CNSC-86. Cognitive and Psychiatric Recovery After Frontotemporal Meningioma Surgery: A Comprehensive Analysis of Outcomes and Predictive Factors

Cognitive and psychiatric impairments are common in frontotemporal meningioma patients, but their potential for reversibility after surgery is poorly understood, creating a knowledge gap compared to glioma research. This study aimed to evaluate cognitive and psychiatric changes and identify tumor-related prognostic factors in patients with frontotemporal meningiomas. We retrospectively analyzed 29 patients who underwent total surgical resection and completed both pre- and post-operative neuropsychological testing (NOPT, SNSB-II, or BNTP-M1). Linear regression analysis was used to identify factors associated with outcomes. Post-operatively, patients demonstrated significant improvements across all tested domains: attention (p=0.002), language (p=0.041), memory (p<0.001), visuospatial function (p=0.024), executive function (p<0.001), and psychiatric symptoms (p=0.043). Regression analysis revealed key predictors. Bilateral tumors were associated with better psychiatric recovery (β=−23.884, p=0.001) but poorer visuospatial function (β=−4.021, p=0.042), while frontal lobe involvement predicted worse language outcomes (β=−3.762, p=0.002). Frontal base tumors were linked to poorer psychiatric recovery (β=−14.908, p=0.005). Greater peritumoral edema predicted worse pre-operative attention (β=0.438, p=0.037) and psychiatric symptoms (β=42.804, p=0.001), though these deficits improved post-operatively. Our findings demonstrate that cognitive and psychiatric impairments from frontotemporal meningiomas are substantially reversible with surgery. Specific tumor characteristics are critical predictors of recovery, underscoring the importance of early diagnosis, tailored surgical strategies, and structured monitoring to optimize patient outcomes. Future research incorporating neurodegenerative biomarkers is warranted to distinguish tumor-induced deficits from comorbid age-related decline.