Impact of meningioma surgery on use of antiepileptic, antidepressant, and sedative drugs: A Swedish nationwide matched cohort study

Thurin, Erik; Rydén, Isabelle; Skoglund, Thomas; Smits, Anja; Gulati, Sasha; Hesselager, Göran; Bártek, Jiří; Henriksson, Roger; Salvesen, Øyvind; Jakola, Asgeir Store

doi:10.1002/cam4.3868

Cited by 10 publications

(9 citation statements)

References 39 publications

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“…However, we did not account for preoperative seizures in the analyses and with longer follow-ups frequencies of seizures would be expected to increase. In a Swedish registry-based study, nearly one in five meningioma patients were still on antiepileptic drugs 2 years after surgery [ 30 ]. Thus, due to the frequent use of antiepileptic drugs postoperatively in patients with preoperative seizures, and due to the short follow-up in many studies, underestimation of postoperative seizure frequencies is likely.…”

Section: Discussionmentioning

confidence: 99%

Brain infarction following meningioma surgery—incidence, risk factors, and impact on function, seizure risk, and patient-reported quality of life

et al. 2022

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In this study, we seek to explore the incidence of and potential risk factors for postoperative infarctions after meningioma surgery, in addition to the possible association with new neurological deficits, seizures, and health-related quality of life (HRQoL). A single-center cohort study was conducted, where all patients operated for an intracranial meningioma at our institution between 2007 and 2020 were screened for inclusion. Clinical data were prospectively collected in a local tumor registry, and HRQoL was assessed using both generic and disease-specific instruments. In total, 327 meningioma operations were included, and early postoperative MRIs showed peritumoral infarctions in 114 (34.9%). Median infarction volume was 4.5 ml (interquartile range 2.0–9.5) and 43 (37.7%) of the infarctions were rim-shaped, 44 (38.6%) were sector-shaped, 25 (21.9%) were a combination of rim- and sector-shaped, and two (1.8%) were remote infarctions. Permanent neurological deficits were seen in 22 patients (6.7%) and deficits were associated with infarctions (p < 0.001). There was no difference in frequency of registered postoperative epilepsy between patients with versus without infarctions. Patients with infarctions reported more future uncertainty; otherwise, there were no significant differences in disease specific HRQoL between patients with versus without infarctions. In this study, we found that peritumoral infarctions after meningioma resection are common. Most patients with permanent neurological deficits had infarctions. Yet, most infarctions were small, and although sometimes symptomatic on individual level, infarctions did not lead to significant deterioration of HRQoL on group level.

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Section: Discussionmentioning

confidence: 99%

Brain infarction following meningioma surgery—incidence, risk factors, and impact on function, seizure risk, and patient-reported quality of life

et al. 2022

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“…The low levels of antidepressant use in VS patients are interesting considering what is known for low-grade glioma [ 33 ] and meningioma [ 43 ], where the rate of antidepressant use is distinctly increased after surgery. For low-grade glioma, the increased use of antidepressants is presumably related to the higher morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Our study of a comparable population undergoing meningioma surgery during a similar time period demonstrated a clear peak around the time of surgery and a slight increase in long-term sedative use [ 43 ]. The expected brief, but significant, increase in sedative use for patients a few weeks after the index date did not cause long-term increased use in patients with VS.…”

Section: Discussionmentioning

confidence: 99%

Depression and ability to work after vestibular schwannoma surgery: a nationwide registry-based matched cohort study on antidepressants, sedatives, and sick leave

et al. 2021

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Background In patients with vestibular schwannomas (VS), tumor control is often achieved, and life expectancy is relatively good. The main risks of surgical treatment are hearing loss and facial nerve function. The occurrence of mood and sleeping disorders in relation to surgery is an important aspect of health that has rarely been studied. Similarly, only limited data exist on the rate of sick leave for patients with VS. In this nationwide registry-based study, we define the use of antidepressants and sedatives and the sick leave pattern before and after VS surgery. Methods Adult patients with histopathologically verified VS were identified in the Swedish Brain Tumor Registry (SBTR) and clinical data were linked to relevant national registries after assigning five matched controls to each patient. We studied patterns of dispensed antidepressants and sedative drugs as well as patterns of sick leave compared to respective controls at 2 years before and 2 years following surgery. Results We identified 333 patients and 1662 matched controls. The rate of antidepressant use was similar between patients and controls 2 years before surgery (6.0% vs 6.3%) and 2 years after surgery (10.1% vs 7.5%). The rate of sedative use was also similar 2 years before surgery (3.9% vs 4.3%) and 2 years after surgery (4.8% vs 5.3%). The rate of sick leave was similar at baseline between patients and controls, but at 2 years after surgery, 75% of patients vs 88% of controls (p < 0.01) had no registered sick leave. Long-term sick leave after surgery was predicted by use of sedatives (OR 0.60, 95% CI 0.38–0.94, p = 0.03), more preoperative sick leave (OR 0.91, 95% CI 0.89–0.93, p < 0.001), and new-onset neurological deficits after surgery (OR 0.42, 95% CI 0.24–0.76, p = 0.004). Conclusion This nationwide study shows no significant differences in the use of antidepressants and sedatives between patients and controls, while the rate of postoperative sick leave was higher in patients than in controls after VS surgery. Our findings underpin the importance of avoiding surgical sequelae and facilitating return to normal professional life.

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“…frontal convexity, falx or olfactory groove meningiomas). Depressive symptoms and fatigue are common amongst all meningioma patients 53–55 ; thus, these symptoms cannot only be caused by direct, local tumour pressure.…”

Section: Introductionmentioning

confidence: 99%

“…Studies exploring quality of life and everyday life from a patient perspective in patients with WHO grade 3 meningioma are non‐existing. In meningioma, irrespective of grade, recent studies found a long‐term reduction in health‐related quality of life, 103,104 elevated use of anti‐depressants even two years after surgery, 54 and a high burden of socioeconomic difficulties after meningioma surgery 105 . Moreover, patients with meningioma experienced a lack of support in the postoperative phase for optimal recovery 106 and could experience a paradox when they had to undergo extensive surgery for a benign tumour 107 .…”

Section: Introductionmentioning

confidence: 99%

Malignant meningioma

Maier

2022

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Impact of meningioma surgery on use of antiepileptic, antidepressant, and sedative drugs: A Swedish nationwide matched cohort study

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 10 publications

References 39 publications

Brain infarction following meningioma surgery—incidence, risk factors, and impact on function, seizure risk, and patient-reported quality of life

Brain infarction following meningioma surgery—incidence, risk factors, and impact on function, seizure risk, and patient-reported quality of life

Depression and ability to work after vestibular schwannoma surgery: a nationwide registry-based matched cohort study on antidepressants, sedatives, and sick leave

Malignant meningioma

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