There is a vast body of literature with reports on the neurological outcomes of patients operated on for brain diseases, such as meningiomas, cavernomas, ependymomas, metastases and gliomas in eloquent areas. Currently, the specific effects of glioma surgery on higher cognitive functions, such as language, memory, attention and executive functions, however, are not entirely clear. Recent publications show that, with this technique, maximal resection percentages with minimal neurological deficits can be attained. Currently, the “gold standard” treatment for LGG is awake surgery with direct electrocortical stimulation to preserve functions. Therefore severe neurological and/or cognitive disturbances are assumed to be relatively rare. 5 mm per year, the brain is supposed to be able to reorganise the functions at risk for impairment (e.g. However, due to the slow growth rate of LGGs, i.e. LGGs often reside in the so-called “eloquent areas” of the brain. LGGs are mostly revealed by epileptic seizures and/or by mild cognitive complaints. In The Netherlands, the incidence of newly diagnosed primary brain tumours is 5–7 per 100,000, of which 20 % are low-grade gliomas (LGGs). More studies with longer postoperative follow-up with tests for cognitive change are necessary for a better understanding of the conclusive effects of glioma surgery on cognition. ConclusionsĬognitive recovery to the preoperative level after surgery is possible to a certain extent however, the results are too arbitrary to draw definite conclusions and not all studies investigated all cognitive domains. In the longer term (3–6/6–12 months postoperatively), the following tests showed both recovery and deterioration compared with the preoperative level: naming and verbal fluency (language), verbal word learning (memory) and Trailmaking B (executive functions). Immediately postoperatively, all studies except one, found deterioration in one or more cognitive domains. Language was the domain most frequently examined. We included 17 studies with tests assessing the cognitive domains: language, memory, attention, executive functions and/or visuospatial abilities. We systematically searched the electronical databases Embase, Medline OvidSP, Web of Science, PsychINFO OvidSP, PubMed, Cochrane, Google Scholar, Scirius and Proquest aimed at cognitive performance in glioma patients preoperatively and postoperatively. In this study, we aimed to elucidate the short-term and long-term effects of glioma surgery on cognition by identifying all studies who conducted neuropsychological tests preoperatively and postoperatively in glioma patients. However, this conclusion was relatively ungrounded due to the lack of extensive neuropsychological testing in homogenous patient groups. Several studies claimed that surgery in eloquent areas is possible without causing severe cognitive damage. Cognitive preservation is crucial in glioma surgery, as it is an important aspect of daily life functioning.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |