Supplemental material

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J Neurosurg SUPPLEMENTAL MATERIAL

©AANS 2020, except where prohibited by US copyright law

ONLINE ONLY

Supplemental material

Contralesional homotopic functional plasticity in patients with temporal glioma

Liu et al.

https://thejns.org/doi/abs/10.3171/2019.11.JNS191982

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Supplemental Data MethodsS.2.2

All subjects were evaluated by a standardized clinical interview and neurocognitive tests. Several classical neurocognitive tests, including block design (Wechsler adult intelligence scale-Chinese revision; WAIS-RC), including digital symbol substitution test (DSST), mapping test, digit span test (DST), similarity test, math test, visuospatial test and visual memory test (Wechsler memory scale-Chinese revision; WMS-RC) were performed to measure information, executive, processing, visuospatial and memory abilities. The evaluation process was conducted by two experienced neuropsychologists, and the scores of each cognitive domain were transformed into z-values for further Pearson’s partial correlation analysis.

MethodsS.2.3

Resting-state functional MRI images including 140 volumes were obtained with a gradient-recalled echo-planar imaging (GRE-EPI) sequence, with the following parameters: repeate time (TR) = 2000 ms; echo time (TE) = 30 ms; flip angle = 90°; acquisition matrix size= 64 × 64; field-of-view (FOV) = 240 mm × 240 mm; number of slices = 30; slice thickness = 3.0 mm; gap = 4 mm, and voxel size = 3.75 × 3.75 × 4 mm3.

T1-weighted MR images were obtained using a 3D magnetization-prepared rapid gradient echo (MPRAGE) sequence with following parameters: TR=1900 ms; TE= 2.49 ms; time inversion (TI) = 900 ms; matrix = 256 x256; flip angle = 90°; thickness =1 mm; gap = 0.5 mm; slices = 176.

MethodsS.2.4

The procedure of overlapping image construction was achieved manually using RANO criteria 2,5. Several tumors with unclear borders (TempL n=1, TempR n=2) were verified via contrasting axial fluid-attenuated inversion recovery (FLAIR) images and T1 enhancement images. All lesion tracings were checked and re-confirmed by a second radiologist. Thus, a volume of interest (VOI) of the glioma could be created for each patient. All patients’ tumor VOIs were then stacked together to construct a left and a right group tumor overlapping mask. To ensure that group comparisons of ALFF were restricted in the contralateral homotopic hemispheres, the group lesion overlapping masks were symmetrically transformed along the midline through SPM12. In addition, the tumor overlapping masks were further eliminated from a whole-brain GM mask to generate a non-lesion GM mask, which restricted the following FC analysis to non-lesion GM regions.

MethodsS.2.5

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excluded for each subject in order to eliminate the mechanical noise at the beginning of the scan. Slice timing and realignment were then respectively performed to correct temporal differences and head motion of the remaining images. The criterion for the head motion was set as 3 mm in translation and 3° in rotation 5. Following this, structural images (T1-weighted) and fMRI were manually reoriented and shifted to redefine the anterior commissure as the origin (coordinate 0,0,0). The resulting functional images were spatially normalized to the standard MNI space using an individual T1 image unified segmentation, and the normalized images were resampled to an isotropic resolution of 3 × 3 × 3mm3. Several common nuisance signals were regressed out, including the Friston’s 24 head motion parameter 1, white matter, and cerebrospinal fluid signals. Due to ambiguity regarding the regression of global signal 5_{, this variable was not regressed out. The resulting images were spatially smoothed} with an 8 mm full-width half-maximum (FWHM) isotropic Gaussian kernel 4. Finally, a temporal band-pass filtering (0.01–0.08 Hz) was applied to eliminate magnetic field drifts of the low- and high-frequency physiological and scanner noise.

