Late neurocognitive sequelae in patients with WHO grade I meningioma

BACKGROUND: Information on the neurocognitive outcome following treatment of benign meningiomas is virtually lacking. This is remarkable considering these patientsś survival is the most favorable of all intracranial tumors. The aim of the present study is therefore to document the extent and nature of neurocognitive deficits in WHO grade I meningioma patients after treatment. METHODS: Eighty-nine WHO grade I meningioma patients who underwent surgery with or without adjuvant radiotherapy were individually matched to 89 healthy controls for age, sex, and educational level. Neurocognitive functioning of patients was assessed at least one year following treatment and compared to that of healthy controls using Student's t-tests. Additionally, associations between tumor characteristics (size, lateralization and localization), treatment characteristics (radiotherapy), and epilepsy burden (based on seizure frequency and antiepileptic drug use) and neurocognitive functioning were investigated. RESULTS: Compared to healthy controls meningioma patients showed significant impairments in executive functioning (p < 0.001), verbal memory (p < 0.001), information processing capacity (p = 0.001), psychomotor speed (p = 0.001), and working memory (p = 0.006). Patients with skull base meningiomas performed significantly lower on three out of six neurocognitive domains when compared to convexity meningiomas. Left-sided as opposed to right sided meningiomas were related to verbal memory deficits. A higher epilepsy burden was significantly associated with lower executive functioning, which primarily could be attributed to antiepileptic drug use. No significant associations were established between neurocognitive status and radiotherapy or tumor volume. CONCLUSIONS: Meningioma patients are characterized by long-term deficits in neurocognitive functioning that can partly be attributed to the use of antiepileptic drugs and tumor location, but not to the use of radiotherap

Long-term Impact of Cognitive Deficits and Epilepsy on Quality of Life in Patients With Low-Grade Meningiomas

WHO Grade I meningiomas are common, usually benign, primary brain tumors. Little is known about the health-related quality of life (HRQOL) of patients with meningiomas. To investigate the long-term HRQOL in patients with meningiomas and its association with cognitive deficits and epilepsy. HRQOL was assessed by the Short-Form Health Survey questionnaire (SF-36) in 89 patients with WHO Grade I meningiomas at least 1 year following neurosurgery with or without radiotherapy. Cognitive functioning was measured by a neuropsychological test battery, and epileptic seizure frequency and antiepileptic drug (AED) use were determined for each patient. HRQOL of patients was compared to that of 89 healthy controls individually matched for age, sex, and educational level. As a group, patients with meningiomas did not differ from healthy controls on 7 out of 8 SF-36 scales; the only difference was that patients reported more role limitations caused by physical problems (P < .05). Patients with meningiomas had significant impairment in 4 of 6 cognitive domains, most pronounced in the domain of executive functioning. Both impaired cognitive functioning and AED use were associated with a compromised HRQOL. Of the 23 patients using AEDs, HRQOL was significantly impaired on 5 out of 8 SF-36 scales. In patients using AED, neither cognitive functioning nor HRQOL differed between those with and those without seizure control. The HRQOL of most patients with WHO Grade I meningiomas is comparable to that of the general population. However, HRQOL is worse in patients with major cognitive deficits and those using AEDs, irrespective of seizure contro