ArticleNeuro-oncology advances
Leisure-related cognitive reserve and postoperative cognitive outcomes after brain tumor surgery.
Article in Neuro-oncology advances. 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: Cognitive reserve (CR) is increasingly recognized as a factor associated with cognitive outcomes in neurological diseases; however, its relevance in patients undergoing brain tumor surgery remains incompletely understood. This study aimed to investigate the relationships between CR, particularly leisure-related CR, postoperative cognitive outcomes, and white matter tract disconnection. Methods: Forty patients in the chronic postoperative phase following supratentorial brain tumor resection were evaluated using the Mini-Mental State Examination (MMSE) and the Japanese Adult Reading Test (JART). Cognitive reserve was assessed using the Cognitive Reserve Index (CRI), including education, occupational attainment, and leisure subdomains. Postoperative structural magnetic resonance imaging was analyzed using an atlas-based disconnection approach (BCBtoolkit and Tractotron) to quantify tract-specific white matter disconnection. Associations among cognitive reserve, cognitive performance, and white matter disconnection were examined using correlation analyses and multivariable regression with stepwise variable selection. Results: MMSE and JART scores were positively correlated after covariate adjustment. Among CRI subdomains, only leisure-related CR was significantly associated with both MMSE and JART scores. Disconnection of the left inferior fronto-occipital fasciculus and the right posterior superior longitudinal fasciculus was associated with lower JART scores. Higher leisure-related CR was associated with relatively preserved cognitive performance in the presence of white matter tract disconnection. Conclusions: Leisure-related cognitive reserve was associated with postoperative cognitive outcomes in the context of white matter disconnection after brain tumor surgery. These findings suggest that individual differences in cognitive reserve may contribute to variability in postoperative cognitive outcomes and be informative for understanding cognitive vulnerability following tumor resection.
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