Relationships between tumor grade and neurocognitive functioning in patients with glioma of the left temporal lobe prior to surgical resection

Noll, Kyle R.; Sullaway, Catherine M.; Ziu, Mateo; Weinberg, Jeffrey S.; Wefel, Jeffrey S.

doi:10.1093/neuonc/nou233

Cited by 112 publications

(91 citation statements)

References 28 publications

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“…The clinical outcomes of WHO grade 4 gliomas are worse than for other gliomas that have similar effects on neurocognitive function at presentation [11,19]; accordingly, grade 4 gliomas were analyzed separately. After comparing patients with grade <4 and grade 4 gliomas, the GA and AC groups were compared within the grade <4 and grade 4 groups.…”

Section: Discussionmentioning

confidence: 99%

Awake craniotomy versus craniotomy under general anesthesia for the surgical treatment of insular glioma: choices and outcomes

Gravesteijn

Keizer

Vincent

et al. 2017

Neurological Research

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Objective: To investigate differences in outcomes in patients who underwent surgery for insular glioma using an awake craniotomy (AC) vs. a craniotomy under general anesthesia (GA). Methods:Data from patients treated at our hospital between 2005 and 2015 were analyzed retrospectively. The preoperative, intraoperative, postoperative, and longer term follow-up characteristics and outcomes of patients who underwent surgery for primary insular glioma using either an AC or GA were compared. Results: Of the 52 identified patients, 24 had surgery using an AC and 28 had surgery under GA. The extent of resection was similar for the two anesthesia techniques: the median extent of resection was 61.4% (IQR: 37.8-74.3%) in the WHO grade <4 AC group vs. 50.5% (IQR: 35.0-71.2%) in the grade <4 GA group and 73.4% (IQR: 54.8-87.2%) in the grade 4 AC group vs. 88.6% (IQR: 61.2-93.0%) in the grade 4 GA group. Consistent with literature, there were more early neurological deficits after an AC, while the GA group showed more new late neurological deficits; however, these trends were not significant. Survival was similar between the two groups, with 100% 1-and 2-year survival in the grade <4 groups. Conclusion: Our results showed that the extent of resection, neurological outcomes, and survival were similar using the two anesthesia techniques. Since AC is more challenging for the patient and for his or her caregiver after surgery, this finding has implications for clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Awake craniotomy versus craniotomy under general anesthesia for the surgical treatment of insular glioma: choices and outcomes

Gravesteijn

Keizer

Vincent

et al. 2017

Neurological Research

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“…Similarly, those on antiepileptic medications exhibited better executive function performances than those not taking antiepileptic medication. Rather than suggesting a positive effect of seizures or anticonvulsant medication upon NCF, this likely reflects the fact that fewer high grade glioma patients have seizures compared to lower grade patients [38], and those with high grade glioma tend to exhibit greater NCF problems than low grade patients [28]. …”

Section: Discussionmentioning

confidence: 99%

“…For mean NCF scores that significantly differed across temporal lobe groups, follow-up one-way analysis of covariance (ANCOVA) tests controlling for tumor grade (high vs. low) were performed, given known associations between tumor histology and NCF. [28] Mean NCF performances were further analyzed by temporal lobe region of lesion with one-way analysis of variance (ANOVA) for both LTL and RTL groups. Tukey’s honestly significant difference (HSD) test was used for post hoc comparisons.…”

Section: Methodsmentioning

confidence: 99%

Neurocognitive functioning in patients with glioma of the left and right temporal lobes

et al. 2016

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Patients with glioma frequently suffer from deficits of neurocognitive functioning (NCF), though few studies have assessed NCF in localized glioma patients prior to surgery. One hundred and three patients (M age = 52.0; M education = 14.6 years) with histologically confirmed glioma in the right (RTL: n = 30; 57 % glioblastoma) or left temporal lobe (LTL: n = 73; 49 % glioblastoma) completed presurgical neuropsychological assessment. Impairment of NCF was identified in 75 % of all patients. Notably, patients with RTL glioma were most frequently impaired on measures of verbal memory and executive functioning, and at similar rates as the LTL group. Nonetheless, χ2 tests revealed that impairment rates were significantly higher in the LTL group on attention and object naming tests (p ≤ .05). Independent-samples t-tests revealed that mean performances of patients with LTL glioma were also significantly below RTL patients on measures of attention (p = .01), verbal learning and memory (p = .05), and language (p <.03). A trend was observed in which anterior LTL tumors were associated with reduced verbal learning and medial LTL lesions with delayed recall problems, though patients with lesions involving multiple LTL regions exhibited the greatest difficulty across all verbal memory measures. Significant group differences in NCF performances remained so after controlling for FLAIR volume and tumor histology. These findings indicate that temporal lobe glioma frequently present with impaired NCF, though impairments are often milder in RTL compared to LTL patients. Nonetheless, the relatively frequent verbal memory impairment in the RTL group underscores the bilaterality of verbal memory processes.

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“…21 Tumors with extension into 2 or more areas were considered multi-region. Tumor location was classified as involving eloquent, near-eloquent, or non-eloquent regions.…”

Section: Methodsmentioning

confidence: 99%

Neurocognitive Changes Associated With Surgical Resection of Left and Right Temporal Lobe Glioma

Noll

Weinberg²,

Ziu

et al. 2015

Neurosurgery

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Background Little is known regarding the neurocognitive impact of temporal lobe tumor resection. Objective To clarify subacute surgery-related changes in neurocognitive functioning (NCF) in patients with left (LTL) and right (RTL) temporal lobe glioma. Methods Patients with glioma in the LTL (n=45) or RTL (n=19) completed comprehensive pre- and postsurgical neuropsychological assessments. NCF was analyzed with two-way mixed design repeated measures analysis of variance, with hemisphere (LTL or RTL) as an independent between-subjects factor and pre- and postoperative NCF as a within-subjects factor. Results About 60% of patients with LTL glioma and 40% with RTL lesions exhibited significant worsening on at least one NCF test. Domains most commonly impacted included verbal memory and executive functioning. Patients with LTL tumor showed greater decline than patients with RTL tumor on verbal memory and confrontation naming tests. Nonetheless, over one-third of patients with RTL lesions also showed verbal memory decline. Conclusion In patients with temporal lobe glioma, NCF decline in the subacute postoperative period is common. As expected, patients with LTL tumor show more frequent and severe decline than patients with RTL tumor, particularly on verbally-mediated measures. However, a considerable proportion of patients with RTL tumor also exhibit decline across various domains, even those typically associated with left hemisphere structures, such as verbal memory. While patients with RTL lesions may show even greater decline in visuospatial memory, this domain was not assessed. Nonetheless, neuropsychological assessment can identify acquired deficits and help facilitate early intervention in patients with temporal lobe glioma.

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Relationships between tumor grade and neurocognitive functioning in patients with glioma of the left temporal lobe prior to surgical resection

Cited by 112 publications

References 28 publications

Awake craniotomy versus craniotomy under general anesthesia for the surgical treatment of insular glioma: choices and outcomes

Awake craniotomy versus craniotomy under general anesthesia for the surgical treatment of insular glioma: choices and outcomes

Neurocognitive functioning in patients with glioma of the left and right temporal lobes

Neurocognitive Changes Associated With Surgical Resection of Left and Right Temporal Lobe Glioma

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