Brain tumour microstructure is associated with post-surgical cognition

Maite Aznarez-Sanado, Rafael Romero-Garcia, Chao Li, Rob C. Morris, Stephen J. Price, Thomas Manly, Thomas Santarius, Yaara Erez, Michael G. Hart, John Suckling

Research output: Contribution to journalArticlepeer-review


Brain tumour microstructure is potentially predictive of changes following treatment to cognitive functions subserved by the functional networks in which they are embedded. To test this hypothesis, intra-tumoural microstructure was quantified from diffusion-weighted MRI to identify which tumour subregions (if any) had a greater impact on participants’ cognitive recovery after surgical resection. Additionally, we studied the role of tumour microstructure in the functional interaction between the tumour and the rest of the brain. Sixteen patients (22–56 years, 7 females) with brain tumours located in or near speech-eloquent areas of the brain were included in the analyses. Two different approaches were adopted for tumour segmentation from a multishell diffusion MRI acquisition: the first used a two-dimensional four group partition of feature space, whilst the second used data-driven clustering with Gaussian mixture modelling. For each approach, we assessed the capability of tumour microstructure to predict participants’ cognitive outcomes after surgery and the strength of association between the BOLD signal of individual tumour subregions and the global BOLD signal. With both methodologies, the volumes of partially overlapped subregions within the tumour significantly predicted cognitive decline in verbal skills after surgery. We also found that these particular subregions were among those that showed greater functional interaction with the unaffected cortex. Our results indicate that tumour microstructure measured by MRI multishell diffusion is associated with cognitive recovery after surgery.

Original languageEnglish
Article number5646
JournalScientific Reports
Issue number1
StatePublished - 7 Mar 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2024.


This research was supported by the Guarantors of Brain; Cancer Research UK Cambridge Centre (ref: A25117); The Brain Tumour Charity; the Ministerio de Universidades (marco del Programa Estatal de Promoción del Talento y su Empleabilidad en I + D + i, Subprograma Estatal de Movilidad, del Plan Estatal de Investigación Científica y Técnica y de Innovación 2017–2020); the EMERGIA Junta de Andalucia program; (EMERGIA20_00139) Plan de Generación de Conocimiento (PID2021-122853OA-I00); the National Institute for Health and Social Care (BRC-1215–20014 to Cambridge Biomedical Research Centre, CDF-2018–11-ST2-003 to S.J.P.). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

FundersFunder number
Cancer Research UK Cambridge CentreA25117
EMERGIA Junta de AndaluciaEMERGIA20_00139
Plan de Generación de ConocimientoPID2021-122853OA-I00
National Institute for Social Care and Health ResearchBRC-1215–20014, CDF-2018–11-ST2-003
Guarantors of Brain
Brain Tumour Charity
Ministerio de Universidades


    • Brain tumors
    • Diffusion MRI
    • Microstructure
    • Neurosurgery
    • Tumour microstructure


    Dive into the research topics of 'Brain tumour microstructure is associated with post-surgical cognition'. Together they form a unique fingerprint.

    Cite this