Cognition, Emotional States and Health-Related Quality of Life in Awake Craniotomy for Glioma: A Case Series

BACKGROUND: Awake craniotomy is an effective procedure for optimizing the onco-functional balance of re-sections in glioma. However, limited data exists on the cognition, emotional states, and health-related quality of life (HRQoL) of patients with glioma who undergo awake craniotomy. This study aims to describe 1) perioperative cognitive function and emotional states in a multilingual Asian population, 2) associations between perioperative cognitive function and follow-up HRQoL, and 3) associations between preoperative emotional states and follow-up HRQoL.METHODS: This is a case series of 14 adult glioma patients who underwent awake craniotomy in Singapore. Cognition was assessed with the Montreal Cognitive Assessment and the Repeatable Battery for the Assessment of Neuropsychological Status, emotional states with the Depression, Anxiety and Stress Scale-21 Items, and HRQoL using the EuroQol-5D-5L, the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, and the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-BN20.RESULTS: Patients with better preoperative cognitive scores on all domains reported better HRQoL. Better post-operative immediate memory and language scores were associated with better HRQoL. Moderate preoperative depression scores and mild and moderate preoperative stress scores were associated with poorer HRQoL compared to scores within the normal range. Mild preoperative anxiety scores were associated with better HRQoL compared to scores within the normal range.CONCLUSION: This descriptive case series showed that patients with higher preoperative cognitive scores reported better follow-up HRQoL, while patients who reported more preoperative depressive and stress symptomatology reported worse follow-up HRQoL. Future analytical studies may help to draw conclusions about whether perioperative cognition and emotional states predict HRQoL on follow-up.

Automated summary

This case series study investigated the perioperative cognitive function and emotional states in a multilingual Asian population of glioma patients who underwent awake craniotomy. The study found that higher preoperative cognitive scores were associated with better follow-up HRQoL, while preoperative depressive and stress symptomatology were associated with worse follow-up HRQoL. Mild preoperative anxiety was associated with better follow-up HRQoL.