199 Distinct Connectomic Features Associate With Neurocognitive Function and Functional Independence Following Resection of Eloquent Gliomas

INTRODUCTION: Decline in neurocognitive functioning (NCF) is common following resection of eloquent gliomas, which can impact ability to independently perform activities of daily living. While data suggest that surgically-induced alterations in the functional connectome contribute to these outcomes, it is unclear if neurocognition and independence share underlying connectomic correlates. METHODS: Fifteen patients with left perisylvian glioma underwent resting-state fMRI and neuropsychological evaluation with formal neurocognitive function (NCF) testing and functional independence measured using the Instrumental Activities of Daily Living scale (IADL). Graph theoretical analysis was used to calculate functional brain connectivity properties. RESULTS: Need for assistance and at least mild decline were seen in IADL and NCF scores in a majority of patients (80% and 87%, respectively). There were significant correlations between outcomes on IADL activities and NCF tests, such as Financial Management and Delayed Recall Memory, Processing Speed, Phonemic Verbal Fluency, and Block Design. Increases in IADL Total scores (reduced independence) were significantly associated with increase in the Local Efficiency (p=.002) and Clustering Coefficient measures (p=.022). Significant inverse associations (p < .05) were observed in betweeness centrality and assortativity properties and NCF testing of language, executive functioning, and learning and memory. KPS, manual dexterity, tumor volume, or extent of resection did not correlate significantly with connectivity features. CONCLUSIONS: While intuitively NCF and functional independence share underlying neural mechanisms, the connectomic features associated with decline differed across these aspects of patient functioning. Functional independence outcomes correlated with features of segregation (clustering coefficient and local efficiency), while NCF outcomes correlated with centrality and assortativity (“hubness”). This may suggest that patient independence not only relies on specific isolated neurocognitive functions, but also the coordinated integration of various cognitive domains.