NCOG-17. FACTORS INFLUENCING POOR INDEPENDENCE LEVEL FOLLOWING RESECTION OF THE RIGHT TEMPORO-PARIETAL GLIOBLASTOMAS

In glioma surgeries, cognitive outcomes for the dominant hemisphere have gained much attention compared to the non-dominant hemisphere. For non-dominant hemispheric glioblastomas, we previously observed decreased independence level following glioblastoma resection of the posterior temporal to the parietal lobes. Here, we investigated the reason for the poor Karnofsky Performance Status (KPS) in such glioblastomas. A total of 41 patients with resection of the right cerebral hemispheric primary glioblastoma were enrolled for the study. Several kinds of neuropsychological functions and KPS of the brain regions were evaluated at pre- and postoperative 3 months by performing the Spearman’s correlation analysis and voxel-based lesion symptom mapping (VLSM). Additionally, the correlation between the resected volume of each gyrus or white matter tract and neuropsychological function score was analyzed. KPS at chronic phase (73.6) declined significantly compared with preoperation (81.0, p = 0.020). Functional factors influencing the KPS were general cognitive function, visuospatial cognition, emotion recognition, executive function, and apathy. The VLSM analysis revealed that the resection of the ventral parietal lobe and supramarginal gyrus (VPL-SMG) resulted in significantly poor KPS. Among the functional factors affecting KPS, VPL-SMG resection contributed to significantly lower scores in visuospatial cognition, emotion recognition, and apathy than those without resection (p = 0.0045, 0.047, and 0.0002, respectively). Further, we investigated whether the damage of the VPL-SMG could result in KPS related functional deficit. We found visuospatial cognition related to the posterior occipital lobe, SMG, arcuate fasciculus (AF), and dorsal superior longitudinal fasciculus, emotion recognition to the middle to inferior occipital gyrus and AF, and apathy to the inferior parietal lobe and middle temporal gyrus. We concluded that deficits of visuospatial cognition, emotion recognition, and apathy due to the damage of the cortical and white matter areas, including the VPL-SMG, were responsible for KPS of the non-dominant hemispheric glioblastomas.

Visualizations

Visualizations (i.e., thinking in images internally in the human mind) or externally expressing a concept via graphical means—such as documenting an observation in a hand-drawn or digital visuospatial sketch, or creating a visual output from data—have always been an integral part of scientific inquiry and communication. One might argue that the ‘graphy’ part of ‘geography’ refers to visually and spatially (i.e., visuospatially) documenting the world. For the vast majority of people, a significant part of human experience is shaped by sight, and the human visual system occupies a large chunk of human cognitive processing capacity. Given that, one can speculate that comprehension and communication through visuospatial means could be ‘second nature’ to people. There is ample evidence to support this line of thinking: As opposed to written words or a large list of numbers, visualizations allow us to see patterns and anomalies quickly, sometimes even at a glance. However, the power of visualizations depends on a number of factors including the details of their design, the abilities and background of the human viewing them, and the context in which a visualization is used. This power must also be critically viewed from an ethics perspective. These three factors are elaborated under various subsections. However, first, a fundamental question needs to be asked: Is visualization a product or a process? The word visualization is commonly used as a noun for a visual product (e.g., a map or a plot is a visualization). However, both mental and external visualizations are processes, and the term ‘visualization’ as it was introduced into scientific discourse refers to a process. The process aspect is important to remember, because this is viewed as a key factor that distinguishes using visualizations to explain what is already known versus exploring the unknown. With the latter activity, visualizing things becomes a part of the scientific inquiry as an active tool that helps build hypotheses and thus facilitate thinking and reasoning, in addition to explaining what is already known. Whether the goal is to explain or to explore, the design and use of visualizations needs to be intentional and not arbitrary. To create and read visualizations intentionally, a certain level of visual literacy built on design, technology, and knowledge of human visuospatial cognition is necessary. This manuscript identifies scholarly resources to help all scientists and aspiring scientists, especially those in spatial sciences, to build, refresh their knowledge of, and learn or teach about visualizations.

