Prevalence and trends in the neuropsychological burden of patients having intracranial tumors with respect to neurosurgical intervention

Background: The burden of neuropsychological symptoms evidenced by behavioral changes among patients with intracranial tumors has not been studied in detail. Purpose: This study was conducted to prospectively assess the neuropsychological symptoms in patients with intracranial tumors undergoing treatment. Methods: A longitudinal study was conducted using purposive sampling to assess the neuropsychological symptoms in conscious and consenting patients with intracranial tumors who were availing treatment from a tertiary care center. Neuropsychiatric Inventory Questionnaire (NPI-Q), which identifies 12 behavioral disturbances, was assessed at baseline, and later at 1 month and 6 months after treatment, and scored as symptom severity as well as symptom scores. Results: Among the 34 patients studied, all had experienced at least one neuropsychological symptom. The commonest neuropsychological symptoms at baseline were anxiety (82%), agitation (75%), irritability (74%), depression (74%), and sleep disturbances (70%). The neuropsychiatric symptom and severity scores were 5.84 (SD ±2.7) and 11.8 (±7.1) at baseline, which reduced significantly to 4.3 (±3.1) and 5.6 (±3.2) at 1 month, and further to 2.3 (±2.9) and 3.6 (±3.2) at 6 months, respectively. The neuropsychological symptoms persistent at 6 months were anxiety (33%), depression (33%), sleep disturbances (33%), agitation (25%), irritability (25%), and disinhibition (25%). Conclusion: There is substantial neuropsychological burden among patients with intracranial tumors. The severity score improved immediately after surgery, while the symptom score improved gradually. The variable spectrum of improvement in neuropsychological symptoms at 6 months after surgical treatment needs further consideration. Addressing these symptoms should be one of the long-term goals of the neuro-oncology teams.