Assessment of Neuropsychological Parameters and Quality of Life to Evaluate Outcome in Patients With Surgically Treated Supratentorial Meningiomas

Krupp, Wolfgang; Klein, Christoph; Koschny, Ronald; Holland, Heidrun; Seifert, Volker; Meixensberger, Juergen

doi:10.1227/01.neu.0000336330.75381.39

Cited by 48 publications

(45 citation statements)

References 41 publications

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“…One interpretation for the adaptive function decline in both vmPFC and non-vmPFC groups is that neurosurgical intervention for meningioma has an effect on adaptive functions independent of meningioma location. This interpretation is consistent with previous studies showing postoperative decline in quality of life measures 18 . Interestingly, for patients in the vmPFC group there was greater preoperative impairment in adaptive function, along with greater decline in adaptive function between the pre and postoperative epoch (Figure 2).…”

Section: Discussionsupporting

confidence: 93%

“…Several studies have examined neuropsychological outcomes in meningioma patients 8,18,26 . Dijkstra and colleagues studied 89 patients who underwent resection of WHO I meningiomas and reported significant impairment in executive functioning, verbal memory, information processing capacity, psychomotor speed, and working memory 8 .…”

Section: Discussionmentioning

confidence: 99%

“…There have been case reports describing personality changes in patients with meningioma 21–23 , but larger studies specifically describing personality change in anterior skull base meningioma patients are lacking. Some neuropsychological studies have described basic cognitive outcomes in anterior skull base meningioma patients 8,18,26 . These studies report deficits in cognitive functioning, specifically with executive function, working memory, processing capacity, and motor speed.…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, although anterior skull base meningiomas frequently involve (and lesion) vmPFC, the cognitive and behavioral manifestations of anterior skull base meningiomas remain poorly understood 26 . Several authors have reported minimal change in cognition following surgical resection for meningiomas 18,26 . However, despite no significant measureable difference in cognitive or behavioral functioning after surgery, many patients do not return to their premorbid level of function 18 .…”

Section: Introductionmentioning

confidence: 99%

“…Several authors have reported minimal change in cognition following surgical resection for meningiomas 18,26 . However, despite no significant measureable difference in cognitive or behavioral functioning after surgery, many patients do not return to their premorbid level of function 18 . Such outcomes suggest that meningioma lesions, albeit not entirely caused by surgery itself, can lead to significant morbidity after treatment.…”

Section: Introductionmentioning

confidence: 99%

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The cognitive and behavioral effects of meningioma lesions involving the ventromedial prefrontal cortex

Abel¹,

Manzel

Bruss

et al. 2016

JNS

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Object Anterior skull base meningiomas are frequently associated with changes in personality and behavior. Although such meningiomas often damage ventromedial prefrontal cortex (vmPFC), which is important for higher cognition, the cognitive and behavioral effects of these meningiomas remain poorly understood. Using detailed neuropsychological assessments in a large series of patients, this study examines the cognitive and behavioral effects of meningioma lesions involving vmPFC. Methods We reviewed neuropsychology and lesion mapping records of 70 patients who underwent resection of meningiomas. The patients were drawn from the Neurological Patient Registry at the University of Iowa. Patients were sorted into two groups: those with lesions involving vmPFC and those with lesions that did not involve vmPFC. Neuropsychological data pertaining to a comprehensive array of cognitive and behavioral domains were available preoperatively in 20 patients and postoperatively in all 70 patients. Results There was no change in basic cognitive functions (e.g. attention, perception, memory, construction and motor performance, language, or executive functions) from the pre-operative to post-operative epochs for vmPFC and non-vmPFC groups. There was a significant decline in the behavioral domain, specifically adaptive function, for both the vmPFC and non-vmPFC groups, and this decline was more pronounced for the vmPFC group. Additionally, postoperative data indicated that the vmPFC group had a specific deficit in value-based decision making, as evidenced by poor performance on the Iowa Gambling Task, compared to the non-vmPFC group. The vmPFC and non-vmPFC groups did not differ postoperatively on other cognitive measures, including intellect, memory, language, and perception. Conclusions Lesions of vmPFC resulting from meningiomas are associated with specific deficits in adaptive function and value-based decision making. Meningioma patients showed decline in adaptive function postoperatively, and this decline was especially notable in patients with vmPFC region meningiomas. Early detection and resection of meningiomas of the anterior skull base (involving gyrus rectus) may prevent these deficits.

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Section: Discussionsupporting

confidence: 93%