Assessment of verbal working memory before and after surgery for low-grade glioma.

OBJECT: While scarcely reported in low-grade glioma (LGG), accurate assessment of higher functions is essential to evaluate then preserve the quality of life. We assessed verbal working memory (vWM) in patients with LGG in language areas, before and after surgery, to evaluate the effect of glioma and resection on cognition, respectively.

METHODS: About 23 patients harboring a LGG in language areas underwent awake surgery. All patients had a vWM assessment, before and immediately after the resection, in addition to KPS. vWM was also evaluated 3 months after surgery in eight patients (KPS in all cases), who performed postoperative rehabilitation.

RESULTS: Preoperatively, 91% of patients had vWM disorders (KPS > or =90 in 22 patients). Immediately after surgery, 96% of patients had vWM worsening (50% of KPS > or =90). At 3 months, among the eight patients examinated, five recovered their preoperative vWM score, and three significantly improved it (KPS > or =90 in 23 patients).

CONCLUSION: In LGG, neuropsychological assessment is encouraged in addition to KPS. vWM evaluation before treatment showed that most patients had a cognitive deficit. Moreover, surgery induced a transient vWM worsening, which nevertheless recovers within 3 months. Specific rehabilitation might help to recover and even to improve the preoperative cognitive status.