Neuropsychological deficits in patients with meningiomas

718 Abstracts /Archives of Clinical Neuropsychology 15 (2000) 653-850 Self-report of neuropsychological impairment Epker J, Haley R, Matt Maddrey A. in Gulf War veterans High evoked glucose and insulin secretion predict decrements healthy young adults Awad N, Messier C, Gagnon M, Desrochers A, Tsiakis M. in verbal memory performance of Previous studies have shown that decrements in insulin sensitivity, as observed in Type II diabetics and in patients with Alzheimer’s disease, are associated with varying degrees of neuropsychological impairment. Given that glucose regulation is variable in the healthy population and that protracted glucose tolerance impairment usually proceeds to a Type II diabetes diagnosis, this study was conducted to find whether similar neuropsychological impairments may be observed in healthy individuals with inefficient glucose regulation. Indices of glucose regulation, as determined by relative blood glucose and insulin fluctuations following ingestion of a glucose (75g) solution, were correlated with neuropsychological performance in 45 healthy university undergraduates. Various measures of attentional processes, working memory, immediate and delayed memory, visual memory and central executive functioning were evaluated. Glucose regulation was observed to predict verbal memory performance, as reflected by performance on the Logical Memory subtest of the WAIS-III. Good control of blood glucose, characterized by low evoked glucose and insulin levels, was associated with better performance on the Logical Memory subtest. Poorer blood glucose control, characterized by high evoked glucose and insulin levels, was associated with poorer performance on the Logical Memory subtest. Increased insulin secretion observed in these subject may reflect a reduced insulin sensitivity that usually precedes diagnosis with Type II diabetes. These findings have implications for the role of insulin sensitivity on neuropsychological performance in health and disease. Neuropsychological Jo M-x Armstrong deficits in patients with meningiomas C, Hunter J. Meningiomas are the most common of the non-glial, primary brain tumors and are often associated with good clinical prognosis and longer life expectancy due to their relatively benign histology and primarily non-cortical (i.e., non-infiltrating) tumor locus. Because of longer survival rates associated Downloaded from https://academic.oup.com/acn/article/15/8/718/3669 by guest on 11 July 2022 Previous research has identified 3 primary and 3 secondary clusters of symptoms that support the existence of several distinct syndromes that comprise Gulf War illness (GWS). In the current study, the Neuropsychological Impairment Scale (NIS) was completed by a sample of veterans who fought in the Persian Gulf War to assess their level of self-reported neurocognitive impairment, and to investigate potential within sample differences among syndromes. Analyses demonstrated that veterans identified as having Gulf War syndrome reported significantly greater impairment on each of the scales of the NIS than did non-ill veterans. In addition, scores from veterans with primarily neurocognitively oriented symptoms (i.e., Syndrome 1, impaired cognition and Syndrome 2, confusion-ataxia) were not significantly different from GW veterans with other syndromes. However, the latter 2 groups differed from each other with regard to memory, attention, and cognitive efficiency. These findings indicate that some of the differences between syndromes of GWS may be identifiable through self-report of neuropsychological functioning, and suggest that further research of subjectively identified manifestations of GWS is warranted. Abstracts /Archives of Clinical Neuropsychologv 15 (2000) 653450 719 Neuroanatomical effects of attention on patients with intracranial Goldstein B, Armstrong CL. tumors The neurocognitive impairments arising from brain tumors are not extensively understood because many studies examine only patients with cortical tumors who have received radiation or chemotherapy. Consequently, it is unclear how much neuropsychological impairment is attributed to the location and presence of the tumor or to the radiation and/or chemotherapy. This study investigated the neuropsychological effects of intracranial tumor presence on attention in a low-grade brain tumor population. Fifty-five subjects (mean age = 40) with varying, singular, low-grade intracranial tumors without widespread neurologic disturbance were included. All subjects were administered neuropsychological tests of attention at baseline (6 weeks post surgery and prior to any radiation or chemotherapy). The subject’s tumor location were initially classified into 5 categories (left anterior, right anterior, left posterior, right posterior and subcortical). The groups were also analyzed in terms of their anterior/ posterior location and hemisphere (left/right), using the subcortical tumor patients as a control group. Tests were factor analyzed and classified. Significant differences among the 5 brain regions found on the WCST Categories, Visual Memory Span-Forward (VMSF) and Digit Span-Forward (DGSF) were due to the poorer performance of the subcortical tumor patients. Also, the right anterior group scored lower in VMSF. While the right anterior group showed the expected impairment in visual spatial working memory, the neuroanatomically specific cortical effects were not found. Instead, although prior research has not emphasized the cognitive effects of subcortical tumors because of their size and location within the cerebral hemispheres, the results of this research indicate that their presence can impact attentional processing. Downloaded from https://academic.oup.com/acn/article/15/8/718/3669 by guest on 11 July 2022 with meningiomas, patients can usually expect increased functional capacity at work, school, or home, compared to other brain tumor patients. Although there are several reports of associated neurologic and behavioral symptoms, there have been no studies of the effects of meningiomas on cognitive functions. We report on the cognitive complications of meningiomas. Compared to tumors that invade the parenchyma, we expect meningiomas to have less of a negative effect on brain functions. We gathered neuropsychological data on 6 patients with meningiomas and examined their cognitive profiles prior to post-surgical treatment, compared to glioma patients who were matched on age, education, and general tumor location. Five of the 6 meningioma patients were women and all were between the ages of 42-66 years, with a mean age of 53.8 years. All 6 patients showed significant cognitive declines in at least 1 cognitive domain. Findings showed that most of the deficits in the meningioma patients were either mild or moderate; they did not evidence as many of the severe deficits seen in patients with cortical tumors. However, the domains of cognitive deficits seen in the meningioma patients were similar to those seen in the cortical tumor patients. Domains of cognitive deficits were more closely associated with location of tumor rather than type of tumor. Our investigation showed that meningiomas do result in significant cognitive impairments. Cognitive deficits were not consistently affected by risk factors cited in the literature for cortical damage, such as mass effect, edema, tumor size, or post-surgical effects. Rather, our study suggested that increased cognitive deficits were more closely associated with increased age and tumor recurrence. Proposed mechanisms include available brain reserve (function of age), long-term effects of tumor survival, and cortex impingement by the tumor.