Tosi Umberto, Sacks-Zimmerman Amanda, Villamater Francis Michael, Spat-Lemus Jessica S, Perrine Kenneth, Souweidane Mark, Bender Heidi Allison
Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA.
Department of Neurological Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Cancers (Basel). 2025 Jan 27;17(3):416. doi: 10.3390/cancers17030416.
Resection of colloid cysts, a rare third ventricle pathology, is accepted clinical practice. Owing to their location proximal to deep gray nuclei and forniceal columns, colloid cysts have been theorized to contribute to cognitive decline. Comprehensive pre- and post-operative cognitive testing, however, has rarely been implemented.
We analyzed formal neuropsychological testing performed in 20 patients undergoing endoscopic cyst resection. Pre- and post-operative performance was compared either for each individual patient or according to aggregated neuropsychological factor scores grouped via expert census. A change in performance was deemed significant if (i) it reached statistical significance and (ii) was greater than 1.5 pre-operative standard deviations.
Twenty patients with colloid cysts (average diameter 13.3 ± 1.3 mm) underwent matched pre- and post-operative testing. No patient had a significant change in cognitive performance. Neurocognitive metrics assessing cognitive functions typically subsumed by the temporal ( = 0.35), extratemporal ( = 0.20), occipitoparietal ( = 0.31), or frontal lobes ( = 0.11) did not change post-operatively. Similarly, no differences emerged when factor scores were generated according to composite scores of different neurocognitive domains: attention ( = 0.32), executive function ( = 0.14), language ( = 0.98), and visuospatial function ( = 0.42).
Neuropsychological testing allows for the careful monitoring of cognitive status before and after surgery and for the identification of patients who may benefit from pre- and post-operative cognitive rehabilitation. It should also be used as a valuable surgical psychometric marker and adjuvant. No significant cognitive decline was observed in this cohort.
切除胶体囊肿是一种罕见的第三脑室病变，是公认的临床实践。由于其位于深灰质核和穹窿柱附近，理论上认为胶体囊肿会导致认知能力下降。然而，很少实施全面的术前和术后认知测试。
我们分析了20例接受内镜囊肿切除术患者的正式神经心理学测试。对每位患者的术前和术后表现进行比较，或根据专家普查分组的综合神经心理学因素评分进行比较。如果（i）达到统计学显著性且（ii）大于术前标准差的1.5倍，则认为表现变化具有显著性。
20例胶体囊肿患者（平均直径13.3±1.3mm）接受了匹配的术前和术后测试。没有患者的认知表现有显著变化。评估通常由颞叶（=0.35）、颞外叶（=0.20）、枕顶叶（=0.31）或额叶（=0.11）涵盖的认知功能的神经认知指标术后没有变化。同样，根据不同神经认知领域的综合评分生成因素评分时，也没有出现差异：注意力（=0.32）、执行功能（=0.14）、语言（=0.98）和视觉空间功能（=0.42）。
神经心理学测试有助于仔细监测手术前后的认知状态，并识别可能从术前和术后认知康复中受益的患者。它还应作为一种有价值的手术心理测量指标和辅助手段。在该队列中未观察到显著的认知能力下降。
