Anxiety and Depression after Awake Craniotomy for Cerebral Glioma

Awake surgery usually used for eloquent region gliomas, however it may be associated with neuropsychological distress. In this study we evaluate the level of anxiety and depression before and after awake craniotomy.

Twenty-eight patients (Mean age = 39.25±11.09, 78.5% males vs. 21.5% females) who were awake craniotomy candidate, were enrolled in this longitudinal study. The level of anxiety and depression were assessed using Hospital Anxiety and Depression Scale (HADS) questionnaire before awake craniotomy and 1, 6 months after it. Patients were categorized as having depressive/anxiety symptoms or not if they scored ≥ 8 or ≤ 7 on the HADS, respectively. Information pertaining to histological diagnosis, extent of resection and adjuvant therapies were obtained from medical records.

17 patients were diagnosed with high grade glioma and 11 patients with low grade glioma. Depressive and anxiety symptoms were diagnosed in 50% and 25% of patients respectively. The mean preoperative despressive and anxiety score were 4.89±5.03 and 7.71±5.85 respectively. One month after surgery they were 6±4.96 and 7.39±16 and in 6 months’ follow-up they were 5.54±5.16 and 5.38 ±4.23 respectively. There was no significant variation between none of the times mentioned above. However, preoperative anxiety (P < 0.001) and depressive (P: 0.001) mean score is significantly higher amongs women. In addition, there is a significant difference between preoperative anxiety (P: 0.017) mean score in patients with high grade glioma in comparison to low grade group, whereas there is no difference between preoperative depressive (P: 0.30) mean score in high / low grade glioma patients.

Depressive and anxiety symptoms are common in glioma patients. In this study it has been showed despite an increase in depressive and a decrease in anxiety mean score during the follow-up period, there is no difference between anxiety and depressive symptoms before and after surgery.