Neuropsychological functioning and emotional processing in acoustic schwannoma: Insights from an Indian cohort

Acoustic schwannomas are a highly prevalent yet poorly studied class of benign brain tumors impacting neuropsychological functioning, clinical, and functional outcomes. The study aims to assess neurocognitive functions and emotional processing in right-handed adults of Indian origin with acoustic schwannomas and identify neuropsychological impairments and relevant correlates. A prospective cross-sectional research design with consecutive sampling was employed. The sample (n = 44) was screened according to the WHO Classification of Tumors of the Central Nervous System (2021) and recruited by consecutive sampling from a referral and tertiary care medical center in South India. Selected neuropsychological tests from the Post-Graduate Institute Battery of Brain Dysfunction, Wechsler Memory Scale III, and National Institute of Mental Health and Neurosciences Neuropsychology Battery were administered along with a task developed for the assessment of emotion processing. The data was statistically analyzed using Statistical Analysis System (SAS) for descriptive analysis and non-parametric inferential statistics. The cohort had a mean age of 43.86 (±11.09) years, with a median of 12 (±3.02) years of education and right hemispheric (54.5%) cerebellar-pontine angle lesions. Our results demonstrate impairment in multiple neurocognitive domains, including visuospatial construction, visual/verbal memory, attention, executive functions, and difficulty in emotional processing in acoustic schwannoma patients, consistent with cerebellar contributions to higher-order functions. These deficits correlated with sociodemographic and clinical factors, potentially implicating networks such as the default mode network, cerebello-thalamo-cortical, and fronto-cerebellar pathways. The study highlights the need for comprehensive neuropsychological assessments in acoustic schwannomas and implications for functional outcomes.