Risk factors for neurocognitive impairment in patients with benign intracranial lesions

Stefanie Bette,Melanie Barz,Benedikt Wiestler,Julia M Ruhland,Bernhard Meyer,Claus Zimmer,Jens Gempt,Florian Ringel,Yu-Mi Ryang

doi:10.1038/s41598-019-44466-y

Abstract

This study was designed to assess risk factors for neurocognitive impairment in patients with benign intracranial lesions including tumors and vascular lesions. 74 patients (29 m, 51 f, mean age 54.4 years) with surgery for benign intracranial lesions were included in this prospective single-center study. Extensive neuropsychological testing was performed preoperatively, including tests for attention, memory and executive functions. Furthermore, headache and depression were assessed using the german version of the HDI (IBK) and the BDI-II. Multiple linear regression analyses of the percentile ranks (adjusted for age, sex and education) including the parameters age, Karnofsky Performance Status Scale (KPS), mood, pain and lesion size were performed to identify risk factors for cognitive impairment. Using the Mann-Whitney U test, the influence of hemisphere and type of lesion (tumor/vascular) was assessed. Posthoc Bonferroni correction was performed. Poorer neurocognitive functions were observed only in the category attention in patients with higher age (divided attention, WMS) and reduced KPS (WMS). Lesion volume, mood, pain, hemisphere or the type of the lesion (tumor, vascular) were not identified as risk factors for poorer neurocognitive functions in patients with benign intracranial lesions. Age and KPS are the main risk factors for poorer neurocognitive functions in the category attention in patients with benign intracranial lesions. Knowledge of these risk factors might be important to find appropriate therapy regimes to improve cognitive functions and quality of life.

Highlights

For patients with intracranial lesions, the most important recorded parameters are age, neurological status and functional independence, as measured by the Karnofsky Performance Status Scale (KPS)[1]
Very little is known about neurocognitive functions in patients with intracranial vascular lesions or rare intracranial tumors
One patient did receive neuroradiological intervention for an intracranial aneurysm and was excluded from the study. 6 patients presented with trigeminal nerve neuralgia and were excluded due to a missing intracranial lesion

Summary

Introduction

For patients with intracranial lesions, the most important recorded parameters are age, neurological status and functional independence, as measured by the Karnofsky Performance Status Scale (KPS)[1]. Recent studies analyzed the role of neurocognitive impairment for glioma patients and showed that cognitive function is a predictor for survival[2,3,4,5]. Age, KPS and tumor grade as risk factors for neurocognitive impairment of glioma patients were identified[3,7]. A few studies analyzed cognitive functions in patients with pituitary adenomas and unruptured intracranial aneurysms[24,25,26]. Very little is known about neurocognitive functions in patients with intracranial vascular lesions (except for intracranial aneurysms26,27) or rare intracranial tumors. The aim of this study was to assess preoperative neurocognitive functions in patients with benign intracranial lesions, to identify risk factors for cognitive impairment

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Discussion

Conclusion