An analytical approach to visuospatial cognition: What can neurodevelopmental disorders tell us about developmental pathways?

To appear in: “Taking development seriously: Neuroconstructivism and the multi-disciplinary approach to understanding the emergence of mind.A Festschrift for Annette Karmiloff-Smith”Editors: Michael S. C. Thomas, Denis Mareschal, and Victoria Knowland

The Cerebellar Cognitive Affective/Schmahmann Syndrome: a Task Force Paper

Sporadically advocated over the last two centuries, a cerebellar role in cognition and affect has been rigorously established in the past few decades. In the clinical domain, such progress is epitomized by the “cerebellar cognitive affective syndrome” (“CCAS”) or “Schmahmann syndrome.” Introduced in the late 1990s, CCAS reflects a constellation of cerebellar-induced sequelae, comprising deficits in executive function, visuospatial cognition, emotion–affect, and language, over and above speech. The CCAS thus offers excellent grounds to investigate the functional topography of the cerebellum, and, ultimately, illustrate the precise mechanisms by which the cerebellum modulates cognition and affect. The primary objective of this task force paper is thus to stimulate further research in this area. After providing an up-to-date overview of the fundamental findings on cerebellar neurocognition, the paper substantiates the concept of CCAS with recent evidence from different scientific angles, promotes awareness of the CCAS as a clinical entity, and examines our current insight into the therapeutic options available. The paper finally identifies topics of divergence and outstanding questions for further research.

Sex Similarities and Differences in Intelligence in Children Aged Two to Eight: Analysis of SON-R 2–8 Scores

The aim of this study was to investigate sex similarities and differences in visuospatial and fluid abilities and IQ scores based on those abilities in children aged two to eight. Standardization data from the Snijders-Oomen Nonverbal Intelligence Test for Children aged 2–8 (SON-R 2–8) were used. A representative sample composed of 965 children from the Netherlands and 762 children from Germany was examined. Small but significant mean sex differences favoring girls were observed until age four. At ages six and seven, boys achieved similar cognitive development levels to girls regarding all abilities assessed and outperformed girls on the Mosaics subtest measuring visuospatial cognition. Boys also displayed higher variability rates in performance. The distribution of IQ scores, with the overrepresentation of girls scoring above mean and the overrepresentation of boys scoring below mean in early childhood, altered with age towards parity between the sexes. The results suggest that girls tend to mature earlier with respect to cognitive abilities. During the course of development, however, the differences between girls and boys may become negligible.

Glioma surgery under awake condition can lead to good independence and functional outcome excluding deep sensation and visuospatial cognition

Background Awake surgery for the eloquent cortex is a common strategy for glioma surgery. Although a recent emphasis has been placed on awake surgery both for dominant and nondominant cerebral hemispheres to preserve neurological/neuropsychological functions, those functional outcomes are not well investigated because few studies have focused on the longitudinal recovery process. This study explored the outcome of neurological/neuropsychological functions following awake surgery until the chronic phase. Methods A total of 87 patients with glioma who underwent awake surgery were included, and of these 66 patients matched our inclusion criteria. Each patient was assessed for neurological/neuropsychological functions before surgery, as well as acute and chronic phase. Additionally, scores for the KPS were collected. Results Almost all functions recovered within 3 months postoperatively, even when transient deficits were observed in the acute phase; however, deep sensory perception deficits and visuospatial cognitive disorders persisted into the chronic phase (15.4% of patients with parietal lesions, 14.3% of patients with right cerebral hemispheric lesion, respectively). KPS score ≥90 was achieved in 86.0% of patients with lower-grade glioma, whereas only 52.2% of glioblastoma patients scored ≥90. Primary causes of declined KPS were disorder of visuospatial cognition, sensorimotor function including deep sensation, aphasia, and emotional function. Conclusions Awake surgery leads to good functional outcome at the chronic phase of neurological/neuropsychological functions, except for deep sensory and visuospatial cognition. Because sensation and visuospatial cognitive disorder have major impacts on patients’ independence level, further importance should be placed on preserving these functions during surgery.