Neurocognitive status in patients with newly-diagnosed brain tumors in good neurological condition: The impact of tumor type, volume, and location.
OBJECTIVE
Neurocognitive function is of great importance in patients with brain tumors. Even patients in good neurological condition may suffer from neurocognitive dysfunction that affects their daily living. The purpose of the present study was to identify risk factors for neurocognitive dysfunction in patients suffering from common supratentorial brain tumors with minor neurological deficits.


METHODS
A prospective study evaluating neurocognitive dysfunction in patients with a newly-diagnosed brain tumor in good neurological condition was performed at a major German academic institution. Patients underwent extensive neurocognitive testing assessing perceptual speed, executive function, visual-spatial and verbal working memory, short- and long-term memory, verbal fluency, fluid intelligence, anxiety, and depression. For each patient, a healthy control was pair-matched based on age, sex, handedness, and profession.


RESULTS
A total of 46 patients and 46 healthy controls underwent neurocognitive testing. Patients suffered from glioblastoma multiforme (10), cerebral metastasis (10), pituitary adenoma (13), or meningioma (13). There was neither any difference in age, educational level, fluid intelligence, neurological deficits, and anxiety nor in any depression scores between tumor subgroups. Overall, neurocognitive performance was significantly worse in patients compared to healthy controls. Larger tumor volume, frontal location, and left/dominant hemisphere were associated with worse executive functioning and verbal fluency. Additionally, larger tumors and left/dominant location correlated with impairments on perceptual speed tasks. Frontal tumor location was related to worse performance in visual-spatial and short- and long-term memory. Tumor type, clinical presentation, and patient self-awareness were not associated with specific neurocognitive impairments.


CONCLUSIONS
Patients suffering from newly-diagnosed brain tumors presenting in good neurological condition display neurocognitive impairments in various domains. Larger tumor volumes, frontal location, and left/dominant hemisphere are important predictors for potential neurocognitive deficits. Tumor type, clinical presentation, or self-awareness are less significant at the time of diagnosis.
Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany. Electronic address: hendrix.philipp@gmail.com.
Philipp
P
Hendrix
Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany.
Elisa
E
Hans
Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA; Department of Neurosurgery, Geisinger Health System, Danville, PA, USA.
Christoph J
CJ
Griessenauer
Department of Neuroradiology, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany.
Andreas
A
Simgen
Department of Neurosurgery, Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg/Saar, Germany.
Joachim
J
Oertel
Department of Psychology, Goethe-University, Frankfurt, Germany.
Julia
J
Karbach
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D001932:Brain Neoplasms / Q000473:pathology* / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000523:psychology; D056344:Executive Function; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D057567:Memory, Long-Term; D008570:Memory, Short-Term; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011930:Reaction Time; D013028:Space Perception; D015173:Supratentorial Neoplasms / Q000473:pathology* / Q000523:psychology*
Brain tumor; Cognition; Frontal lobe; Left hemisphere; Neurocognitive assessment