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Verbal fluency predicts work resumption after awake surgery in low-grade glioma patients

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Abstract

Background

Resuming professional activity after awake surgery for diffuse low-grade glioma (DLGG) is an important goal, which is not reached in every patient. Cognitive deficits can occur and persist after surgery. In this study, we analyzed the impact of mild cognitive impairments on the work resumption.

Methods

Fifty-four surgeries (including five redo surgeries) performed between 2012 and 2020 for grade 2 (45) and 3 (nine) DLGG in 49 professionally active patients (mean age 40 [range 23–58.) were included. We retrospectively extracted the results of semantic and phonemic verbal fluency tests from preoperative and 4-month postoperative cognitive assessments. Patients were interviewed about their working life after surgery, between April and June 2021.

Results

Patients (85%) returned to work, most within 3 to 6 months. Patients (76%) reported subjective complaints (primarily fatigue). Self-reported symptoms and individual and clinical variables had no impact on the work resumption. Late-postoperative average Z-scores in verbal fluency tasks were significantly lower than preoperative for the entire cohort (Wilcoxon test, p < 0.001 for semantic and p = 0.008 for phonemic fluency). The decrease in Z-scores was significantly greater (Mann Whitney U-test, semantic, p = 0.018; phonemic, p = 0.004) in the group of patients who did not return to work than in the group of patients who did.

Conclusion

The proportion of patients returning to work was comparable to similar studies. A decrease in verbal fluency tasks could predict the inability to return to work.

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Data availability

All cognitive and individual data are available in Online resource 1.

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Authors and Affiliations

  1. Neurosurgery Unit, Hôpital Lariboisière, AP-HP, 75010, Paris, France

    Marion Barberis, Isabelle Poisson, Cécile Prévost-Tarabon, Sophie Letrange, Sébastien Froelich & Emmanuel Mandonnet

  2. Université de Paris Cité, 75010, Paris, France

    Sébastien Froelich & Emmanuel Mandonnet

  3. INRIA, CEA, Université Paris Saclay, 91120, Palaiseau, France

    Bertrand Thirion

  4. UMR 7225, Frontlab, Paris Brain Institute, CNRS, INSERM U1127, 75013, Paris, France

    Marion Barberis & Emmanuel Mandonnet

Authors
  1. Marion Barberis
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  2. Isabelle Poisson
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  3. Cécile Prévost-Tarabon
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  4. Sophie Letrange
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  5. Sébastien Froelich
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  6. Bertrand Thirion
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  7. Emmanuel Mandonnet
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Corresponding author

Correspondence to Marion Barberis.

Ethics declarations

Ethical approval

This study was conducted with our institutions’ ethical standards for a retrospective study; all the procedures being performed were part of a routine care.

Informed consent

Patients were informed about the use of their pseudonymized data for the purpose of clinical research, and their oral consent was obtained and registered in writing by the clinicians.

Conflict of interest

The authors declare no competing interests.

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Comments

The authors present a study concerning diffuse low-grade glioma patients (DLGG) with respect to the extent in which mild cognitive deficits after surgery, affect their work resumption. Clinical and cognitive data of the DLGG patients who had undergone awake surgery were retrospectively collected. Finally 49 patients were included in the study. The cognitive data were derived from neuropsychological assessment of the patients phonemic respectively semantic verbal fluency, one day before operation, a few days after and four months postoperatively. Between April 2021 and June 2021, the patients were interviewed by the research team about their working life and subjective complaints after surgery. Interestingly the decline in the phonemic respectively the semantic fluency four months after operation was significantly more pronounced in the patients who did not return to work than in those who resumed working life. In contrast no association was found between fatigue and return to work. The results of the present study suggest that even a relatively mild decline in verbal fluency with this function still lying within normal limits according to normative data, could be a sensitive predictor of an inability to go back to working life.

Åsa Bergendal

Stockholm Sweden

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Barberis, M., Poisson, I., Prévost-Tarabon, C. et al. Verbal fluency predicts work resumption after awake surgery in low-grade glioma patients. Acta Neurochir 166, 88 (2024). https://doi.org/10.1007/s00701-024-05971-w

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