Department of Neurological Surgery, University of California San Francisco, San Francisco, California.
Department of Psychology, University of Michigan, Ann Arbor, Michigan.
Neurosurgery. 2021 Jun 15;89(1):1-10. doi: 10.1093/neuros/nyaa400.
Cognitive decline is common among patients with low- and high-grade glioma and can significantly impact quality of life. Although cognitive outcomes have been studied after therapeutic interventions such as surgery and radiation, it is important to understand the impact of the disease process itself prior to any interventions. Neurocognitive domains of interest in this disease context include intellectual function and premorbid ability, executive function, learning and memory, attention, language function, processing speed, visuospatial function, motor function, and emotional function. Here, we review oncologic factors associated with more neurocognitive impairment, key neurocognitive tasks relevant to glioma patient assessment, as well as the relevance of the human neural connectome in understanding cognitive dysfunction in glioma patients. A contextual understanding of glioma-functional network disruption and its impact on cognition is critical in the surgical management of eloquent area tumors.
认知能力下降在低级别和高级别胶质瘤患者中很常见，并且会显著影响生活质量。虽然已经研究了治疗干预（如手术和放疗）后的认知结果，但在进行任何干预之前，了解疾病过程本身的影响很重要。在这种疾病背景下，感兴趣的神经认知领域包括智力和先前能力、执行功能、学习和记忆、注意力、语言功能、处理速度、视空间功能、运动功能和情绪功能。在这里，我们回顾了与更多神经认知障碍相关的肿瘤学因素、与胶质瘤患者评估相关的关键神经认知任务，以及人类神经连接组在理解胶质瘤患者认知功能障碍中的相关性。在语言功能区肿瘤的手术治疗中，需要从上下文角度理解胶质瘤-功能网络破坏及其对认知的影响。
