title: Glioma surgery in eloquent areas: can we preserve cognition?
abstract: BACKGROUND
  Cognitive preservation is crucial in glioma surgery, as it is an important aspect of daily life functioning. Several studies claimed that surgery in eloquent areas is possible without causing severe cognitive damage. However, this conclusion was relatively ungrounded due to the lack of extensive neuropsychological testing in homogenous patient groups. In this study, we aimed to elucidate the short-term and long-term effects of glioma surgery on cognition by identifying all studies who conducted neuropsychological tests preoperatively and postoperatively in glioma patients.
  
  
  METHODS
  We systematically searched the electronical databases Embase, Medline OvidSP, Web of Science, PsychINFO OvidSP, PubMed, Cochrane, Google Scholar, Scirius and Proquest aimed at cognitive performance in glioma patients preoperatively and postoperatively.
  
  
  RESULTS
  We included 17 studies with tests assessing the cognitive domains: language, memory, attention, executive functions and/or visuospatial abilities. Language was the domain most frequently examined. Immediately postoperatively, all studies except one, found deterioration in one or more cognitive domains. In the longer term (3-6/6-12 months postoperatively), the following tests showed both recovery and deterioration compared with the preoperative level: naming and verbal fluency (language), verbal word learning (memory) and Trailmaking B (executive functions).
  
  
  CONCLUSIONS
  Cognitive recovery to the preoperative level after surgery is possible to a certain extent; however, the results are too arbitrary to draw definite conclusions and not all studies investigated all cognitive domains. More studies with longer postoperative follow-up with tests for cognitive change are necessary for a better understanding of the conclusive effects of glioma surgery on cognition.
authors.affiliation: Department of Neurosurgery, Erasmus MC-University Medical Centre, Wytemaweg 80, Room EE220, 3015 GE, Rotterdam, The Netherlands. d.satoer@erasmusmc.nl.|Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands. d.satoer@erasmusmc.nl.
authors.forename: Djaina
authors.initials: D
authors.lastname: Satoer
authors.affiliation: Department of Neurosurgery, Erasmus MC-University Medical Centre, Wytemaweg 80, Room EE220, 3015 GE, Rotterdam, The Netherlands.
authors.forename: Evy
authors.initials: E
authors.lastname: Visch-Brink
authors.affiliation: Department of Neurosurgery, Erasmus MC-University Medical Centre, Wytemaweg 80, Room EE220, 3015 GE, Rotterdam, The Netherlands.
authors.forename: Clemens
authors.initials: C
authors.lastname: Dirven
authors.affiliation: Department of Neurosurgery, Erasmus MC-University Medical Centre, Wytemaweg 80, Room EE220, 3015 GE, Rotterdam, The Netherlands.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Vincent
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000523:psychology* / Q000601:surgery*; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology*; D005910:Glioma / Q000523:psychology* / Q000601:surgery*; D006801:Humans; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000517:prevention & control* / Q000523:psychology*; D016896:Treatment Outcome
keywords: Cognition; Eloquent areas; Glioma surgery; Neuropsychological tests; Systematic review