Profiling Cognitive Functions in Patients with Cranial Meningioma

Abstract Meningiomas are known to cause cognitive deficits. The study aims to profile cognitive impairments in preoperative patients with supratentorial meningiomas, to find the differences in cognition pre- and postoperatively, and to find the influence of tumor variables, namely type, size, laterality, grade, and edema, on cognition pre- and postoperatively. The study included 250 patients who were assessed preoperatively for cognition using selected tests from the NIMHANS Neurocognitive Battery, and a subset of 90 patients who underwent cognitive assessments between 3 and 6 months postoperatively. Tumor-related factors of edema, laterality, size, type, and effects of anterior fossa tumors influencing cognition were studied. A statistically significant difference was observed in cognitive variables between the preoperative and postoperative groups. In the preoperative group, edema was found to have significant associations with Logical Memory, verbal memory and learning, verbal fluency, TMT-A, and Digit Symbol Substitution Test. Grade had a significant association with TMT A, and laterality was significantly associated with Rey–Osterrieth Complex Figure Test (RCFT). Postoperatively, edema had a statistically significant association with rate of learning and information processing speed, laterality with verbal fluency and anterior fossa meningiomas with TMT B. There is a difference between the pre- and postoperative patients in the improvement of cognition. In the preoperative and in the postoperative group, the figural recall of the RCFT was shown to be the cognitive function that was most compromised, followed by the executive functions of set shift and focused attention. The cognitive function with the least impairment was verbal fluency and information processing speed. The study highlights the need for preoperative and subsequent cognitive assessments.