![]() Performance on each of these tasks is likely to be influenced by several cognitive domains. We selected tasks from five cognitive domains that have previously been used to investigate cognitive functioning in brain-damaged patients, including memory, attention, processing speed, executive function, and working memory, consistent with prior research on patients with brain tumors. Thus, we sought to identify primary cognitive functions common to several cognitive tasks, and furthermore, we aimed to investigate brain regions related to the primary cognitive deterioration following tumor resection.Ĭognitive functions can be divided into several domains such as memory, attention, and executive function. Damage to primary cognitive functions, regardless of whether they recover, could have a significant influence on daily functioning, consequently determining the quality of life of patients. Therefore, cognitive functions affecting multiple cognitive tasks can be regarded as “primary” cognitive functions. For example, a memory retrieval function could be recruited for tasks requiring verbal retrieval from semantic memory, such as word recall or verbal fluency. Conversely, one cognitive process is often involved in multiple cognitive tasks. For example, scores on a standardized test of verbal memory may reflect several functions, including encoding, storage, and retrieval. ![]() To examine a patient’s cognitive performance, although standardized neuropsychological tests are particularly useful to consistently evaluate an individual’s cognitive state, it is unclear how damage on subserving cognitive functions is reflected in the scores of such tests. However, it is more difficult to investigate the effects of brain tumor surgery on cognitive functions such as memory, attention, and executive functions compared to motor and verbal functions, and brain regions that remain vulnerable to cognitive impairments for an extended period following surgery have not been sufficiently investigated to date. Brain regions related to these functions have been extensively investigated in patients with brain tumors using intraoperative cortical mapping techniques in the hope that these functions could be preserved. Introductionĭisturbance of motor, sensory, and verbal functions could have a significant impact on the quality of life of brain-damaged patients. It is suggested that primary cognitive functions related to specific brain regions were possibly affected by glioma resection. On the other hand, the negative component affected concept shifting, word fluency, and digit span forward tasks, and VLSM revealed significant regions in the right inferior frontal cortex. VLSM related to deficits of the Stroop task revealed significant regions in the anterior medial frontal cortex. The first cognitive component in the right glioma group affected positive and negative factor loadings on the task, such that the positive cognitive component affected only the Stroop color-word task. The second cognitive component affected verbal memory, and verbal fluency tasks and VLSM analysis indicated two different significant regions, the medial temporal regions and the middle temporal gyrus to the posterior parietal lobes. VLSM analysis revealed significant regions from the posterior middle temporal gyri to the supramarginal gyrus. The first cognitive component in the left glioma group affected the digit span forward and backward tasks and concept shifting and the letter-digit substitution tasks. Factor analysis revealed two primary cognitive components in each glioma group. Next, lesion analyses were performed using voxel-based lesion-symptom mapping (VLSM) to identify critical brain regions related to impairments of the primary cognitive functions. Factor analyses were conducted to identify “primary” common cognitive functions affecting the task performance in left and right glioma groups. Seven neuropsychological tasks from five cognitive domains were conducted pre- and 6 months postoperation. Patients with glioma in the left ( ) and the right ( ) hemisphere participated in the study. The objective of this study was to investigate primary cognitive factors affecting not only simple cognitive tasks but also several other cognitive tasks and associated brain regions. However, to preserve the postsurgical QOL of patients with brain tumors, it is important to identify “primary” cognitive functions and associated brain regions that are more vulnerable to cognitive impairments following surgery. ![]() Previous studies have shown that cognitive impairments in patients with brain tumors are not severe. ![]()
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