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Effects of Glioblastoma Resection on Cognitive Function and Affective Symptoms at Three-Month Follow-Up
Carina E Tschirky1,2, David Bellut3, Nicolin Hainc4
1Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Background:
Glioblastoma (GBM) is the most frequent primary malignant brain tumor characterized by aggressive growth and poor prognosis, frequently accompanied by cognitive and affective deficits that severely impair quality of life (QoL). However, the short-term course of these cognitive and emotional functions after surgical resection remains insufficiently understood.
Aims:
This study aimed to investigate changes in cognitive performance and affective symptoms before and 3 months after GBM resection and to explore the influence of tumor characteristics such as lateralization and location. We hypothesized that cognitive function and affective symptoms would improve or remain stable postoperatively and that tumor-related factors would modulate these trajectories.
Methods:
In this multicenter pre-post observational study, 37 adults with histopathologically confirmed GBM (World Health Organization [WHO] 2021) were assessed using the Montreal Cognitive Assessment (MoCA) and the Hospital Anxiety and Depression Scale (HADS). Paired t-tests, Wilcoxon tests, ANOVA, and linear regression were conducted to evaluate pre- to postoperative changes and correlations with tumor characteristics.
Results:
Cognitive performance remained stable after resection. Although the HADS total score showed no significant pre- to postoperative change, patients with preoperative anxiety or depressive symptoms demonstrated significant postoperative improvement (HADS-A p = 0.010; HADS-D p = 0.012). Higher preoperative HADS scores predicted greater symptom reduction. Higher affective burden was shown in patients with right-hemispheric and parieto-occipital tumors, while temporal lobe tumors were associated with anxiety that decreased after resection (p = 0.009).
Conclusions:
GBM resection maintained cognitive function while improving affective symptoms in patients with elevated preoperative distress. Systematic psychological screening and tailored psychosocial interventions may enhance emotional resilience and QoL in GBM care.
