Brain Side Effects Similar Across Modern Brain Surgeries

What was studied

This study was a systematic review with meta-analysis. It included 48 published articles with 2,678 total participants to compare neuropsychological side effects after radiofrequency ablative neurosurgery for psychiatric disorders with side effects reported after other brain surgeries.

The comparison groups were people who had surgery for epilepsy, neurovascular conditions, or brain tumors. The authors searched PubMed, Embase, and LILACS for studies published from 1990 to 2022 in English or Spanish.

What they found

The review found that transient and permanent neuropsychological side effects after psychiatric neurosurgery fell within ranges that were comparable to those reported after epilepsy, vascular, and tumor-related brain surgeries.

For permanent side effects, the psychiatric neurosurgery group had better outcomes than the epilepsy surgery group in memory, language, and social cognition, but worse outcomes in executive and perceptual-motor functions. Compared with the vascular surgery group, the psychiatric neurosurgery group had better executive function but worse complex attention. Compared with the oncology surgery group, the psychiatric neurosurgery group had fewer permanent deficits in executive function, complex attention, and perceptual-motor domains, but lower language performance.

Limits of the evidence

This review combined many different studies, and the abstract does not describe how similar the patients, surgeries, or testing methods were across those studies. That makes comparisons less certain.

The abstract reports ranges of side effects, but it does not provide detailed pooled effect sizes for each outcome here. The abstract also does not describe the severity of side effects, length of follow-up, or how well the findings apply to children or adolescents.

For families and caregivers

For families, this study suggests that contemporary ablative psychiatric neurosurgery may have a similar risk of neuropsychological side effects to other kinds of brain surgery that are more commonly used, including epilepsy surgery.

At the same time, the pattern of side effects differed by function, such as memory, language, attention, or executive skills. Families may want to ask which thinking abilities are most relevant for the planned surgery and how neuropsychological testing is used before and after treatment.

What to watch next

Future studies could help by using the same cognitive tests, longer follow-up, and more direct comparisons between surgery types.

Terms in this summary

systematic review

A study that collects and evaluates all relevant research on a question using a planned method.

meta-analysis

A method that combines results from multiple studies to look for overall patterns.

neuropsychological side effects

Changes in thinking, memory, language, attention, behavior, or related brain functions after treatment.

radiofrequency ablative neurosurgery

A brain surgery method that uses heat made by radiofrequency energy to create a small targeted lesion.

executive function

Mental skills used for planning, organizing, problem-solving, and self-control.

perceptual-motor function

Skills that help a person use what they see to guide movement, such as drawing or hand-eye coordination.

complex attention

The ability to focus, shift attention, and handle more than one mental demand at a time.

social cognition

The ability to understand other people's feelings, intentions, and social cues.