Cirurgia dels gliomes de baix grau i la memòria de treball
SUMMARY: SURGERY LOW-GRADE GLIOMA AND WORKING MEMORY OBJECTS: While scarcely reported, accurate assessment of higher functions in patients operated on for a low-grade glioma (LGG) is essential to evaluate then preserve the quality of life (QoL). Working memory is an instrument crucial for the cognitive functions. Our goal was to assess verbal WM (vWM) in patients with LGG in language areas, before surgery, to evaluate the effect of glioma on cognition. Postoperatively, the surgical impact on vWM was also determined. METHODS: This study includes 23 patients harboring a LGG in language areas, who underwent awake surgery. All patients had a vWM assessment, before and immediately after the resection, in addition to KPS evaluation. vWM were also evaluated 3 months after surgery in 8 patients (KPS in all cases), who performed postoperative neurocognitive rehabilitation focussed on vWM. Preoperatively, 91% of patients had vWM disorders (KPS ? 90 in all patients but one). Immediately after the surgery, 96% of patients had vWM worsening (50% of KPS ? 90). At three months, among the 8 patients with vWM assessment, 5 recovered their preoperative vWM score, and 3 significantly improved (all with KPS ? 90). CONCLUSIONS: In LGG, neuropsychological evaluation seems mandatory in addition to the classical scale of QoL. Indeed, a detailed preoperative vWM assessment showed that most of patients presented yet a cognitive deficit. Moreover, surgery almost systematically induced a transient vWM worsening, which nevertheless can recover within 3 months. Specific rehabilitation could help patients to return to their preoperative cognitive state, and even to improve this status. KEY WORDS: Working Memory, Cognitive functions, Brain Tumor, Surgery, Electrical stimulations.
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Advisor:Acebes Martín, Juan José; Duffau, Hugues
School:Universitat de Barcelona
Source Type:Master's Thesis
Keywords:cirurgia i especialitats quirúrgiques
Date of Publication:04/29/2005