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Neurocognitive function before and after surgery for insular gliomas.

Adam S Wu1, Mariana E Witgert, Frederick F Lang

  • 1Department of Neurosurgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.

Journal of Neurosurgery
|September 13, 2011
PubMed
Summary
This summary is machine-generated.

Surgery for insular gliomas is feasible with acceptable neurological morbidity. While preoperative naming deficits were noted, postoperative cognitive decline was similar between insular and control groups, with a trend towards greater learning and memory impairment in insular glioma patients.

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Area of Science:

  • Neurosurgery
  • Neuro-oncology
  • Cognitive Neuroscience

Background:

  • Insular gliomas pose unique surgical challenges.
  • Higher-order neurocognitive function after insular glioma resection is not well understood.
  • Previous studies have underappreciated the impact of gliomas on neurocognition.

Purpose of the Study:

  • To evaluate neurocognitive function in patients with insular gliomas.
  • To compare neurocognitive outcomes in insular glioma patients with a matched control group of patients with gliomas in adjacent brain regions.
  • To assess the impact of insular glioma resection on specific cognitive domains.

Main Methods:

  • Neuropsychological evaluations were conducted pre- and post-operatively in 33 patients with insular gliomas (WHO Grade II or III).
  • A matched control group of patients with gliomas in nearby frontal, temporal, and parietal regions was established based on age, education, KPS, tumor side, grade, and volume.
  • Pre- and postoperative cognitive test results were compared between and within the insular and control groups.

Main Results:

  • Preoperative neurocognitive impairment was prevalent in both insular and control groups.
  • Patients with insular gliomas showed significantly worse preoperative performance in naming tasks.
  • Postoperative cognitive decline was observed across most domains in both groups, with no statistically significant differences in decline rates. However, a trend indicated greater postoperative decline in learning and memory for insular glioma patients.

Conclusions:

  • Few statistically significant cognitive differences were found between insular and control groups, pre- or post-operatively.
  • A trend suggests insular glioma patients may experience more significant postoperative decline in learning and memory.
  • Resection of insular gliomas is feasible, with many patients avoiding profound neurological or cognitive morbidity.