Cognitive outcomes following neurosurgery for frontal intracerebral tumors: A systematic review and meta-analysis
Elisa Pellencin1, Fabio Masina2,3, Nicolò Castelli4
1Clinical Psychology and Psychological Well-being Unit, ASST Spedali Civili of Brescia, Italy.
Objective:
Neurosurgical resection of frontal lobe tumors poses specific challenges to the patients. Even when lesions involve the so-called "non-eloquent" areas, such as the prefrontal cortex, neurosurgery can still affect critical functions, because the prefrontal regions are essential for executive functions and other complex cognitive processes. The aim of this study is to systematically review the literature and quantitatively assess the impact of frontal lobe tumor resection on patients' cognitive functioning.
Methods:
In the present systematic review and meta-analysis, we synthesized data from 50 studies that included pre- and post-neurosurgery neuropsychological assessments. In addition, we conducted a meta-analysis of a subset of studies (n = 15) including sufficient data to quantitatively evaluate the cognitive effects of frontal lobe tumor resections.
Results:
We found that cognitive performance, after neurosurgery, was not significantly changed compared to pre-neurosurgery performance. We also identified several limitations in the literature, including variability in neuropsychological assessment protocols, differences in follow-up time points, inconsistent reporting of baseline cognitive functioning, and underpowered sample sizes.
Conclusions:
In future studies, researchers should adopt standardized, comprehensive assessments, with well-powered cohorts and long-term follow-ups, to better characterize post-neurosurgical cognitive outcomes, including those regarding "non-eloquent" frontal regions. A multidisciplinary and harmonized approach remains crucial for understanding the cognitive impact of frontal lobe tumor neurosurgery and for improving patient care.
