Patients with diffuse frontal gliomas often present with post-operative apathy after tumour removal. However, the association between apathy and tumour removal of gliomas from the frontal lobe remains unknown. This study aimed to investigate the factors influencing post-operative apathy after tumour removal in patients with diffuse frontal gliomas. We compared the demographics and clinical characteristics of patients with and without post-operative apathy in a cohort of 54 patients who underwent awake brain mapping for frontal gliomas. The frequency of clinical parameters such as left-sided involvement, high-grade tumour types (WHO grades III, IV), main tumour location in the anterior cingulate gyrus (ACC) and/or dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) was significantly greater in the apathetic group compared to the non-apathetic group. The apathetic group scored significantly lower on neuropsychological assessments such as the Letter Fluency Test among the Word Fluency Tests than the non-pathetic group (p = .000). Moreover, the scores of Parts 3, and 3–1 of the Stroop test were significantly lower in the apathetic group than those in the non-apathetic group (p = .023, .027, respectively). Multivariate model analysis revealed that the appearance of post-operative apathy was significantly related to side of the of lesion [left vs. right, hazard ratio (HR) = 8.00, 95% confidence interval (CI) = 1.36–46.96, p = .021], location of the main tumour in the frontal lobe (ACC/DLPFC/OFC vs. others, HR = 7.99, 95% CI = 2.16–29.59, p = .002), and the Letter Fluency Test (HR = .37, 95% CI = .15–.90, p = .028). Post-operative apathy is significantly associated with ACC and/or DLPFC and OFC in the left hemisphere of diffuse frontal gliomas. Apathy in frontal gliomas is correlated with a decline in the Letter Fluency Test scores. Therefore, this instrument is a potential predictor of post-operative apathy in patients with diffuse frontal gliomas undergoing awake brain mapping.

中文翻译：

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弥漫性额叶神经胶质瘤患者接受清醒脑测绘术后冷漠的预测因素

弥漫性额叶神经胶质瘤患者在肿瘤切除后常常表现出术后冷漠。然而，冷漠与额叶神经胶质瘤切除之间的关联仍不清楚。本研究旨在探讨弥漫性额叶胶质瘤患者肿瘤切除后影响术后冷漠的因素。我们比较了 54 名接受额叶神经胶质瘤清醒脑成像的患者中患有和不患有术后冷漠的患者的人口统计学和临床​​特征。临床参数的频率，例如左侧受累、高级别肿瘤类型（WHO III、IV 级）、前扣带回 (ACC) 和/或背外侧前额皮质 (DLPFC) 和眶额皮质 (OFC) 的主要肿瘤位置）与非冷漠组相比，冷漠组显着更大。冷漠组在神经心理学评估（例如单词流畅性测试中的字母流畅性测试）上的得分显着低于非冷漠组（p  = .000）。此外，冷漠组的 Stroop 测试第 3 部分和第 3-1 部分的分数显着低于非冷漠组（分别为p  = 0.023、0.027）。多变量模型分析显示，术后冷漠的出现与病变的一侧显着相关[左与右，风险比（HR）= 8.00，95％置信区间（CI）= 1.36-46.96，p  = . 021]，额叶主要肿瘤的位置（ACC/DLPFC/OFC 与其他，HR = 7.99，95% CI = 2.16–29.59，p  = .002），以及字母流利度测试（HR = .37） ，95% CI = .15–.90，p  = .028）。术后冷漠与弥漫性额叶神经胶质瘤左半球的 ACC 和/或 DLPFC 和 OFC 显着相关。额叶神经胶质瘤的冷漠与​​字母流利度测试分数的下降相关。因此，该仪器是接受清醒脑成像的弥漫性额叶神经胶质瘤患者术后冷漠的潜在预测指标。