ArticleNeuro-oncology practice2026
Neuropsychological outcomes following awake surgery in adult glioma patients: A systematic review.
Article in Neuro-oncology practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Awake craniotomy is essential for glioma resection in functionally integrated brain regions, allowing real-time monitoring to reduce cognitive and emotional deficits. Although widely used, its long-term neuropsychological effects remain debated. This systematic review aims to investigate cognitive and emotional outcomes after awake brain surgery and the factors that influence recovery, including extent of resection, follow-up timing, and neural plasticity. Methods: This systematic review analyzes 34 studies on pre- and postoperative functional outcomes in glioma patients undergoing awake surgery. Following PRISMA guidelines, studies were selected with adult glioma patients (WHO grade I-IV) who had neuropsychological assessments before and after surgery. Data on preoperative cognitive profiles, recovery trajectories, and follow-up durations were examined, focusing on methodological consistency and assessment tools. Results: The findings demonstrated substantial variability in functional outcomes, with many patients recovering within 3 to 6 months post-surgery, while others experienced persistent deficits. Functional recovery was influenced not only by the extent of tumor resection but also by network-level reorganization. Methodological inconsistencies in neuropsychological assessments highlighted the need for standardized, personalized evaluation protocols, emphasizing the importance of comprehensive functional assessments. Conclusions: This review emphasizes the shift from a localized cortical approach to a dynamic, network-based view of cognitive and emotional recovery. It calls for standardized, personalized neuropsychological assessments to optimize rehabilitation, along with extended follow-ups, and multidisciplinary care for long-term quality of life. Future research should refine assessment methods and strategies to better understand neuroplasticity and improve clinical outcomes in neuro-oncology.
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