Neuropsychological deficit and postoperative recovery dynamics in patients with olfactory groove meningiomas: a single-center prospective study

Olfactory groove meningiomas (OGMs) are slow-growing tumors that compress the orbitofrontal cortex, potentially causing executive dysfunction, affective disturbances and behavioral alterations. However, prospective, multi-domain neuropsychological outcome data remain scarce. This study aimed to characterize cognitive, emotional, and psychopathological changes in OGM patients across three standardized time points. In this prospective single-center study, 39 OGM patients underwent comprehensive assessments preoperatively, at early postoperative, and at long-term follow-up periods. Evaluation included the MoCA test, phonemic verbal fluency, digit span forward/backward, and validated scales for depression, apathy, and general psychopathological assessment (PANSS). The Karnofsky performance scale (KPS) was employed to evaluate patients’ functional status. Linear mixed models and multiple regression with feature selection were applied. Verbal fluency significantly improved from preoperative baseline to early postoperative period ( p = 0.021), with sustained benefit at follow-up. Digit span and MoCA scores remained stable over time. PANSS total scores decreased significantly after surgery ( p = 0.014), indicating reduced psychopathological symptoms. Depression and apathy showed non-significant improving trends. Larger tumor volume ( p = 0.032) and lower preoperative functional status ( p = 0.003) were associated with greater individual improvement in MoCA scores postoperatively, with the cross-validated model explaining 28% of variance in MoCA score changes, although MoCA scores remained stable at the group level. Resection of OGMs yields domain-specific, sustained improvement in executive function and reduces psychopathological symptoms without compromising other cognitive domains. Preoperative functional status and tumor volume predict the magnitude of change in global cognitive performance, underscoring the value of routine neuropsychological assessment and identifying patients who could potentially benefit from targeted rehabilitation strategies in the future.