MethodsS.2.6

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Table. S1. The demographics and clinical data of the patients with glioma. No. Sex Age (year) Handed ness Tumor

Side Tumor Location

WHO Grade

Paresis/Speech

Disturbance Pathological Diagnosis

1 M 52 R Left Temporal (Insular) 2 No Astrocytoma

2 F 70 R Left Temporal 4 No Glioblastoma

3 M 61 R Left Temporal 3 Slight Anaplastic astrocytoma

4 M 58 R Left Temporal 3 No Anaplastic astrocytoma

5 F 57 R Left Temporal 3 No Anaplastic oligodendroglioma

6 M 47 R Left Temporal 3 No Anaplastic oligodendroglioma

7 M 63 R Left Temporal 4 Slight Glioblastoma

8 M 35 R Right Temporal 2 No Astrocytoma

9 M 60 R Right Temporal 4 Slight Glioblastoma

10 F 55 R Right Temporal (Insular) 2 No Pleomorphic xanthoastrocytoma

11 M 66 R Right Temporal 1 No Astrocytoma

12 M 53 R Right Temporal (Insular) 2 No Astrocytoma

13 F 38 R Right Temporal 2 No Astrocytoma

14 M 67 R Right Temporal 3 Slight Anaplastic astrocytoma

15 F 43 R Right Temporal 1 No Subependymoma

16 F 65 R Right Temporal 4 No Glioblastoma

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Figure S1 Contra-lesional ALFF analysis in patients with left temporal glioma.

Legend: A: Overlap maps of gliomas in patients with left temporal glioma (tempL)

group, the warm color indicates regions overlapped, the color bar represents the number of tempL with a lesion on each voxel. The light blue indicates the homotopic mask in the contralesional right hemisphere; B: No significant differences were found between HCs and tempL group within the homotopic mask.

Figure S2 Contra-lesional ALFF analysis in patients with right low-grade

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Legend: A: Tumors overlap maps of patients only with low-grade glioma (n=7) in

TempR group. The warm color indicates regions overlapped by LGG. The color bar represents the number of tempR with a lesion on each voxel. The light blue indicates the homotopic mask in the contra-lesional left hemisphere; B: Bright yellow color indicates increased ALFF within the homotopic mask in patients only with LGG in tempR group (Permutation test, TFCE-FWE corrected p < 0.05), which was also selected as Region of interest (ROI).

Figure S3 ROI-based whole-brain functional connectivity of patients only with

low-grade glioma in TempR group.

Legend: C: Bright and blue colors indicate the increased and decreased functional

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Figure S4 ROI-based whole-brain functional connectivity of patients only with

low-grade glioma in TempR group.

Legend: A: Tumors overlap maps of patients only with High-grade glioma (n=6) in

TempL group. The warm color indicates regions overlapped by HGG. The color bar represents the number of tempR with a lesion on each voxel. The light blue indicates the homotopic mask in the contra-lesional right hemisphere; B: No significant difference was found between HCs and patients with HGG in tempL group within the homotopic mask.

Table S2. Details of the regions showing significant differences in ALFF or Functional

connectivity between HCs and only patients with low-grade right temporal glioma (n=7).

Notes: Mean strength column are values expressed as the mean (standard deviation, SD).

a_{Peak coordinates (x, y, z) of MNI (Montreal Neurological Institute) brain atlas.}

b _{Representing p-value was corrected by TFCE-FWE correction (1000 times of permutation test).} c _{Representing p-value was corrected by GRF correction (voxel-level p < 0.0005, cluster-level p < 0.05).} abbreviations：HCs, healthy control subjects; Hip and ParaHip, hippocampal gyrus and para-hippocampal gyrus;

TempR vs. HCs Regions Peak MNI

a Coordinate Cluster Size (voxels) Mean strength (z) T value Corrected P value TempR HCs (z)ALFF

TempR > HCs Left Hip and ParaHip gyrus (-33 -15 -21) 53 -0.27(0.20) -0.64(0.18) 4.8509 p<0.05b

Functional Connectivity

TempR < HCs Left inferior frontal gyrus (-51 3 27) 212 -0.75(0.08) 0.20(0.14) -5.618 p<0.05c TempR < HCs Right Insula/

Right superior temporal gyrus

(33 -3 12) 148 0.10 (0.07) 0.31(0.13) -5.380 p<0.05c

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TFCE-FWE, threshold-free cluster enhancement family-wise error.

References

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2. Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, et al: Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963-1972, 2010

3. Yan CG, Craddock RC, Zuo XN, Zang YF, Milham MP: Standardizing the intrinsic brain: towards robust measurement of inter-individual variation in 1000 functional connectomes. Neuroimage 80:246-262, 2013