Cognitive improvement in meningioma patients after surgery: clinical relevance of computerized testing.

Cognitive dysfunction is common in patients with primary brain tumors, and may have a major impact on activities of daily living and on quality of life. This is the first prospective study that investigated the incidence and severity of cognitive dysfunction in meningioma patients before and after surgery, and the change in dysfunction over time, both at group and individual patient level. Sixty-eight meningioma patients were neuropsychologically tested one day before brain surgery. Sixty-two patients were followed up 3 months after surgery. All patients were assessed with a brief (30 min) computerized screening battery of neuropsychological tests (i.e., CNS Vital Signs). Pre- and post-operatively, meningioma patients demonstrated significantly lower scores in all cognitive domains; memory, psychomotor speed, reaction time, complex attention, cognitive flexibility, processing speed, and executive functioning, in comparison with normative data. Pre-operatively, 47 out of 68 patients (69 %) scored low or very low in one or more cognitive domains. Post-operatively, 27 out of 62 patients (44 %) scored within this range. Test performance improved in all cognitive domains post-operatively, with the exception of psychomotor speed and reaction time. In line with previous studies with conventional neuropsychological tests, meningioma patients are faced with cognitive dysfunction in several cognitive domains both pre- and post-operatively. However, a large proportion of patients shows post-operative improvement in cognitive functioning. Longer-term follow-up is recommended to identify potential predictors of cognitive improvement after surgery. Diagnosis and treatment of these cognitive deficits will improve outcomes and quality of life in meningioma patients.