P01.05.a cognitive outcomes in adult meningioma patients after surgery with or without radiotherapy

Abstract BACKGROUND Meningioma patients often report cognitive complaints after therapy, profoundly impacting health-related quality of life. However, prevalence of these cognitive sequelae is inconsistent across trials. Moreover, meningioma patients often suffer from severe anxiety after treatment compared to healthy controls, possibly adversely affecting cognition. MATERIAL AND METHODS In this cohort study, 41 adult WHO grade 1 and 2 meningioma patients underwent comprehensive cognitive testing, covering the domains of memory, executive functioning, visuomotor functioning, attention, and language. Cognitive scores were transformed into z-scores using normative data adjusted for age, education, and sex. Patients were categorized as cognitively impaired if at least 2 tests scores differed ≥ - 1.5 SD or if at least 1 test score differed ≥ - 2.0 SD from the reference mean. Moreover, all patients filled out an online self-report inventory, assessing anxiety. Anxiety, age at diagnosis and treatment modality were included as predictors in a linear regression model per cognitive domain. Bonferroni correction was applied to correct for multiple testing. RESULTS In this cohort, 26 out of 41 patients showed cognitive impairment (63,4%) and the same number reported to have higher anxiety levels compared to the norm. Patients performed worse than the norm in cognitive domains of language and visuomotor functioning. No significant differences were found in cognitive outcomes regarding therapy, being either surgery (n=31) or surgery followed by cranial radiotherapy (n=10). Age at time of diagnosis was the only significant predictor of language (p=.005) and attention (p=.015) performance, with worse performance in case of diagnosis at younger age. No impact of anxiety nor treatment modality was found in this study. CONCLUSION More than half of meningioma patients showed to be cognitively impaired after surgery with or without radiotherapy treatment, mostly in domains of language and visuomotor functioning. Younger patients could be affected more by language and attention difficulties in their daily lives. Given their more active stage in life, this can have an important impact. This effect was independent of emotional functioning. These findings will need to be validated in larger prospective longitudinal trials.