Evaluation of neuropsychological outcome and “quality of life” after glioma surgery

Wolf, Julia; Campos, Benito; Brückner, Thomas; Vogt, Lidia; Unterberg, Andreas; Ahmadi, Rezvan

doi:10.1007/s00423-016-1403-6

Cited by 24 publications

(18 citation statements)

References 15 publications

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“…3 Main complaint (include multiple responses) of patients with RCS < 40. They could be divided into three categories, function related issues which was the highest percentage (41%), work related issues, and disease or treatment related issues synonymous [28][29][30], while others have suggested that functional factors and QOL are not related or that functional factors alone cannot fully explain the outcome [31,32]. Accordingly, KPS = 100 signified significantly higher QOL than KPS ≤ 90 in our patient group (Online Resource 5).…”

Section: Discussionmentioning

confidence: 80%

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Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

et al. 2021

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IntroductionThe outcome of awake surgery has been evaluated based on functional factors, return to work, and oncological aspects, and there have been no reports directly examining QOL. This study aimed to investigate the outcome of QOL following awake surgery and to determine the functional factors influencing QOL. Methods Seventy patients with WHO grade II/III gliomas were included. For the assessment of QOL, we used the SF-36 and calculated summary and sub-component scores. Three summary component scores, including physical (PCS), mental (MCS), and role/social summary (RCS) component scores, were computed based on sub-component scores. Additionally, various assessments of neurological/neuropsychological function were performed. We performed univariate and multiple regression analyses to investigate the functional factors influencing the SF-36. Results PCS and MCS were maintained, but only RCS was low to 42.0 ± 16.1. We then focused on the RCS and its subcomponents: general health (GH), role physical (RP), social functioning (SF), and role emotional (RE). Multiple regression analysis showed following significant correlations between the sub-component scores and brain functions: GH to executive function and movement (p = 0.0033 and 0.032), RP to verbal fluency and movement (p = 0.0057 and 0.0010), and RE to verbal fluency (p = 0.020). Furthermore, when the sub-component scores were compared between groups with and without functional deficits related to GH, RP, and RE, each score was significantly lower in the groups with functional deficits (p = 0.012, 0.014, and 0.0049, respectively). Conclusions In patients who underwent awake surgery, a subset of patients had low QOL because of poor RCS. Functional factors influencing QOL included executive function, verbal fluency, and movement.

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Section: Discussionmentioning

confidence: 80%

“…Similarly, the term functional outcome was sometimes used as synonymous with QOL [28][29][30]. However, functional outcomes such as Karnofsky Performance Status (KPS) and neuropsychological function do not necessarily conform with QOL in clinical practice [31,32].…”

Section: Introductionmentioning

confidence: 99%

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

et al. 2021

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“…However, the present study identified improvements in all neurocognitive domains at long-term follow-up, both compared to preoperative baseline as well as the short-term postoperative phase. Of particular note, we conducted long-term follow-up examinations after a median period of 18.3 months, whereas previous studies evaluating neurocognitive changes over the postoperative period reported on long-term neurocognitive assessments 3 to 6 months after surgery ( 32 , 39 – 42 ). By contrast, we defined neurocognitive assessments within the first 9 postoperative months to fall into short-term evaluations (with the median coming up to 4.1 months), since we observed a significant change in patients´ neurocognitive performances at this time point during their course of disease.…”

Section: Discussionmentioning

confidence: 99%

Neurocognitive Outcome and Seizure Freedom After Awake Surgery of Gliomas

et al. 2022

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ObjectivesGliomas are often diagnosed due to epileptic seizures as well as neurocognitive deficits. First treatment choice for patients with gliomas in speech-related areas is awake surgery, which aims at maximizing tumor resection while preserving or improving patient’s neurological status. The present study aimed at evaluating neurocognitive functioning and occurrence of epileptic seizures in patients suffering from gliomas located in language-related areas before and after awake surgery as well as during their follow up course of disease.Materials and MethodsIn this prospective study we included patients who underwent awake surgery for glioma in the inferior frontal gyrus, superior temporal gyrus, or anterior temporal lobe. Preoperatively, as well as in the short-term (median 4.1 months, IQR 2.1-6.0) and long-term (median 18.3 months, IQR 12.3-36.6) postoperative course, neurocognitive functioning, neurologic status, the occurrence of epileptic seizures and number of antiepileptic drugs were recorded.ResultsBetween 09/2012 and 09/2019, a total of 27 glioma patients, aged 36.1 ± 11.8 years, were included. Tumor resection was complete in 15, subtotal in 6 and partial in 6 patients, respectively. While preoperatively impairment in at least one neurocognitive domain was found in 37.0% of patients, postoperatively, in the short-term, 36.4% of patients presented a significant deterioration in word fluency (p=0.009) and 34.8% of patients in executive functions (p=0.049). Over the long-term, scores improved to preoperative baseline levels. The number of patients with mood disturbances significantly declined from 66.7% to 34.8% after surgery (p=0.03). Regarding seizures, these were present in 18 (66.7%) patients prior to surgery. Postoperatively, 22 (81.5%) patients were treated with antiepileptic drugs with all patients presenting seizure-freedom.ConclusionsIn patients suffering from gliomas in eloquent areas, the combination of awake surgery, regular neurocognitive assessment - considering individual patients´ functional outcome and rehabilitation needs – and the individual adjustment of antiepileptic therapy results in excellent patient outcome in the long-term course.

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“…The clinical relevance of the observed cognitive alterations is difficult to answer because cognition does not correlate with quality of life (Boele et al, ; Wolf et al, ). Nevertheless, our findings can have clinical implications.…”

Section: Discussionmentioning

confidence: 99%

Linking late cognitive outcome with glioma surgery location using resection cavity maps

Hendriks

Habets

Taphoorn

et al. 2018

Human Brain Mapping

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Patients with a diffuse glioma may experience cognitive decline or improvement upon resective surgery. To examine the impact of glioma location, cognitive alteration after glioma surgery was quantified and related to voxel‐based resection probability maps. A total of 59 consecutive patients (range 18–67 years of age) who had resective surgery between 2006 and 2011 for a supratentorial nonenhancing diffuse glioma (grade I–III, WHO 2007) were included in this observational cohort study. Standardized neuropsychological examination and MRI were obtained before and after surgery. Intraoperative stimulation mapping guided resections towards neurological functions (language, sensorimotor function, and visual fields). Maps of resected regions were constructed in standard space. These resection cavity maps were compared between patients with and without new cognitive deficits (z‐score difference >1.5 SD between baseline and one year after resection), using a voxel‐wise randomization test and calculation of false discovery rates. Brain regions significantly associated with cognitive decline were classified in standard cortical and subcortical anatomy. Cognitive improvement in any domain occurred in 10 (17%) patients, cognitive decline in any domain in 25 (42%), and decline in more than one domain in 10 (17%). The most frequently affected subdomains were attention in 10 (17%) patients and information processing speed in 9 (15%). Resection regions associated with decline in more than one domain were predominantly located in the right hemisphere. For attention decline, no specific region could be identified. For decline in information speed, several regions were found, including the frontal pole and the corpus callosum. Cognitive decline after resective surgery of diffuse glioma is prevalent, in particular, in patients with a tumor located in the right hemisphere without cognitive function mapping.

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Evaluation of neuropsychological outcome and “quality of life” after glioma surgery

Abstract: Our study suggests that extended tumour resection is not necessarily linked to a loss in QOL.

Cited by 24 publications

References 15 publications

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

Neurocognitive Outcome and Seizure Freedom After Awake Surgery of Gliomas

Linking late cognitive outcome with glioma surgery location using resection cavity maps

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