed to the study conception and design. Data collection was performed by Katharine Drummond, Rosalind Jeffree, Sarah Olson, Emma Murton, and Benjamin Ong. Data processing and analysis was performed by Elaine Kearney, Sonia Brownsett, Valeriya Tolkacheva, Katie McMahon, and Greig de Zubicaray. The first draft of the manuscript was written by Elaine Kearney and all authors amended and/or commented on subsequent versions of the manuscript. All authors read and approved the final manuscript.

Data Availability Statement

The data that support the findings of this study are openly available on OSF at https://osf.io/h5s9z/.

Additional information

Funding

This study was supported by the National Health and Medical Research Council (NHMRC) [APP1079157] and Cancer Council Queensland [APP1060699]. G.A.R. was supported by a NHMRC Boosting Dementia Research Leadership Fellowship [APP1135769]. SB was supported by the NHMRC-funded Centre of Research Excellence in Aphasia Recovery and Rehabilitation [APP1153236].