Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Christian-Albrechts University, Olshausenstraße 62, 24118, Kiel, Germany.
Mehdorn Consilium, Prüner Gang 7, 24103, Kiel, Germany.
J Neurooncol. 2018 Oct;140(1):145-153. doi: 10.1007/s11060-018-2944-z. Epub 2018 Jul 7.
To date, little is known about neuropsychiatric symptoms in patients with tumors within the cerebellopontine angle (CPA). These, however, might be of clinical relevance. Aim of this study was thus to assess possible impairment in cognition, elevation in mood symptoms, and fatigue in this specific patient group.
Forty-five patients with an untreated CPA tumor (27 vestibularis schwannoma, 18 meningioma) were tested within a cross-sectional observational study in a single institution prior to neurosurgical treatment. Patients were administered a multifaceted battery comprising of widely-used tests for assessment of neuropsychiatric functioning.
The majority of the included patients (69%) showed neurocognitive impairment, most frequently in the areas of attention and visuo-motor speed (e.g., alertness) (62%) as well as visuo-construction (44%). Impaired structural integrity of the brain stem was accompanied by more serious neurocognitive deficits. About one-third of the sample reported clinically relevant depression and/or anxiety and an even higher proportion (48%) described high levels of fatigue. Cognitive and affective symptoms as well as fatigue contributed significantly to patients' Quality of Life, indicating the clinical relevance of neuropsychiatric symptoms in patients with CPA tumors.
Although patients with untreated CPA tumors often suffer from devastating and prominent physical symptoms, neuropsychiatric problems are also frequent. Including these aspects in the routine clinical assessment and initiating treatment accordingly might thus improve clinical management of the patients and improve Quality of Life.
迄今为止，人们对桥小脑角（CPA）内肿瘤患者的神经精神症状知之甚少，但这些症状可能具有临床意义。因此，本研究旨在评估该特定患者群体认知功能障碍、情绪症状升高和疲劳的可能性。
在一家医疗机构的横断面观察性研究中，对 45 名未经治疗的 CPA 肿瘤患者（27 例前庭神经鞘瘤，18 例脑膜瘤）进行了测试。患者接受了一项多方面的测试，包括广泛用于评估神经精神功能的测试。
大多数纳入的患者（69%）表现出神经认知障碍，最常见于注意力和视动速度（如警觉性）（62%）以及视空间构建（44%）领域。脑干结构完整性受损与更严重的神经认知缺陷相关。约三分之一的样本报告了临床相关的抑郁和/或焦虑，甚至更高比例（48%）描述了高水平的疲劳。认知和情感症状以及疲劳对患者的生活质量有显著贡献，表明 CPA 肿瘤患者的神经精神症状具有临床意义。
尽管未经治疗的 CPA 肿瘤患者常遭受破坏性和突出的身体症状，但神经精神问题也很常见。在常规临床评估中包括这些方面并相应地开始治疗，可能会改善患者的临床管理并提高生活质量。
