Department of Neurosurgery, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Institut for Clinical Psychology, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria.
Acta Neurochir (Wien). 2024 Oct 10;166(1):402. doi: 10.1007/s00701-024-06295-5.
Early diagnosis and the refinement of treatment of patients with intracranial meningiomas have brought quality of life (QoL) and neurocognitive functioning as outcome measures into focus. The aim of this study is a comprehensive assessment of neurocognitive function, quality of life and the presence of depression in meningioma patients before and after surgery.
Patients with MRI diagnosis of intracranial meningioma and indication for surgery were prospectively included. A clinical neuropsychologist performed neurocognitive assessments within 3 months before and 12 months after surgery. The test battery included investigation of selective and divided attention, verbal and figural memory, executive functioning, and word fluency. Self-report questionnaires to assess depressive symptoms, QoL, and disease coping were administered. Raw values and t-values were compared pre-and postoperatively. Outcome was stratified by tumor- and peritumoral brain edema (PTBE) volumes, postoperative resolution of PTBE and WHO grade. The study included 18 predominantly female patients (83%) with a median age of 59 years and mostly CNS WHO grade 1 meningiomas (83%).
There was a significant postoperative improvement in the ability to selectively react under stress, in working memory and improved delayed reproduction of verbal and visual memory content. QoL improved regarding a reduction in physical problems, an improvement in energy, and social functioning. There was a trend towards worse preoperative scores in all tests, and greater postoperative improvement in patients with PTBE. Tumor volume had no effect on the measured outcome. The patients did not suffer from depressive symptoms before the surgery but improved postoperatively and most patients had an active, problem-oriented coping strategy.
Resection of intracranial meningiomas leads to an improvement in multiple neurocognitive domains and QoL. There is a trend towards poorer preoperative neurocognitive functioning and greater postoperative improvement in patients with PTBE. Depression appears to play a minor role in the context of neurocognitive functioning and disease coping.
颅内脑膜瘤的早期诊断和治疗精细化已将生活质量（QoL）和神经认知功能作为结果指标纳入研究焦点。本研究旨在全面评估脑膜瘤患者手术前后的神经认知功能、生活质量和抑郁状态。
前瞻性纳入经 MRI 诊断为颅内脑膜瘤且有手术适应证的患者。临床神经心理学家在手术前 3 个月内和手术后 12 个月内进行神经认知评估。测试包包括选择性和分散注意力、言语和图像记忆、执行功能和词汇流畅性的调查。使用自我报告问卷评估抑郁症状、生活质量和疾病应对方式。比较术前和术后的原始值和 t 值。根据肿瘤和瘤周脑水肿（PTBE）体积、术后 PTBE 缓解和世界卫生组织（WHO）分级对结果进行分层。该研究纳入了 18 名主要为女性（83%）患者（中位年龄 59 岁），大多数为中枢神经系统（CNS）WHO 分级 1 级脑膜瘤（83%）。
在应激下选择性反应能力、工作记忆和言语及视觉记忆内容的延迟再现方面，术后有显著改善。生活质量在身体问题减少、能量和社会功能改善方面得到改善。所有测试的术前得分均呈下降趋势，PTBE 患者术后改善程度更大。肿瘤体积对测量结果无影响。患者在手术前没有抑郁症状，但术后有所改善，大多数患者采用积极的、面向问题的应对策略。
颅内脑膜瘤切除术可改善多种神经认知领域和生活质量。PTBE 患者的术前神经认知功能较差，术后改善程度较大，这一趋势较为明显。在神经认知功能和疾病应对方面，抑郁似乎作用较小。
