Preoperative and postoperative cognitive functioning in patients with frontal meningiomas

Tucha, Oliver; Smely, Christian; Preier, Michael; Becker, Georg; Paul, Geraldine M.; Lange, Klaus W.

doi:10.3171/jns.2003.98.1.0021

Cited by 258 publications

(98 citation statements)

References 42 publications

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“…This is in agreement with previous studies suggesting that meningiomas can cause neurocognitive and behavioral deficits, 25 probably due to compression effects on normal brain tissue. 4 With regard to tumor laterality, patients with left-sided meningiomas had decreased verbal fluency and recall for verbal material compared with patients with right-sided meningiomas.…”

Section: Discussionsupporting

confidence: 93%

“…Our postoperative results overall support those in the study by Tucha and colleagues, 24,25 which showed no cognitive deterioration after surgery in patients with frontal meningiomas, but instead showed that some attention functions were improved. However, our results are in disagreement with studies showing that patients with left-hemisphere meningiomas should not expect any improvement postoperatively.…”

Section: Discussionsupporting

confidence: 90%

“…The association between frontal lobe lesions and impairment of executive function has been observed previously in a number of studies, 7 including extraaxial mass lesions. 25 On the other hand, posterior convexity meningioma patients presented with parietal association cortex disturbances. Parietal lobe association deficits have been reported in parietal glial tumor patients before and after resection of the parietal lobe.…”

Section: Discussionmentioning

confidence: 99%

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Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study

Liouta

Koutsarnakis

Liakos

et al. 2016

JNS

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MeningioMas constitute approximately 15%-20% of all intracranial neoplasms and are often associated with favorable clinical prognosis because of their benign histology. Because of the high survival rates associated with meningiomas, patients with meningiomas can expect increased functional capacity compared with patients harboring other brain tumors. Parameters such as the rate of survival, tumor recurrence, and progression, 8 as well as the quality of life 3,17 of these patients, have traditionally been used to assess outcomes after intracranial meningioma surgery. According to recommendations from current outcomes research programs, neuropsychological-cognitive parameters also need to be incorporated to comprehensively evaluate surgical outcomes.Although meningiomas are extraaxial tumors, cognitive decline may arise due to perilesional edema and mass obJective Current recommendations stress the need for cognitive parameters to be integrated in the evaluation of outcomes for intracranial meningioma surgery. The aim of this prospective study was to examine neurocognitive function in meningioma patients pre- and postoperatively. methods Patients with skull base (anterior and middle fossa) and convexity (anterior and posterior) meningiomas (n = 54) underwent neuropsychological examination prior to and 1 year after surgery. A control group (n = 52) of healthy volunteers matched for age, sex, and education underwent the same examination. Assessments included executive, memory, and motor functions with standardized testing. Patients with convexity meningiomas were clinically assessed for parietal association cortex functions. results All patients performed significantly worse (p < 0.05) in most neurocognitive domains than controls. The skull base group showed more disturbances in memory than the convexity group (p < 0.05). The anterior convexity group showed more deficits in executive function than the posterior convexity group, which presented with parietal association cortex deficits. Verbal deficits were more pronounced in the left hemisphere than in the right hemisphere. Patients with a large tumor (> 4 cm) had more severe neurocognitive deficits than those with a small tumor (< 4 cm). Postoperatively, patients showed no deterioration in neurocognitive function. Instead, significant improvement (p < 0.05) was observed in some executive, motor, and parietal association cortex functions. coNclusioNs According to the authors' findings, intracranial meningiomas may cause neurocognitive deficits in patients. Surgery does not cause a deterioration in cognitive function; instead, it may lead to improvements in some functions. Permanent neuropsychological postoperative deficits should be interpreted as tumor-induced rather than due to surgery.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study

Liouta

Koutsarnakis

Liakos

et al. 2016

JNS

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show abstract

“…Very few studies have been published on neurocognitive functioning of meningioma patients. Tucha et al [21] examined neurocognitive functioning before and shortly after surgery for a frontal meningioma. Surgery improved neurocognitive functioning but, compared with healthy controls, significant postoperative neurocognitive deficits remained, particularly a lowered attention span and decreased executive functions.…”

