Raysi Dehcordi S, Mariano M, Mazza M, Galzio R J
Department of Life, Health and Environmental Sciences University of L'Aquila, L'Aquila, Italy -
J Neurosurg Sci. 2013 Sep;57(3):259-66.
Studies in the literature with specific information concerning the neuropsychological alterations in patients with high and low grade gliomas are poor. The aim of the present study was to investigate and compare the cognitive functioning in patients with high and low-grade glioma pre- and postoperatively.
Between January 2009 and January 2011 27 patients with high-grade glioma (HG group) and 15 patients with low-grade glioma (LG group) were neuropsychologically assessed in the preoperative time, as well as 6 months and 1 year after surgery. During the examination, memory, visuo-constructive abilities, language and executive functions were tested. In addition in the preoperative time, the effect on cognition of lateralization, size and edema was analyzed for each group.
Both in the HG and LG group statistical comparisons of the pre- and postoperative assessments of cognitive abilities showed a postoperative improvement in memory functions and in processing speed (P<0.05). In particular the analysis of the significance of clinical factors in the postoperative outcome of patients with glioma showed that lesion size, edema and lateralization affect cognitive functioning in varying degree.
These findings demonstrated different levels of impairments in executive and memory domains and in processing speed in patients with low and high grade gliomas. These deficits may have a strong impact on quality of life. Psychiatric interventions may be useful for patients and their families; in particular for helping the patient to become aware of the illness, in bolstering coping strategies, and for facilitating their support at home.
文献中关于高级别和低级别胶质瘤患者神经心理学改变的具体信息研究较少。本研究的目的是调查和比较高级别和低级别胶质瘤患者术前和术后的认知功能。
2009年1月至2011年1月期间,对27例高级别胶质瘤患者(HG组)和15例低级别胶质瘤患者(LG组)在术前、术后6个月和1年进行神经心理学评估。检查期间,测试记忆、视觉构建能力、语言和执行功能。此外,在术前,分析每组患者的偏侧化、肿瘤大小和水肿对认知的影响。
HG组和LG组认知能力术前和术后评估的统计学比较均显示,术后记忆功能和处理速度有所改善(P<0.05)。特别是对胶质瘤患者术后结果中临床因素的重要性分析表明,肿瘤大小、水肿和偏侧化对认知功能有不同程度的影响。
这些发现表明,低级别和高级别胶质瘤患者在执行和记忆领域以及处理速度方面存在不同程度的损害。这些缺陷可能对生活质量产生重大影响。心理干预可能对患者及其家人有用;特别是有助于患者了解病情、增强应对策略,并便于在家中获得支持。