Examining the Neuropsychiatric Sequelae Postsurgical Resection of Adult Brain Tumors Through a Scoping Review

Abstract

Background: Improving brain tumor survival rates have drawn increasing focus on neuropsychiatric and psychological outcomes.

Objective: This review characterizes the literature on neuropsychiatric sequelae after neurosurgical resection of adult brain tumors.

Methods: Using a scoping method, we reviewed articles describing patients with adult brain tumor who underwent partial or total brain resection and examined major neuropsychiatric domains after intervention.

Results: The initial search yielded 9903 articles. After duplicate removal, abstract screening, review, and hand searching, 81 articles were found: 63 empirical and 18 nonempirical. Most articles centered on survivorship within the first year. Cognition was most widely studied with a transient worsening during the first month and usually recovery or improvement thereafter. Depression increased in frequency during survivorship and was associated with frontotemporal location, time to survival, quality of life, cognitive and physical parameters, and functional status. Anxiety, independent of depression, related to tumor histology and grading and had a weaker association with cognition and quality of life. Obsessive-compulsive symptoms, psychosis, mania, and delirium received little attention. Most studies did not include preoperative neuropsychiatric assessment, and treatment was poorly addressed.

Conclusion: This review highlights key gaps, including preoperative and postoperative neuropsychiatric assessment and a short follow-up. A better understanding of postresection neuropsychiatric outcomes can inform our ability to prognosticate and tailor management for patients at risk for these life-impairing conditions.

Keywords: consultation-liaison psychiatry; neuropsychiatry; oncology; psycho-oncology.