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  • 1. Campanella, Fabio
    et al.
    Del Missier, Fabio
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi. University of Trieste, Italy.
    Shallice, Tim
    Skrap, Miran
    Localizing Memory Functions in Brain Tumor Patients: Anatomical Hotspots over 260 Patients2018Ingår i: World Neurosurgery, ISSN 1878-8750, E-ISSN 1878-8769, Vol. 120, s. e690-e709Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Memory complaints are common in patients after brain tumor, but is difficult to map memory functions during awake surgery, to preserve them. Thus we analyzed one of the largest data sets on clinical, surgical, and anatomical correlates of memory in patients with brain tumor to date, providing anatomical hotspots for short and long-term memory functions. METHODS: A total of 260 patients with brain tumor (130 high-grade gliomas; 76 low-grade gliomas [LGG]; 54 meningiomas) were tested on 2 commonly used short-term memory (Digit Span Forward and Corsi Spatial Span) and 2 long-term memory tasks (Narrative Memory and Delayed Recall of Rey Figure). Patients were evaluated before and immediately after surgery and (for LGG) after 4 months and data analyzed by means of analysis of covariance and the voxel-based lesion-symptom mapping technique. RESULTS: As expected, patients with high-grade gliomas were already impaired before surgery, whereas patients with meningioma were largely unimpaired. Patients with LGG were unimpaired before surgery, but showed significant performance drop immediately after, with good recovery within few months. Voxel-based lesion-symptom mapping analyses identified specific anatomical correlates for verbal memory tasks, whereas visuospatial tasks provided good sensitivity to cognitive damage but failed to show anatomical specificity. Anatomical hotspots identified were in line with both previous functional magnetic resonance imaging and clinical studies on other neurological populations. CONCLUSIONS: Verbal memory tasks revealed a set of specific anatomical hotspots that might be considered eloquent for verbal memory functions, unlike visuospatial tasks, suggesting that commonly used spatial memory tasks might not be optimal to localize the damage, despite an otherwise good sensitivity to cognitive damage.

  • 2. Campanella, Fabio
    et al.
    Palese, Alvisa
    Del Missier, Fabio
    Stockholms universitet, Samhällsvetenskapliga fakulteten, Psykologiska institutionen, Kognitiv psykologi. University of Trieste, Italy.
    Moreale, Renzo
    Ius, Tamara
    Shallice, Tim
    Fabbro, Franco
    Skrap, Miran
    Long-Term Cognitive Functioning and Psychological Well-Being in Surgically Treated Patients with Low-Grade Glioma2017Ingår i: World Neurosurgery, ISSN 1878-8750, E-ISSN 1878-8769, Vol. 103, s. 799-808.e9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The aim of this work is to provide an in-depth investigation of the impact of low-grade gliomas (LGG) and their surgery on patients' cognitive and emotional functioning and well-being, carried out via a comprehensive and multiple-measure psychological and neuropsychological assessment.

    Patients and Methods: Fifty surgically treated patients with LGG were evaluated 40 months after surgery on their functioning over 6 different cognitive domains, 3 core affective/emotional aspects, and 3 different psychological well-being measures to obtain a clearer picture of the long-term impact of illness and surgery on their psychological and relational world. Close relatives were also involved to obtain an independent measure of the psychological dimensions investigated.

    Results: Cognitive status was satisfactory, with only mild short-term memory difficulties. The affective and well-being profile was characterized by mild signs of depression, good satisfaction with life and psychological well-being, and good personality development, with patients perceiving themselves as stronger and better persons after illness. However, patients showed higher emotional reactivity, and psychological well-being measures were negatively affected by epileptic burden. Well-being was related to positive affective/emotional functioning and unrelated to cognitive functioning. Good agreement between patients and relatives was found.

    Conclusions: In the long-term, patients operated on for LGG showed good cognitive functioning, with no significant long-term cognitive sequelae for the extensive surgical approach. Psychologically, patients appear to experience a deep psychological change and maturation, closely resembling that of so-called posttraumatic growth, which, to our knowledge, is for the first time described and quantified in patients with LGG.

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