Predictive factors of post-operative apathy in patients with diffuse frontal gliomas undergoing awake brain mapping

IF 1.8 4区 心理学 Q2 PSYCHOLOGY
Kazuya Motomura, Ai Kawamura, Fumiharu Ohka, Kosuke Aoki, Tomohide Nishikawa, Junya Yamaguchi, Yuji Kibe, Hiroki Shimizu, Sachi Maeda, Ryuta Saito
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Abstract

Patients with diffuse frontal gliomas often present with post-operative apathy after tumour removal. However, the association between apathy and tumour removal of gliomas from the frontal lobe remains unknown. This study aimed to investigate the factors influencing post-operative apathy after tumour removal in patients with diffuse frontal gliomas. We compared the demographics and clinical characteristics of patients with and without post-operative apathy in a cohort of 54 patients who underwent awake brain mapping for frontal gliomas. The frequency of clinical parameters such as left-sided involvement, high-grade tumour types (WHO grades III, IV), main tumour location in the anterior cingulate gyrus (ACC) and/or dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) was significantly greater in the apathetic group compared to the non-apathetic group. The apathetic group scored significantly lower on neuropsychological assessments such as the Letter Fluency Test among the Word Fluency Tests than the non-pathetic group (p = .000). Moreover, the scores of Parts 3, and 3–1 of the Stroop test were significantly lower in the apathetic group than those in the non-apathetic group (p = .023, .027, respectively). Multivariate model analysis revealed that the appearance of post-operative apathy was significantly related to side of the of lesion [left vs. right, hazard ratio (HR) = 8.00, 95% confidence interval (CI) = 1.36–46.96, p = .021], location of the main tumour in the frontal lobe (ACC/DLPFC/OFC vs. others, HR = 7.99, 95% CI = 2.16–29.59, p = .002), and the Letter Fluency Test (HR = .37, 95% CI = .15–.90, p = .028). Post-operative apathy is significantly associated with ACC and/or DLPFC and OFC in the left hemisphere of diffuse frontal gliomas. Apathy in frontal gliomas is correlated with a decline in the Letter Fluency Test scores. Therefore, this instrument is a potential predictor of post-operative apathy in patients with diffuse frontal gliomas undergoing awake brain mapping.

Abstract Image

接受清醒脑标测的弥漫性额胶质瘤患者术后冷漠的预测因素。
弥漫性额胶质瘤患者在肿瘤切除后通常表现为术后冷漠。然而,冷漠与额叶胶质瘤切除之间的关系仍然未知。本研究旨在探讨影响弥漫性额胶质瘤患者肿瘤切除后冷漠的因素。我们比较了54名接受额叶胶质瘤清醒脑标测的患者中有无术后冷漠患者的人口统计学和临床特征。与非昏迷组相比,冷漠组的左侧受累、高级别肿瘤类型(世界卫生组织III、IV级)、前扣带回(ACC)和/或背外侧前额叶皮质(DLPFC)和眶额皮质(OFC)的主要肿瘤位置等临床参数的频率显著更高。在单词流利性测试中,冷漠组在神经心理学评估(如字母流利性测试)上的得分显著低于非可怜组(p = .000)。此外,Stroop测试的第3部分和第3-1部分的分数在冷漠组中显著低于非冷漠组(p = .023、.027)。多变量模型分析显示,术后冷漠的表现与病变侧显著相关[左与右,风险比(HR) = 8.00,95%置信区间(CI) = 1.36-46.96,p = .021],主要肿瘤在额叶的位置(ACC/DLPFC/OFC与其他,HR = 7.99,95%CI = 2.16-29.59,p = .002)和字母流利性测试(HR = .37.95%CI = .15-.90,p = .028)。在弥漫性额胶质瘤的左半球,术后冷漠与ACC和/或DLPFC和OFC显著相关。额胶质瘤的冷漠与字母流利性测试分数的下降相关。因此,该仪器是接受清醒脑标测的弥漫性额胶质瘤患者术后冷漠的潜在预测指标。
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来源期刊
Journal of Neuropsychology
Journal of Neuropsychology 医学-心理学
CiteScore
4.50
自引率
4.50%
发文量
34
审稿时长
>12 weeks
期刊介绍: The Journal of Neuropsychology publishes original contributions to scientific knowledge in neuropsychology including: • clinical and research studies with neurological, psychiatric and psychological patient populations in all age groups • behavioural or pharmacological treatment regimes • cognitive experimentation and neuroimaging • multidisciplinary approach embracing areas such as developmental psychology, neurology, psychiatry, physiology, endocrinology, pharmacology and imaging science The following types of paper are invited: • papers reporting original empirical investigations • theoretical papers; provided that these are sufficiently related to empirical data • review articles, which need not be exhaustive, but which should give an interpretation of the state of research in a given field and, where appropriate, identify its clinical implications • brief reports and comments • case reports • fast-track papers (included in the issue following acceptation) reaction and rebuttals (short reactions to publications in JNP followed by an invited rebuttal of the original authors) • special issues.
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