title: Effects of intracranial meningioma location, size, and surgery on neurocognitive functions: a 3-year prospective study.
abstract: OBJECT 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.
authors.affiliation: Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital; and.|Hellenic Center for Neurosurgical Research "Prof. Petros Kokkalis," Athens, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Liouta
authors.affiliation: Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital; and.
authors.forename: Christos
authors.initials: C
authors.lastname: Koutsarnakis
authors.affiliation: Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital; and.
authors.forename: Faidon
authors.initials: F
authors.lastname: Liakos
authors.affiliation: Department of Neurosurgery, National and Kapodistrian University of Athens, Evangelismos Hospital; and.|Hellenic Center for Neurosurgical Research "Prof. Petros Kokkalis," Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Stranjalis
mesh_terms: D001929:Brain Edema / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008579:Meningioma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D008875:Middle Aged; D009043:Motor Activity; D009483:Neuropsychological Tests; D010296:Parietal Lobe; D011446:Prospective Studies; D019291:Skull Base; D047368:Tumor Burden
keywords: COWAT = Controlled Oral Word Association Test; DWI = diffusion-weighted imaging; RBMT = Rivermead Behavioural Memory Test Extended Version; TMT = Trail Making Test; cognition; convexity meningioma; oncology; prospective study; skull base meningioma; surgery