NCO-13NEUROCOGNITIVE CHANGES ASSOCIATED WITH FRONTAL LOBECTOMY FOR RIGHT AND LEFT FRONTAL LOBE GLIOMA

Abstract

BACKGROUND: Some patients with frontal lobe glioma receive near frontal lobectomy for tumor resection or debulking. However, little is known regarding the impact of frontal lobectomy for glioma on neurocognitive functioning (NCF). METHODS: Patients with glioma in the left (n = 11; 78% anaplastic) or right frontal lobe (n = 9; 73% anaplastic) underwent frontal lobectomy. The posterior resection boundary included the frontal pole of the lateral ventricle and posterior floor of the anterior cranial fossa. Pre- and postsurgical neuropsychological assessments were completed within 4months of resection [includin g WAIS-III: Block Design, Similarities, Digit Span, Digit Symbol; HVLT-R; Controlled Oral Word Association (COWA); Token Test; Trail Making Test (TMT)]. Scores at or below -1.5 SDs from normative means were considered impaired. Reliable change indices classified change in NCF performances as Declined or Stable/Improved. RESULTS: Demographic and tumor characteristics (histology/volume/extent of resection) did not differ by hemisphere. Presurgical NCF impairment was most frequent on COWA (25%), HVLT-R Total Recall (42%), Delayed Recall (41%), Recognition (24%), TMT-A (26%), and TMT-B (24%). In total, 50% of patients evidenced pre- to postoperative interval decline on at least 1 measure, which was most frequent on the HVLT-R Total Recall (26%) and TMT-B (23%). While not statistically significant, trends suggested older patients with greater extent of resection, and those with left frontal tumors were at greatest risk. CONCLUSIONS: NCF impairment was relatively common in patients with frontal lobe glioma in the pre-operative period in the domains of memory and executive functioning. Decline following frontal lobectomy was less common. Nonetheless, a sizeable proportion of patients experience some postoperative decline, most commonly in memory and executive functioning. Older patients with left frontal lesions may be at increased risk.