Meningiomas and Cognitive Impairment after Treatment: A Systematic and Narrative Review

Gondar, Renato; Patet, Gildas; Schaller, Karl; Meling, Torstein R.

doi:10.3390/cancers13081846

Cited by 13 publications

(14 citation statements)

References 42 publications

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“…As this review focused on patient self-report measures, we reported on subjective cognitive complaints rather than results from objective cognitive assessment—which is known to be impaired with approximately 80% of studies finding evidence of cognitive impairment in meningioma patients up to a year after treatment. 36 Cognitive complaints as reported by patients may reflect better the impact of cognitive impairment on everyday life in longer-term survivorship, as experienced by patients, as over time patients may adopt compensatory strategies and/or undergo neurorehabilitation. Importantly, in this review, we did not focus on family caregiver reports, which can substantially differ from patient self-reports, especially when cognitive impairment results in reduced self-awareness of functioning.…”

Section: Discussionmentioning

confidence: 99%

Long-term health-related quality of life in meningioma survivors: A mixed-methods systematic review

Frances,

Murray,

Nicklin

et al. 2024

Neuro-Oncology Advances

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Background Meningiomas account for ~25% of all primary brain tumours. These tumours have a relatively favourable prognosis with ~92% of meningioma patients surviving > 5 years after diagnosis. Yet, patients can report high disease burden and survivorship issues even years after treatment, affecting health-related quality of life (HRQOL). We aimed to systematically review the literature and synthesise evidence on HRQOL in meningioma patients across long-term survival, defined as >2 years post diagnosis. Methods Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO, and Web of Science Core Collection. Any published, peer reviewed article with primary quantitative, qualitative, or mixed methods data covering the physical, mental, and/or social aspects of HRQOL of meningioma survivors were included. Narrative synthesis method was used to interpret findings. Results Searches returned 2253 unique publications, of which 21 were included. Of these, N=15 involved quantitative methodology, N=4 mixed methods and N=2 were qualitative reports. Patient sample survival ranged from 2.75–13 years. HRQOL impairment was seen across all domains. Physical issues included persevering symptoms (e.g. headaches, fatigue, vision problems); mental issues comprised emotional burden (e.g., high prevalence of depressive symptoms and anxiety) and cognitive complaints; social issues included role limitations, social isolation, and affected work productivity. Due to study heterogeneity, the impact of treatment on long-term HRQOL remains unclear. Conclusions Findings from this review highlight the areas of HRQOL that can be impacted in long-term survivorship for patients with meningioma. These findings could help raise awareness among clinicians and patients, facilitating support provision.

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Section: Discussionmentioning

confidence: 99%

Long-term health-related quality of life in meningioma survivors: A mixed-methods systematic review

Frances,

Murray,

Nicklin

et al. 2024

Neuro-Oncology Advances

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“…According to a recent study, almost half of NSBM patients present with significant neurological symptoms ( 43 ) that stay unresolved over an extended period in 27% of the patients ( 27 ). In addition, meningioma patients frequently present with significant neurocognitive impairment ( 44 ), which persists in about 40% of the patients following surgical resection ( 45 ). Particularly patients with NSMB frequently experience partial and general seizures ( 26 , 46 ), leading to antiepileptic drug treatment, which additionally causes compromised neurocognitive function ( 29 , 47 ).…”

Section: Discussionmentioning

confidence: 99%

“…These factors cause significantly impaired quality of life, even up to 10 years after initial diagnosis ( 48 ). Surgical resection may positively influence focal neurological impairment ( 24 , 43 ), neurocognitive function ( 44 ), seizure frequency ( 26 ) and quality of life ( 30 ). Given NSBM’s specific biology, clinical dynamic, and symptomatology ( 11 , 12 , 25 , 49 ), we attempted with our study to assess the functional recovery rates specifically in NSBM patients.…”

