Qol-01. variability in anxiety and depression symptoms after eloquent glioma resection is associated with changes in functional connectomic properties

Abstract Little is known regarding how treatment-related changes in cerebral networks relate to symptoms of anxiety and depression in patients with glioma. Fifteen patients with left perisylvian glioma underwent resting-state fMRI and neuropsychological evaluation before and 1 month after resection. Symptoms of depression and anxiety were characterized with Beck Depression Inventory-II (BDI) and Beck Anxiety Inventory (BAI) Total scores and rates of clinically significant symptom burden. Change scores and reliable change classifications were also examined. Graph theoretical analysis was applied to fMRI connectivity matrices to calculate brain network properties. Comparison of pre- and postoperative measures were performed with Wilcoxon tests. Correlations between changes in anxiety and depression symptom measures and network properties were examined. Pre- and postoperative Total scores did not significantly differ though postoperative symptom burden trended toward reduction [Change: BDI=-1.93(5.73), BAI=-5.80(8.19)] with considerable interindividual variability noted [Change: BDI range=-12 to +6; BAI range=-18 to +6]. Preoperatively, at least mild symptoms were found in 27% of patients on BDI and 60% on BAI. Postoperatively, rates were the same for BDI while BAI was 33%. Using reliable change criteria, improvement was found in 13% of patients on BDI and 33% on BAI without any significant worsening. Significant postoperative connectivity decreases were observed in betweenness centrality [Change = -5.56(12.07), p = .031] and assortativity [Change=-.062(.096), p = .027]. Strong associations were found between pre- to postoperative differences in betweenness centrality and assortativity and changes in BDI [ρ(13)=.58 and .67, p< .02] and BAI Total scores [ρ(13)=.62 and .68, p< .01]. Anxiety and depression symptoms vary considerably postoperatively, though most patients do not show significant worsening. Variability in symptom change appears related to alterations in functional connectomics, with those showing increases in certain connectomic properties exhibiting worse postoperative anxiety and depression symptoms. Surgically-induced connectomic changes may coincide with or potentially contribute to psychological symptom differences in the postoperative setting.