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填补空白:针对接受清醒手术的胶质瘤患者的简短神经心理学评估方案

Filling the gap: brief neuropsychological assessment protocol for glioma patients undergoing awake surgeries.

作者信息

Ohy Juliana Bastos, Formentin Cleiton, Gripp Daniel Andrade, Nicácio Joab Alves, Velho Maíra Cristina, Vilany Larissa Núbia, Greggianin Gabriel Frizon, Sartori Beatriz, Campos Ana Carolina Pinheiro, Verst Silvia Mazzali, Maldaun Marcos Vinicius Calfat

机构信息

Department of Neuro-Oncology, Sírio Libanês Hospital, Sao Paulo, Brazil.

出版信息

Front Psychol. 2024 Aug 9;15:1417947. doi: 10.3389/fpsyg.2024.1417947. eCollection 2024.

Abstract

INTRODUCTION

The literature lacks a concise neurocognitive test for assessing primary cognitive domains in neuro-oncological patients. This study aims to describe and assess the feasibility of the Ohy-Maldaun Fast Track Cognitive Test (OMFTCT), used to pre- and post-operatively evaluate patients undergoing brain tumor surgery in language eloquent areas. The cognitive diagnosis was used to safely guide intraoperative language assessment.

METHODS

This is a prospective longitudinal observational clinical study conducted on a cohort of 50 glioma patients eligible for awake craniotomies. The proposed protocol assesses multiple cognitive domains, including language, short-term verbal and visual memories, working memory, praxis, executive functions, and calculation ability. The protocol comprises 10 different subtests, with a maximum score of 50 points, and was applied at three time points: preoperative, immediately postoperative period, and 30 days after surgery.

RESULTS

Among the initial 50 patients enrolled, 36 underwent assessment at all three designated time points. The mean age of the patients was 45.3 years, and they presented an average of 15 years of education. The predominant tumor types included Glioblastoma, IDH-wt (44.1%), and diffuse astrocytoma, IDH-mutant (41.2%). The tumors were located in the left temporal lobe (27.8%), followed by the left frontal lobe (25%). The full test had an average application time of 23 min.

CONCLUSION

OMFTCT provided pre- and postoperative assessments of different cognitive domains, enabling more accurate planning of intraoperative language testing. Additionally, recognition of post-operative cognitive impairments played a crucial role in optimizing patient care.

摘要

引言

目前文献中缺乏一种用于评估神经肿瘤患者主要认知领域的简洁神经认知测试。本研究旨在描述和评估奥伊-马尔道恩快速认知测试(OMFTCT)的可行性,该测试用于术前和术后评估在语言功能区接受脑肿瘤手术的患者。认知诊断用于安全指导术中语言评估。

方法

这是一项对50名适合清醒开颅手术的胶质瘤患者进行的前瞻性纵向观察性临床研究。所提出的方案评估多个认知领域,包括语言、短期言语和视觉记忆、工作记忆、实践能力、执行功能和计算能力。该方案包括10个不同的子测试,最高分为50分,并在三个时间点应用:术前、术后即刻和术后30天。

结果

在最初纳入的50名患者中,36名在所有三个指定时间点接受了评估。患者的平均年龄为45.3岁,平均受教育年限为15年。主要肿瘤类型包括胶质母细胞瘤,异柠檬酸脱氢酶野生型(44.1%)和弥漫性星形细胞瘤,异柠檬酸脱氢酶突变型(41.2%)。肿瘤位于左侧颞叶(27.8%),其次是左侧额叶(25%)。完整测试的平均应用时间为23分钟。

结论

OMFTCT提供了术前和术后不同认知领域的评估,有助于更准确地规划术中语言测试。此外,识别术后认知障碍在优化患者护理方面发挥了关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2dd/11342098/be513f40f0c1/fpsyg-15-1417947-g001.jpg

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