Cognition and quality of life in patients with brain tumors

Damage to the brain areas involved in cognitive functions can have a crucial effect on the quality-of-life (QoL) of patients. QoL is an important topic that is increasingly relevant considering that gliomas typically affect young individuals potentially capable of returning to work. The objectives of this study were to develop a neuropsychological battery to investigate cognitive functions in patients with primary brain tumors, to identify any permanent cognitive deficit (in particular attention, language, and memory) and to study how patients after surgery perceive their functional status and social well-being. Two hundred patients with high- and low-grade gliomas in the right and left hemisphere were evaluated. We have developed an extensive neuropsychological battery that allows a careful evaluation of patients and a selection of the patients suitable for awake surgery, while detecting the stimuli to use intraoperatively. Cognitive function (memory, language, attention, visuo-spatial orientation, and intelligence) was evaluated by means of this battery and a short interview was run to test their well-being perception. Patients were evaluated before surgery, immediately after surgery, and 3 months after surgery. This neuropsychological evaluation often revealed deficits in language competences or in memory abilities that hardly emerged from a simple clinical evaluation. Patients immediately after surgery reported fatigue and sometimes altered mood. A comparison with the preoperative test showed poorer verbal fluency, attention, verbal or visual learning, or psychomotor speed. Cognitive function did not differ between the evaluation before surgery and follow-up and a high proportion of patients had a good recovery of cognitive function and were able to carry out everyday activities.