gms | German Medical Science

70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

The BReMen trial –impact of rehabilitation in patients after resection of a benign meningioma

Die BReMen Studie –Einfluss einer rehabilitativen Behandlung von Patienten nach Resektion eines gutartigen Meningeoms

Meeting Abstract

  • presenting/speaker Katharina Krause - Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
  • Almuth F. Keßler - Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
  • Basheer Al-Shameri - Universitätsklinikum Würzburg, Neurochirurgische Klinik und Poliklinik, Würzburg, Deutschland
  • Judith Weiland - Universitätsklinikum Würzburg, Neurochirurgische Klinik und Poliklinik, Würzburg, Deutschland
  • Thomas Linsenmann - Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
  • Carsten Hagemann - Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
  • Ralf-Ingo Ernestus - Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
  • Mario Löhr - Universitätsklinikum Würzburg, Neurochirurgische Klinik, Würzburg, Deutschland
  • Elisabeth Jentschke - Universitätsklinikum Würzburg, CCC Mainfranken, Würzburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV106

doi: 10.3205/19dgnc130, urn:nbn:de:0183-19dgnc1300

Published: May 8, 2019

© 2019 Krause et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objective: Despite the good prognosis of benign meningioma, evidence for eventual impairment of patients’ psychological quality of life (pQoL), social and neuropsychological functioning after surgery becomes more and more apparent. These patients might even fail to re-integrate into their private and work environment. Simoustanouesly, the impact of participating in a short term inpatient neurological rehabilitation program (rehab) is still undetermined. The BReMen trial (Belastung und Rehabilitation bei Meningeompatienten) aims to approach these topics.

Methods: In a prospective 2-year-follow up trial 80 patients with newly diagnosed meningioma WHO°I are planned to be included. Test time points included pre- (T1), post-surgery (T2), 3, 6, 12 and 24 months post-surgery (T3-T6). Patients’ characteristics included: age, gender, educational training, localization/size of meningioma, Barthel-, distress- and work-ability-index, time to return to work. Test batteries focused on pQoL and affect: Short Form-36 Health questionnaire (SF-36), EORTC Quality of Life Questionnaire – Score 30, EORTC Quality of Life Questionnaire for brain tumor patients, PHQ-9 depression score, GAD 7 general anxiety score. Cognitive functioning was measured by Regensburger Wortflüssigkeitstest, Verbaler Lern- und Merkfähigkeitstest (VLMT), Trail Making Test A and B, Farb-Wort-Test, Aufmerksamkeits-Belastungstest (d2-R) and Wechsler-Memory-Scale-Revised.

Results: This interim analysis focused on QoL (SF-36 scores), depression (PHQ-9) and distress levels, VLMT and d2-R. So far, 56 patients were recruited, 18 patients dropped out, 35 patients reached T5. 18 of them chose to participate in rehab after surgery, 17 patients refused. Both groups presented an increasing memory function till T5 independently of rehab. Patients with a lower pQoL preferred to enter rehab, improving their SF-36 scores afterwards but again declined at T5. Similarly, patients with a higher depression score also favored rehab with a positive long term effect, thereby declining their distress levels. Additionally, patients showed a higher attention at T5 (d2-R) after rehab compared to T1, while patients without rehab declined.

Conclusion: The benefit of rehab might be reflected by the decline of patients’ depression levels and improved attention. However, the re-decline of their pQoL following rehab one year after resection might hint towards an advantage of long-term neuropsychological support in addition to short term rehab.