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

Abstract

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.

Dynamics in cognition and health-related quality of life in grade 2 and 3 gliomas after surgery

“…This initial recovery period is often characterized by sick leave for most patients and particularly in case of adjunct oncological treatments. However, at 1 year postoperatively, approximately 70% had returned to work, which was fairly similar to previous reports (50-80%) [17,20,33,37], although very high rates (near 100%) have been reported in some series [22]. Interestingly, a greater deterioration in attention and processing speed (coding) at 3 months was associated with a lower rate of return to work again within 1 year in our study.…”

“…It could be that a reduced attention span predisposes for a more optimistic appreciation of HRQoL or that this association was merely a statistical fluke. Interestingly, Nakajima and colleagues found that a deterioration in executive function was associated with lower GH, whereas lower postoperative verbal fluency correlated with lower RP and RE at 6 months postoperatively [ 20 ]. However, they used a different cognitive test battery, the follow-up was slightly later at 6 months postoperatively, and they evaluated HRQoL at 6 months rather than the dynamics between the pre- and postoperative state, which could explain the different results.…”

“…The strength of this study is the combination of cognitive, language, and HRQoL data in a fairly sized study population, when compared to similar studies [ 2 , 17 , 20 , 23 , 31 , 40 , 45 ]. Since the available reports in the literature are still relatively limited, our results contribute with more data to deepen the understanding of the dynamics in cognition and HRQoL after diffuse glioma surgery.…”

Neuromotricidad como recurso interdisciplinar. Justificación teórico-práctica a través del método BAPNE (Neuromotricity as an interdisciplinary resource. Theoretical-practical justification through the BAPNE method)

“…Relacionado con los procesos que llevan a cabo las estrategias adecuadas para la búsqueda de información y su respuesta apropiada en el menor tiempo posible (Nakajima et al, 2022). Se trabaja mediante la capacidad de improvisar verbalmente dentro de unas estructuras determinadas facilitadas por el docente.…”

Differential contribution of language and executive functioning to verbal fluency performance in glioma patients

“…A sensitive and quick test that is widely used in both clinical care and research is verbal fluency. The clinical relevance of this efficient test is underlined by the fact that verbal fluency performance is also related to quality of life (Nakajima et al., 2022). In verbal fluency, participants are asked to generate as many unique words as possible within a given semantic category such as animals and professions (semantic or category fluency) or starting with a given letter (phonemic or letter fluency) within a limited time span.…”