Meningioma can lead to pre-operative cognitive alterations even if localized in sensorimotor areas: A multimodal MRI-neuropsychological study in a series of 46 patients

Brain tumors are generally associated with cognitive changes. Little is known about cognition in patients with meningioma - a lesion that usually shifts and compresses the brain parenchyma with a low probability of infiltrate it. We investigated the cognitive functioning in a consecutive series of 46 patients with a meningioma in the sensorimotor area in the left (LH, N = 27) or in the right (RH, N = 19) hemisphere. All the patients underwent a pre-operative neuropsychological assessment and structural MRI. Clinical symptoms varied between LH and RH meningioma patients. Impaired performance was seen in naming (19.23% noun and 35% verb naming), short-term (18.18%) and working (14.24%) memory in the LH group, and in visuo-spatial tasks (25% neglect, 21.42% visuospatial planning) in the RH group. Both groups were impaired on a sensorimotor mental imagery task (LH, 66.66% of the LH 70% of the RH meningioma patients), while only the RH meningioma group was impaired on the visuo-spatial mental imagery task. The lesion MRI maximum overlap occurred in the postcentral and paracentral lobules. Edema was maximally localized on the left superior longitudinal fasciculus and the superior part of the right superior corona radiata. We found that only the meningioma mass, and not the edema, is a predictive variable in determining patients' performance. Patients with meningioma could present with cognitive alterations at pre-surgical evaluation even if the meningioma occurs in sensorimotor areas. In the present series, a large meningioma vs. a large edema is more relevant for cognitive performance.