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术前认知功能与胶质瘤和脑膜瘤患者的临床和生物学相关性。

Clinical and Biological Correlates of Preoperative Cognitive Functioning of Glioma and Meningioma Patients.

机构信息

Neuroscience Institute, Lithuanian University of Health Sciences, Eiveniu str. 4, LT-50161, Lithuania.

Hospital Of Lithuanian University of Health Sciences, Neurosurgery Department, Eiveniu str. 2, LT-50009 Kaunas, Lithuania.

出版信息

Biomed Res Int. 2020 May 8;2020:2054859. doi: 10.1155/2020/2054859. eCollection 2020.

Abstract

OBJECTIVES

This study aimed to investigate the association of high-sensitivity C-reactive protein (hsCRP) and -terminal pro-B-type natriuretic peptide (NT-proBNP) serum concentrations with cognitive functions of glioma and meningioma patients.

METHODS

177 brain tumor patients awaiting for brain tumor surgery participated in the study. Patients were assessed preoperatively, using neuropsychological tests for verbal memory, psychomotor speed, mental flexibility, and verbal fluency. The functional status of patients was evaluated using the Karnofsky Performance Index. Blood samples were drawn for evaluation of serum hsCRP and NT-proBNP concentrations upon hospital admission.

RESULTS

The highest NT-proBNP concentration was observed in meningioma patients. Glioma and meningioma patients did not differ in hsCRB concentration. Patients in the highest hsCRP tertile were older and more frequently reported cardiovascular comorbidity. Patients in the highest NT-proBNP tertile were older, more frequently with cardiovascular comorbidity, females, and diagnosed with a meningioma. hsCRP was significantly related to slower psychomotor speed in high-grade glioma patients ( = 0.30, < 0.05). In meningioma sample, NT-proBNP correlated with decreased psychomotor speed ( = 0.38, < 0.01), mental flexibility ( = 0.33, < 0.01), worse cumulative learning ( = -0.27, < 0.05), and delayed recall ( = 0.30, < 0.01). However, the relationship between the NT-proBNP and cognitive functions became nonsignificant when demographic and clinical covariates were included into analysis. Higher hsCRP concentration remained significantly related to slower psychomotor speed ( = 0.02) and worse mental flexibility ( = 0.05) in glioma patients, independently from demographic and clinical covariates. Preoperative cognitive functioning was also predicted by older age, gender, side and location of the tumor, and tumor malignancy, and general functional status of a patient.

CONCLUSIONS

NT-proBNP was not associated with memory, language, and attention/executive cognitive domains of glioma and meningioma patients. Increased hsCRP was related to slower psychomotor speed and worse mental flexibility in glioma patients, indicating that inflammation processes are important for cognitive functioning in glial tumors.

摘要

目的

本研究旨在探讨高敏 C 反应蛋白(hsCRP)和 N 末端 pro-B 型利钠肽前体(NT-proBNP)血清浓度与脑胶质瘤和脑膜瘤患者认知功能的关系。

方法

177 名接受脑肿瘤手术的脑肿瘤患者参与了本研究。术前使用神经心理学测试评估患者的语言记忆、运动速度、思维灵活性和语言流畅性。使用卡诺夫斯基绩效指数评估患者的功能状态。入院时抽取血样,评估血清 hsCRP 和 NT-proBNP 浓度。

结果

脑膜瘤患者的 NT-proBNP 浓度最高。胶质瘤和脑膜瘤患者的 hsCRP 浓度无差异。hsCRP 最高三分位组的患者年龄较大,且更常报告心血管合并症。NT-proBNP 最高三分位组的患者年龄较大,更常伴有心血管合并症、女性,且诊断为脑膜瘤。hsCRP 与高级别胶质瘤患者的运动速度较慢显著相关( = 0.30, < 0.05)。在脑膜瘤样本中,NT-proBNP 与运动速度减慢( = 0.38, < 0.01)、思维灵活性降低( = 0.33, < 0.01)、累积学习能力下降( = -0.27, < 0.05)和延迟回忆( = 0.30, < 0.01)相关。然而,当将人口统计学和临床协变量纳入分析时,NT-proBNP 与认知功能之间的关系变得无统计学意义。在胶质瘤患者中,hsCRP 浓度较高仍与运动速度较慢( = 0.02)和思维灵活性更差( = 0.05)显著相关,与人口统计学和临床协变量无关。术前认知功能还与年龄较大、性别、肿瘤侧位和位置、肿瘤恶性程度以及患者的一般功能状态有关。

结论

NT-proBNP 与胶质瘤和脑膜瘤患者的记忆、语言和注意力/执行认知域无关。hsCRP 升高与胶质瘤患者的运动速度较慢和思维灵活性较差有关,表明炎症过程对胶质肿瘤的认知功能很重要。

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