Cognitive, affective and behavioral functioning in patients with olfactory groove meningiomas: a systematic review.

Olfactory groove meningiomas (OGMs) are often linked to cognitive, affective, and behavioral deficits, yet these symptoms remain poorly understood. This systematic review synthesizes existing evidence on the prevalence, nature, and postoperative outcomes of these deficits in OGM patients, focusing on factors influencing neuropsychological recovery and guiding future treatment strategies. Following PRISMA guidelines, a systematic review was conducted using PubMed, Google Scholar, and ScienceDirect (up to December 2024). Studies reporting cognitive, affective, or behavioral symptoms in OGM patients were included, while non-original studies, non-English articles, and studies on other tumor types were excluded. Two independent reviewers screened titles, abstracts, and full texts, extracted data, and assessed risk of bias using the JBI critical appraisal tool for case series. Data on patient demographics, tumor characteristics, surgical approaches, and neuropsychological outcomes were analyzed. Of 1180 studies identified, 38 met the inclusion criteria. Psychiatric symptoms were reported in 14-100% of patients, with memory and attention deficits as well as confusion and disorientation being the most common. Depression, apathy, and behavioral changes were frequently observed. Only five studies used standardized neuropsychological assessments, primarily the Mini-Mental State Examination (MMSE). Postoperative improvements in MMSE scores were noted, suggesting some cognitive recovery. Tumor size and surgical approach influenced outcomes, with larger tumors and bifrontal approaches linked to poorer cognitive recovery. However, the impact of peritumoral edema and extent of resection remains understudied. Cognitive, affective, and behavioral deficits are prevalent in OGM patients but are often underdiagnosed. Limited use of standardized assessments and small sample sizes highlight the need for more rigorous research. Future studies should prioritize multicenter collaborations, prospective designs, and validated tools to better understand these deficits and optimize treatment strategies.