The Impact of Glioma Growth and Resection on Neurocognitive Impairment – a Prospective Observational Study

Cognitive impairments are common among patients suffering from brain tumors. Up to date, however, it is rarely assessed in clinical routine. This study aimed to evaluate pre- and postoperative neurocognitive performance in a wide range of patients suffering from gliomas representing clinical routine by using a test battery of easy-to-use and established neurocognitive tests. Patients undergoing microsurgical glioma resection between 04/2019 and 03/2021 were prospectively included. A structured test set for neurocognitive function was performed preoperatively in 33 patients and during follow-up in 14 patients. Data were converted into z-scores and combined with the corresponding cognitive domains. Thirty-three patients aged 49.2 ± 14.4 (22-81) years were included. The individual tests showed impairments preoperatively most frequently in the trail-making test B (TMT-B) in 63.6% of patients, followed by the Montreal Cognitive Assessment (MoCA) with 39.4%. Preoperatively, a clinically significant impairment was found in the domain of executive function and attention, with a mean domain score of -2.49. At follow-up, the group domain scores were impaired on the same cognitive domains as preoperatively, with executive function and attention significantly impaired (z = -2.58). Neurocognitive deficits are present in the majority of patients with glioma before surgery while still performing well in conventional scores regarding functional status. We did not observe any significant surgery-related deterioration in cognitive performance; however, this finding is compromised by a considerable number of patients lost to follow-up.