Noll Kyle R, Weinberg Jeffrey S, Ziu Mateo, Benveniste Ronald J, Suki Dima, Wefel Jeffrey S
Departments of *Neuro-Oncology and ‡Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; §Brain and Spine Institute, Seton Hospital, Austin, Texas; ¶Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Neurosurgery. 2015 Nov;77(5):777-85. doi: 10.1227/NEU.0000000000000987.
Little is known regarding the neurocognitive impact of temporal lobe tumor resection.
To clarify subacute surgery-related changes in neurocognitive functioning (NCF) in patients with left (LTL) and right (RTL) temporal lobe glioma.
Patients with glioma in the LTL (n = 45) or RTL (n = 19) completed comprehensive pre- and postsurgical neuropsychological assessments. NCF was analyzed with 2-way mixed design repeated-measures analysis of variance, with hemisphere (LTL or RTL) as an independent between-subjects factor and pre- and postoperative NCF as a within-subjects factor.
About 60% of patients with LTL glioma and 40% with RTL lesions exhibited significant worsening on at least 1 NCF test. Domains most commonly impacted included verbal memory and executive functioning. Patients with LTL tumor showed greater decline than patients with RTL tumor on verbal memory and confrontation naming tests. Nonetheless, over one-third of patients with RTL lesions also showed verbal memory decline.
In patients with temporal lobe glioma, NCF decline in the subacute postoperative period is common. As expected, patients with LTL tumor show more frequent and severe decline than patients with RTL tumor, particularly on verbally mediated measures. However, a considerable proportion of patients with RTL tumor also exhibit decline across various domains, even those typically associated with left hemisphere structures, such as verbal memory. While patients with RTL lesions may show even greater decline in visuospatial memory, this domain was not assessed. Nonetheless, neuropsychological assessment can identify acquired deficits and help facilitate early intervention in patients with temporal lobe glioma.
关于颞叶肿瘤切除对神经认知的影响，人们了解甚少。
阐明左（LTL）、右（RTL）颞叶胶质瘤患者亚急性期手术相关的神经认知功能（NCF）变化。
LTL（n = 45）或RTL（n = 19）胶质瘤患者完成了全面的术前和术后神经心理学评估。采用双向混合设计重复测量方差分析对NCF进行分析，以半球（LTL或RTL）作为独立的组间因素，术前和术后NCF作为组内因素。
约60%的LTL胶质瘤患者和40%的RTL病变患者在至少一项NCF测试中表现出显著恶化。最常受影响的领域包括言语记忆和执行功能。在言语记忆和对答命名测试中，LTL肿瘤患者比RTL肿瘤患者下降得更多。尽管如此，超过三分之一的RTL病变患者也出现了言语记忆下降。
在颞叶胶质瘤患者中，术后亚急性期NCF下降很常见。正如预期的那样，LTL肿瘤患者比RTL肿瘤患者表现出更频繁、更严重的下降，尤其是在言语介导的测量方面。然而仍有相当比例的RTL肿瘤患者在各个领域都出现下降，甚至包括那些通常与左半球结构相关的领域，如言语记忆。虽然RTL病变患者在视觉空间记忆方面可能下降得更明显，但该领域未进行评估。尽管如此，神经心理学评估可以识别获得性缺陷，并有助于促进对颞叶胶质瘤患者的早期干预。
