Perioperative neurocognitive functions in patients with neuroepithelial intracranial tumors

• Published in: Journal of neuro-oncology 2020-03, Vol.147 (1), p.77-89
• Main Authors: Bette, Stefanie, Gradtke, Corinna V., Cammardella, Jasmin Hernandez, Albertshauser, Jennifer, Wiestler, Benedikt, Barz, Melanie, Meyer, Bernhard, Zimmer, Claus, Ryang, Yu-Mi, Ringel, Florian, Gempt, Jens
• Format: Article
• Language: English
• Subjects: Brain cancer; Clinical Study; Cognition; Cognitive ability; Executive function; Medicine; Medicine & Public Health; Neurology; Oncology; Patients; Quality of life; Radiation therapy; Risk factors; Surgery; Temporal lobe; Tumors
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-020-03398-8

Purpose This study aimed to assess perioperative neurocognitive functions in patients with surgery for intracranial neuroepithelial tumors. Methods Seventy-one patients [38 male, 33 female, mean age 47.2 years (range 18 to 81)] with surgery for an intracranial neuroepithelial tumor were included in this prospective single-center study. Mini-mental status examination (MMSE) and extensive neurocognitive testing (divided into the categories attention , memory, and executive functions and adjusted for age, sex, and education) were performed pre-(t 0 ) and early postoperatively (t 1 ). Part of the patient cohort (n = 32) also underwent neurocognitive testing during follow-up (t 2 ). The Karnofsky Performance Status Scale (KPS) was used to assess patients’ functional independence. Patients’ quality of life was recorded by the Short Form 36 (SF 36) pre- and postoperatively in a part of the patient cohort. Pre- and postoperative comparisons were performed using the Wilcoxon-test for paired samples. Post hoc Bonferroni correction was performed to adjust for multiple testing. To assess the influence of risk factors on neurocognitive functions, Spearman correlations and the chi-squared test were performed. Subgroup analyses for patients with low-grade and high-grade tumors were performed. Results Postoperative deterioration was observed in 5 of 39 subtests of extensive neurocognitive testing in all 3 categories, whereas no improvement was shown. Patients with WHO Grade I tumors showed no deterioration of cognitive functions. Patients with WHO Grade II and III tumors showed significantly worse results in the executive functions category patients with WHO Grade IV tumors showed deterioration in the attention category. Significantly worse functional independence was recorded postoperatively and during follow-up (P