Sarcouncil Journal of Medical Series

Abstract: Background: Executive function, attention, memory, and language networks are at risk of disruption due to frontal lobe tumor and surgery. Objective: To describe the neurocognitive profiles at 24 months after surgical resection of tumors of the frontal lobe and to determine clinical, tumor-related, and surgical predictors for the trajectory of cognitive outcomes. The methods used in this illustrative longitudinal cohort design involved a neuropsychological battery that was administered at four time points: preoperatively and at 1, 6, 12, and 24 months after resection of a frontal lobe tumor were modeled (N = 129 patients). Mixed-effects regression and multivariate regression were used to assess associations with tumor, surgical, and demographic variables and cognitive trajectories. The results for the current simulated dataset showed that overall composites of cognitive performance showed transient decline in the immediate postoperative period followed by gradual recovery; however, the pattern of change over time varied from one domain to another across executive functions, memory, attention, processing speed, and language. The key factors for the long-term cognitive trajectory were modeled as extent of resection, tumor laterality, involvement of the dorsolateral prefrontal cortex, and postoperative complications. Conclusions: The modeled results reflect the typical pattern of findings from the literature on frontal lobe tumors, that of a cognitive dip in the early postoperative phase followed by some recovery, but with specificity of the vulnerable domains and a substantial number of patients with persistent deficits. This could facilitate multidisciplinary surveillance and individualized rehabilitation planning but needs to be validated with data collected in the real world.