Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
University Health Network Centre for Mental Health, University of Toronto, Toronto, ON, Canada.
Psychosomatics. 2020 May-Jun;61(3):209-219. doi: 10.1016/j.psym.2019.12.008. Epub 2020 Jan 11.
Improving brain tumor survival rates have drawn increasing focus on neuropsychiatric and psychological outcomes.
This review characterizes the literature on neuropsychiatric sequelae after neurosurgical resection of adult brain tumors.
Using a scoping method, we reviewed articles describing patients with adult brain tumor who underwent partial or total brain resection and examined major neuropsychiatric domains after intervention.
The initial search yielded 9903 articles. After duplicate removal, abstract screening, review, and hand searching, 81 articles were found: 63 empirical and 18 nonempirical. Most articles centered on survivorship within the first year. Cognition was most widely studied with a transient worsening during the first month and usually recovery or improvement thereafter. Depression increased in frequency during survivorship and was associated with frontotemporal location, time to survival, quality of life, cognitive and physical parameters, and functional status. Anxiety, independent of depression, related to tumor histology and grading and had a weaker association with cognition and quality of life. Obsessive-compulsive symptoms, psychosis, mania, and delirium received little attention. Most studies did not include preoperative neuropsychiatric assessment, and treatment was poorly addressed.
This review highlights key gaps, including preoperative and postoperative neuropsychiatric assessment and a short follow-up. A better understanding of postresection neuropsychiatric outcomes can inform our ability to prognosticate and tailor management for patients at risk for these life-impairing conditions.
提高脑瘤患者的存活率使得神经精神病学和心理学结果越来越受到关注。
本综述旨在描述成人脑瘤手术后的神经精神后遗症。
采用范围综述法，我们检索了描述接受部分或全部脑肿瘤切除术的成人脑瘤患者的文章，并对干预后主要神经精神领域进行了检查。
最初的搜索产生了 9903 篇文章。经过重复去除、摘要筛选、综述和手工搜索，共发现 81 篇文章：63 篇为实证研究，18 篇为非实证研究。大多数文章集中在手术后的第一年的生存情况。认知是研究最广泛的领域，在第一个月内会出现短暂恶化，通常随后会恢复或改善。在生存期间，抑郁的频率增加，与额颞叶位置、生存时间、生活质量、认知和身体参数以及功能状态有关。与抑郁无关的焦虑与肿瘤组织学和分级有关，与认知和生活质量的相关性较弱。强迫症症状、精神病、躁狂和谵妄受到的关注较少。大多数研究未包括术前神经精神评估，且治疗情况也未得到充分说明。
本综述突出了关键的空白，包括术前和术后神经精神评估以及随访时间短。更好地了解术后神经精神后遗症可以帮助我们预测和针对这些影响生活的情况对患者进行管理。
