Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands.
Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands.
Eur J Neurosci. 2024 Jul;60(1):3759-3771. doi: 10.1111/ejn.16378. Epub 2024 May 13.
Neuropsychological studies have demonstrated that meningioma patients frequently exhibit cognitive deficits before surgery and show only limited improvement after surgery. Combining neuropsychological with functional imaging measurements can shed more light on the impact of surgery on cognitive brain function. We aimed to evaluate whether surgery affects cognitive brain activity in such a manner that it may mask possible changes in cognitive functioning measured by neuropsychological tests. Twenty-three meningioma patients participated in a fMRI measurement using a verbal working memory task as well as three neuropsychological tests focused on working memory, just before and 3 months after surgery. A region of interest based fMRI analysis was used to examine cognitive brain activity at these timepoints within the central executive network and default mode network. Neuropsychological assessment showed impaired cognitive functioning before as well as 3 months after surgery. Neuropsychological test scores, in-scanner task performance as well as brain activity within the central executive and default mode network were not significantly different between both timepoints. Our results indicate that surgery does not significantly affect cognitive brain activity in meningioma patients the first few months after surgery. Therefore, the lack of cognitive improvement after surgery is not likely the result of compensatory processes in the brain. Cognitive deficits that are already present before surgery appear to be persistent after surgery and a considerable recovery period. Our study shows potential leads that comprehensive cognitive evaluation can be of added value so that cognitive functioning may become a more prominent factor in clinical decision making.
神经心理学研究表明，脑膜瘤患者在手术前经常表现出认知缺陷，手术后仅能得到有限的改善。将神经心理学与功能影像学测量相结合，可以更深入地了解手术对认知大脑功能的影响。我们旨在评估手术是否以这样一种方式影响认知大脑活动，以至于可能掩盖通过神经心理学测试测量的认知功能变化。23 名脑膜瘤患者参与了 fMRI 测量，使用言语工作记忆任务以及 3 项专注于工作记忆的神经心理学测试，分别在手术前和手术后 3 个月进行。使用基于感兴趣区域的 fMRI 分析，在中央执行网络和默认模式网络内检查这些时间点的认知大脑活动。神经心理学评估显示，手术前和手术后 3 个月认知功能受损。神经心理学测试分数、扫描内任务表现以及中央执行和默认模式网络内的大脑活动在这两个时间点之间没有显著差异。我们的研究结果表明，脑膜瘤患者手术后的头几个月，手术不会显著影响认知大脑活动。因此，手术后认知改善的缺乏不太可能是大脑代偿过程的结果。手术前已经存在的认知缺陷在手术后似乎仍然存在，并且有相当长的恢复期。我们的研究表明，全面的认知评估可能具有附加价值，因为认知功能可能成为临床决策中更重要的因素。
