Abstract
A significant proportion of brain tumour patients has cognitive impairments. Most studies have focussed on patients with glioma. Meningioma patients have been infrequently studied; we found only seven studies in the literature. Most of these studies lack preoperative measurements, a priori limiting conclusions on the impact of surgery on cognition. We examined cognitive functioning in 100 meningioma patients prior to, and three months after surgery. This study is part of a larger and prospective study in our hospital in which craniotomy patients are routinely tested with a computerized screening battery of neuropsychological tests (i.e., CNS Vital Signs). Testing takes approximately 30 - 45 minutes and results in quantified scores on the domains of memory, psychomotor speed, reaction time, complex attention, cognitive flexibility, processing speed, and executive functioning. For this study we applied stringent exclusion criteria to minimize possible cognitive effects of comorbidity (eg, we excluded patients with a history of intracranial treatment or major neurological disease) and this left us with a group of 68 patients. Average diameter of meningioma was 4.3 cm. Both before and after surgery, meningioma patients showed significantly lower scores on all cognitive domains in comparison with healthy controls. Three months after surgery, significantly improved test performances were found on all cognitive domains, with the exception of psychomotor speed and reaction time. To gain insight in individual test performance, the number of patients scoring ‘low’ or ‘very low’ (i.e, 1.5 and 2 SD below average) was counted. The percentage of these patients decreased from 69% before surgery to 44% three months after surgery. We conclude that (1) cognitive impairments are already present in the majority of untreated meningioma patients, (2) surgery improves these impairments, and (3) a computerized test battery seems an adequate (and time-efficient) clinical instrument to detect cognitive impairments in meningioma patients.
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