Section: Discussionmentioning

confidence: 99%

Symptom burden and surgical outcome in non-skull base meningiomas

et al. 2022

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PurposeNon-skull base meningiomas (NSBM) are a distinct entity and frequently present with focal neurological deficits. This study was designed to analyze functional and oncological outcome following microsurgical tumor resection in patients with NSBM.Patients and methodsAn analysis of 300 patients that underwent NSBM resection between 2003 and 2013 was performed. Assessment measures for functional outcome were Karnofsky Performance Scale (KPS), Medical Research Council - Neurological Performance Scale (MRC-NPS), and improvement rates of focal deficits and seizures. The extent of resection; recurrence-free survival (RFS) and tumor-specific survival (TSS) were also determined.ResultsImpaired KPS and MRC-NPS were present in 73.3% and 45.7%, respectively. Focal neurological deficits were recorded in 123 patients (41.0%), with hemiparesis (21.7%) and aphasia (9.3%) the most prevalent form of impairment. Most meningiomas were localized at the convexity (64.0%), followed by falcine tumors (20.3%). Both KPI and MRC-NPS scores were significantly improved by surgical resection. Postoperative improvement rates of 96.6%, 89.3%, 72.3%, 57.9%, and 27.3% were observed for aphasia, epilepsy, hemiparesis, cranial nerve, and visual field deficits, respectively. Long-term improvement was achieved in 83.2%, 89.3%, 80.0%, 68.4% and 54.6% of patients, respectively. Gross total resection (GTR) over subtotal resection (STR) significantly improved preoperative seizures and visual field deficits and correlated with reduced risk of new postoperative hemiparesis. Poor Simpson grade was the only significant prognostic factor in multivariate analysis for long-term functional deficit, which occurred in 7.3%. Median RFS was 45.9 months (6.0 - 151.5 months), while median TSS was 53.7 months (3.1 – 153.2 months). Both WHO grade (p= 0.001) and Simpson classification (p= 0.014 and p= 0.031) were independent significant prognostic factors for decreased RFS and TSS by multivariate analysis, respectively. Furthermore, tumor diameter > 50 mm (p= 0.039) significantly correlated with decreased TSS in multivariate analysis.ConclusionSurgical resection significantly and stably improves neurological deficits in patients with NSBM.

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“…Therefore, they do not have a large direct destructive effect on brain tissue, which may be reflected by little or no FC alterations. Meningiomas can, however, cause language impairments, despite the absence of infiltrative injury ( Gondar et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Resting-State Electroencephalography Functional Connectivity Networks Relate to Pre- and Postoperative Language Functioning in Low-Grade Glioma and Meningioma Patients

et al. 2021

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Introduction: Preservation of language functioning in patients undergoing brain tumor surgery is essential because language impairments negatively impact the quality of life. Brain tumor patients have alterations in functional connectivity (FC), the extent to which brain areas functionally interact. We studied FC networks in relation to language functioning in glioma and meningioma patients.Method: Patients with a low-grade glioma (N = 15) or meningioma (N = 10) infiltrating into/pressing on the language-dominant hemisphere underwent extensive language testing before and 1 year after surgery. Resting-state EEG was registered preoperatively, postoperatively (glioma patients only), and once in healthy individuals. After analyzing FC in theta and alpha frequency bands, weighted networks and Minimum Spanning Trees were quantified by various network measures.Results: Pre-operative FC network characteristics did not differ between glioma patients and healthy individuals. However, hub presence and higher local and global FC are associated with poorer language functioning before surgery in glioma patients and predict worse language performance at 1 year after surgery. For meningioma patients, a greater small worldness was related to worse language performance and hub presence; better average clustering and global integration were predictive of worse outcome on language function 1 year after surgery. The average eccentricity, diameter and tree hierarchy seem to be the network metrics with the more pronounced relation to language performance.Discussion: In this exploratory study, we demonstrated that preoperative FC networks are informative for pre- and postoperative language functioning in glioma patients and to a lesser extent in meningioma patients.

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Meningiomas and Cognitive Impairment after Treatment: A Systematic and Narrative Review

Cited by 13 publications

References 42 publications

Long-term health-related quality of life in meningioma survivors: A mixed-methods systematic review

Long-term health-related quality of life in meningioma survivors: A mixed-methods systematic review

Symptom burden and surgical outcome in non-skull base meningiomas

Resting-State Electroencephalography Functional Connectivity Networks Relate to Pre- and Postoperative Language Functioning in Low-Grade Glioma and Meningioma Patients

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