胶质瘤手术围手术期的神经认知功能

IF 4.7 2区 医学 Q1 ONCOLOGY
Kyle R. Noll, Mariana Bradshaw, David Sheppard, Jeffrey S. Wefel
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引用次数: 0

摘要

综述目的本综述简要概述了有关胶质瘤患者术前和术后神经认知功能(NCF)的最新文献。最近的研究结果大多数胶质瘤患者在术前会出现神经认知功能障碍,其严重程度因种系和肿瘤遗传、肿瘤分级和病变位置等特征而异。有关术后 NCF 变化的文献资料不一,但许多研究表明,大多数患者的 NCF 会在短期内立即恶化。随后通常会在几个月内恢复;但也有相当一部分患者的病情会持续恶化。衰退似乎与手术引起的大脑结构和功能改变有关,包括肿瘤和切除腔的局部和远端。重要的是,术中脑部映射(包括语言和非语言功能映射)可在一定程度上缓解 NCF 的下降。虽然这增加了我们对NCF成因和手术干预相关衰退风险的了解,但要在整个病程中更好地保护NCF,还需要做更多的工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perioperative Neurocognitive Function in Glioma Surgery

Purpose of Review

This review provides a concise overview of the recent literature regarding preoperative and postoperative neurocognitive functioning (NCF) in patients with glioma. Brief discussion also covers contemporary intraoperative brain mapping work, with a focus on potential influence of mapping upon NCF outcomes following awake surgery.

Recent Findings

Most patients with glioma exhibit preoperative NCF impairment, with severity varying by germ line and tumoral genetics, tumor grade, and lesion location, among other characteristics. Literature regarding postoperative NCF changes is mixed, though numerous studies indicate a majority of patients exhibit immediate and short-term worsening. This is often followed by recovery over several months; however, a substantial portion of patients harbor persisting declines. Decline appears related to surgically-induced structural and functional brain alterations, both local and distal to the tumor and resection cavity. Importantly, NCF decline may be mitigated to some extent by intraoperative brain mapping, including mapping of both language-mediated and nonverbal functions.

Summary

Research regarding perioperative NCF in patients with glioma has flourished over recent years. While this has increased our understanding of contributors to NCF and risk of decline associated with surgical intervention, more work is needed to better preserve NCF throughout the disease course.

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来源期刊
CiteScore
8.50
自引率
0.00%
发文量
187
审稿时长
6-12 weeks
期刊介绍: This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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