Cognitive deficits before treatment among patients with brain tumors

There are few data available on the cognitive deficits of patients with primary or secondary intracranial mass lesions before treatment. The aim of the present study was to document the incidence of cognitive impairments among patients with brain tumors of the frontal or temporal lobes, immediately after diagnosis but before the commencement of treatment.

One hundred thirty-nine patients were neuropsychologically examined using standardized psychometric testing procedures that measured various aspects of memory, attention, language, and executive functions. Furthermore, reports by the patients of their own cognitive functioning in the weeks before treatment were recorded.

With the classification of test performances below the 10th percentile as impaired, more than 90% of patients displayed impairments in at least one area of cognition. Impairments of executive functions were observed for 78% of patients, and impairments of memory and attention were observed for more than 60% of patients. Analysis of the correlation between the patients' own reports and the neuropsychological assessment results revealed only a weak relationship. No effects of anticonvulsant drugs on cognition were observed.

The present findings suggest that most patients with brain tumors of the frontal or temporal lobes demonstrate impairments of cognitive functioning at the time of diagnosis. Therefore, for quality assessments of neurosurgical procedures, baseline evaluations of cognitive measures should be performed.