Section: Discussionmentioning

confidence: 99%

Differential effect of surgery and radiotherapy on neurocognitive functioning and health-related quality of life in WHO grade I meningioma patients

et al. 2007

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Background Potential treatment-related neurotoxicity and the indolent course of the disease mainly feed the controversy concerning the optimal timing of surgery and radiotherapy in meningioma patients. Object To quantify the additional negative effects of conventional radiotherapy compared to surgery alone on neurocognitive functioning and health-related quality of life (HRQOL) in patients with WHO grade I meningiomas. Methods Neurocognitive functioning and HRQOL (SF36, EORTC-BCM20) were assessed in consecutive patients (1999)(2000)(2001)(2002)(2003)(2004)(2005) with WHO grade I meningiomas at least 1 year after surgical treatment in two centers for brain tumor patients. Subsequently, we selected all patients who underwent surgery and conformal external beam fractioned radiotherapy (n = 18) and matched these patients for age, sex, and educational level with the same number of patients who had had surgery only (n = 18), as well as with the same number of healthy controls.Results No significant differences in neurocognitive functioning were found between the two meningioma patient groups; however, even meningioma patients who were treated with surgery only had a significantly lower neurocognitive functioning than healthy controls. Meningioma patients who were treated with surgery and radiotherapy had significantly lower HRQOL scores than meningioma patients who were treated with surgery only, who had HRQOL ratings comparable with healthy controls; these differences, however, disappeared after correction for the duration of disease. Conclusions In contrast with conventional thinking, longterm neurocognitive functioning was significantly impaired in our meningioma patients. Additional radiotherapy following surgery, however, does not have additional deleterious effects on neurocognitive outcome in these patients.

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“…Resectie van een meningeoom geeft op korte termijn meestal een verbetering van de neurologische klachten en verbetering van denkstoornissen. 27 Ongeveer een derde van de patiënten houdt blijvende neurologische restverschijnselen. Uit onderzoek onder 8826 geopereerde meningeoompatiënten bleek dat 26% bij ontslag uit het ziekenhuis naar een verpleeg-of verzorgingshuis moest; dat risico was maar liefst 52% voor patiënten ouder dan 70 jaar.…”

Section: Late Gevolgenunclassified

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Stalpers¹,

Furth²

2008

BIJB

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SamenvattingIeder jaar wordt in Nederland bij zeven-à achthonderd patiënten een goedaardige tumor van het centraal zenuwstelsel vastgesteld. Het aantal langdurige overlevers is een veelvoud daarvan. Ondanks de goede genezingskansen houden veel patiënten (15-50%) blijvend neurologische en psychosociale beperkingen ten gevolge van de aandoening en/of de behandeling. Naast neurologische uitval en epilepsie komen chronische denkstoornissen, stemmingsstoornissen en moeheid veel voor; deze worden soms pas laat ontdekt. Ook het gebruik van anti-epileptica op zichzelf is een risicofactor voor cognitieve achteruitgang en verminderde kwaliteit van leven. Radiotherapie is een belangrijke risicofactor voor mentale achterstand bij kinderen met een hersentumor; bij volwassenen is de cognitieve schade door neurochirurgie en bestraling minder opvallend dan de schade door de tumor. InleidingGoedaardige tumoren van het centraal zenuwstelsel worden histologisch gekenmerkt door een scherp begrensde groei binnen de schedel en het ruggenmergkanaal. Per definitie metastaseren ze niet, maar door lokale druk op hersenen en zenuwen kunnen ze wel aanleiding geven tot neurologische uitval en prikkeling (pijn, epilepsie). De meeste patiënten kunnen worden genezen met neurochirurgie en radiotherapie, maar veel patiënten houden langdurig neurologische, cognitieve en hormonale restverschijnselen. Deze langetermijnproblemen worden pas de laatste jaren onderkend. Er kunnen verschillende redenen zijn waarom de aandacht voor goedaardige tumoren en hun gevolgen zo gering is: . de diagnose 'benigne hersentumor' is een vergaarbak van histologisch zeer verschil-

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Preoperative and postoperative cognitive functioning in patients with frontal meningiomas

Cited by 258 publications

References 42 publications

Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study

Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study

Differential effect of surgery and radiotherapy on neurocognitive functioning and health-related quality of life in WHO grade I meningioma patients

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