PURPOSE This study aimed to assess perioperative neurocognitive functions in patients with surgery for intracranial neuroepithelial tumors. METHODS Seventy-one patients [38 male, 33 female, mean age 47.2 years (range 18 to 81)] with surgery for an intracranial neuroepithelial tumor were included in this prospective single-center study. Mini-mental status examination (MMSE) and extensive neurocognitive testing (divided into the categories attention, memory, and executive functions and adjusted for age, sex, and education) were performed pre-(t0) and early postoperatively (t1). Part of the patient cohort (n = 32) also underwent neurocognitive testing during follow-up (t2). The Karnofsky Performance Status Scale (KPS) was used to assess patients' functional independence. Patients' quality of life was recorded by the Short Form 36 (SF 36) pre- and postoperatively in a part of the patient cohort. Pre- and postoperative comparisons were performed using the Wilcoxon-test for paired samples. Post hoc Bonferroni correction was performed to adjust for multiple testing. To assess the influence of risk factors on neurocognitive functions, Spearman correlations and the chi-squared test were performed. Subgroup analyses for patients with low-grade and high-grade tumors were performed. RESULTS Postoperative deterioration was observed in 5 of 39 subtests of extensive neurocognitive testing in all 3 categories, whereas no improvement was shown. Patients with WHO Grade I tumors showed no deterioration of cognitive functions. Patients with WHO Grade II and III tumors showed significantly worse results in the executive functions category patients with WHO Grade IV tumors showed deterioration in the attention category. Significantly worse functional independence was recorded postoperatively and during follow-up (P < 0.001). Patients reported poorer physical health (SF 36, P = 0.001) at t1, whereas mental health did not differ significantly (P = 0.480). Risk factors for postoperative deterioration of cognition are low KPS scores, postoperative radiotherapy and tumor location in the temporal lobe. CONCLUSIONS After surgery on an intracranial neuroepithelial tumor, early postoperative deterioration of neurocognitive functions, functional independence and physical health occur. Similar results were also shown during follow-up suggesting that these effects are not only due to postoperative systemic factors or fatigue. This knowledge might improve perioperative surveillance of neurocognitive functions.

中文翻译：

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神经上皮颅内肿瘤患者的围手术期神经认知功能。

目的本研究旨在评估颅内神经上皮肿瘤手术患者的围手术期神经认知功能。方法该前瞻性单中心研究纳入了71例接受颅内神经上皮肿瘤手术治疗的患者（男38例，女33例，平均年龄47.2岁（18至81岁））。术前（t0）和术后早期（t1）进行了迷你心理状态检查（MMSE）和广泛的神经认知测试（分为注意，记忆和执行功能类别，并根据年龄，性别和教育程度进行了调整）。在随访期间（t2），部分患者队列（n = 32）也接受了神经认知测试。卡诺夫斯基表现状态量表（KPS）用于评估患者的功能独立性。耐心' 简短的表格36（SF 36）记录了患者队列中一部分患者的生活质量。使用Wilcoxon检验对配对样品进行术前和术后比较。进行事后Bonferroni校正以调整多项测试。为了评估危险因素对神经认知功能的影响，进行了Spearman相关性和卡方检验。对具有低度和高度肿瘤的患者进行亚组分析。结果在所有3个类别的39个广泛的神经认知测试子测试中，有5个观察到了术后恶化，但未见改善。世卫组织I级肿瘤患者未表现出认知功能下降。在执行功能类别中，患有WHO II和III级肿瘤的患者显示出明显更差的结果患有WHO IV级肿瘤的患者在注意类别中显示出恶化。术后和随访期间记录的功能独立性明显较差（P <0.001）。患者在t1时报告的身体健康状况较差（SF 36，P = 0.001），而精神健康状况无显着差异（P = 0.480）。术后认知能力下降的危险因素是KPS评分低，术后放疗和颞叶肿瘤位置。结论颅内神经上皮肿瘤手术后，术后早期出现神经认知功能，功能独立性和身体健康的恶化。随访期间也显示了相似的结果，提示这些作用不仅是由于术后全身因素或疲劳引起的。该知识可能会改善围手术期对神经认知功能的监视。