Cognitive outcomes in meningioma patients undergoing surgery: individual changes over time and predictors of late cognitive functioning

Sophie Rijnen*, Ikram Meskal, Marjan Bakker, Wouter De Baene, Geert-Jan Rutten, Karin Gehring, Margriet Sitskoorn

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Meningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients.

Methods
Patients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0), and 3 (T3) and 12 (T12) months after surgery. Patients’ sociodemographically-corrected scores on 7 cognitive domains were compared to performance of a normative sample using one-sample z tests and Chi-square tests of independence. Reliable change indices with correction for practice effects were calculated for individual patients. Linear mixed effects models were used to identify preoperative predictors of performance at T12.

Results
At T0, 261 patients were assessed, and 229 and 82 patients were retested at T3 and T12, respectively. Patients showed impaired cognitive performance before and after surgery, and although performance improved on the group-level, cognitive scores remained significantly lower than in the normative sample up to T12. On the individual level, performance remained stable in the majority of patients. Better preoperative performance, younger age, male sex, and higher educational level predicted better late cognitive performance.

Conclusions
Meningioma patients face serious and persistent pre- and postsurgical cognitive deficits. A preoperative NPA together with sociodemographic characteristics may provide valuable information on the late cognitive outcome of individual meningioma patients. These results can help to inform patients and clinicians on late cognitive outcomes at an early stage, and emphasizes the importance of presurgical NPA and timely cognitive rehabilitation.
Original languageEnglish
Pages (from-to)911-922
JournalNeuro-Oncology
Volume21
Issue number7
DOIs
Publication statusPublished - 2019

Fingerprint

Meningioma
Vital Signs
Chi-Square Distribution

Keywords

  • BRAIN-TUMORS
  • HOSPITAL ANXIETY
  • QUALITY-OF-LIFE
  • cognition
  • individual changes
  • meningioma
  • predictors
  • reliable change index

Cite this

@article{363d04d7f4c24032882832a5d6453893,
title = "Cognitive outcomes in meningioma patients undergoing surgery: individual changes over time and predictors of late cognitive functioning",
abstract = "BackgroundMeningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients.MethodsPatients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0), and 3 (T3) and 12 (T12) months after surgery. Patients’ sociodemographically-corrected scores on 7 cognitive domains were compared to performance of a normative sample using one-sample z tests and Chi-square tests of independence. Reliable change indices with correction for practice effects were calculated for individual patients. Linear mixed effects models were used to identify preoperative predictors of performance at T12.ResultsAt T0, 261 patients were assessed, and 229 and 82 patients were retested at T3 and T12, respectively. Patients showed impaired cognitive performance before and after surgery, and although performance improved on the group-level, cognitive scores remained significantly lower than in the normative sample up to T12. On the individual level, performance remained stable in the majority of patients. Better preoperative performance, younger age, male sex, and higher educational level predicted better late cognitive performance.ConclusionsMeningioma patients face serious and persistent pre- and postsurgical cognitive deficits. A preoperative NPA together with sociodemographic characteristics may provide valuable information on the late cognitive outcome of individual meningioma patients. These results can help to inform patients and clinicians on late cognitive outcomes at an early stage, and emphasizes the importance of presurgical NPA and timely cognitive rehabilitation.",
keywords = "BRAIN-TUMORS, HOSPITAL ANXIETY, QUALITY-OF-LIFE, cognition, individual changes, meningioma, predictors, reliable change index",
author = "Sophie Rijnen and Ikram Meskal and Marjan Bakker and {De Baene}, Wouter and Geert-Jan Rutten and Karin Gehring and Margriet Sitskoorn",
year = "2019",
doi = "10.1093/neuonc/noz039",
language = "English",
volume = "21",
pages = "911--922",
journal = "Neuro-Oncology",
issn = "1522-8517",
publisher = "OXFORD UNIV PRESS INC",
number = "7",

}

TY - JOUR

T1 - Cognitive outcomes in meningioma patients undergoing surgery: individual changes over time and predictors of late cognitive functioning

AU - Rijnen, Sophie

AU - Meskal, Ikram

AU - Bakker, Marjan

AU - De Baene, Wouter

AU - Rutten, Geert-Jan

AU - Gehring, Karin

AU - Sitskoorn, Margriet

PY - 2019

Y1 - 2019

N2 - BackgroundMeningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients.MethodsPatients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0), and 3 (T3) and 12 (T12) months after surgery. Patients’ sociodemographically-corrected scores on 7 cognitive domains were compared to performance of a normative sample using one-sample z tests and Chi-square tests of independence. Reliable change indices with correction for practice effects were calculated for individual patients. Linear mixed effects models were used to identify preoperative predictors of performance at T12.ResultsAt T0, 261 patients were assessed, and 229 and 82 patients were retested at T3 and T12, respectively. Patients showed impaired cognitive performance before and after surgery, and although performance improved on the group-level, cognitive scores remained significantly lower than in the normative sample up to T12. On the individual level, performance remained stable in the majority of patients. Better preoperative performance, younger age, male sex, and higher educational level predicted better late cognitive performance.ConclusionsMeningioma patients face serious and persistent pre- and postsurgical cognitive deficits. A preoperative NPA together with sociodemographic characteristics may provide valuable information on the late cognitive outcome of individual meningioma patients. These results can help to inform patients and clinicians on late cognitive outcomes at an early stage, and emphasizes the importance of presurgical NPA and timely cognitive rehabilitation.

AB - BackgroundMeningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients.MethodsPatients underwent neuropsychological assessment (NPA) using CNS Vital Signs 1 day before (T0), and 3 (T3) and 12 (T12) months after surgery. Patients’ sociodemographically-corrected scores on 7 cognitive domains were compared to performance of a normative sample using one-sample z tests and Chi-square tests of independence. Reliable change indices with correction for practice effects were calculated for individual patients. Linear mixed effects models were used to identify preoperative predictors of performance at T12.ResultsAt T0, 261 patients were assessed, and 229 and 82 patients were retested at T3 and T12, respectively. Patients showed impaired cognitive performance before and after surgery, and although performance improved on the group-level, cognitive scores remained significantly lower than in the normative sample up to T12. On the individual level, performance remained stable in the majority of patients. Better preoperative performance, younger age, male sex, and higher educational level predicted better late cognitive performance.ConclusionsMeningioma patients face serious and persistent pre- and postsurgical cognitive deficits. A preoperative NPA together with sociodemographic characteristics may provide valuable information on the late cognitive outcome of individual meningioma patients. These results can help to inform patients and clinicians on late cognitive outcomes at an early stage, and emphasizes the importance of presurgical NPA and timely cognitive rehabilitation.

KW - BRAIN-TUMORS

KW - HOSPITAL ANXIETY

KW - QUALITY-OF-LIFE

KW - cognition

KW - individual changes

KW - meningioma

KW - predictors

KW - reliable change index

U2 - 10.1093/neuonc/noz039

DO - 10.1093/neuonc/noz039

M3 - Article

VL - 21

SP - 911

EP - 922

JO - Neuro-Oncology

JF - Neuro-Oncology

SN - 1522-8517

IS - 7

ER -