Evaluation of Mental and Emotional Factors in Awake Brain Mapping for Low-Grade Glioma: A Study of 55 Cases.

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BACKGROUND AND OBJECTIVES: Awake brain mapping (ABM) is widely used for low-grade gliomas in eloquent brain regions, where preservation of neurological function is essential. The aim of this study was to evaluate perioperative anxiety and quality of life (QoL) in patients undergoing ABM.

METHODS: A retrospective observational study was conducted on 55 patients diagnosed with low-grade glioma who underwent ABM between January 2020 and December 2022 at a Comfort Nursing Home Ltd, Bangladesh. Anxiety was measured using the Hospital Anxiety and Depression Scale and the State-Trait Anxiety Inventory, and QoL was assessed with the European Organisation for Research and Treatment of Cancer Qualityof Life Questionnaire-C30. All assessments were completed preoperatively and at postoperative follow-up. Statistical comparisons were made using the Wilcoxon signed rank and paired t-tests, with significance set at P <.05.

RESULTS: The cohort included 30 men and 25 women, with a mean age of 42 years. Seizures were the most frequent presenting symptom (63.6%). At 6 months, the mean anxiety scores increased from 1.84 to 2.18 (P =.034, 95% CI: [1.25, 3.15]). Individual trajectories varied: 8 patients worsened, 6 improved, and the majority remained stable. By contrast, QoL improved significantly, rising from 61.9 preoperatively to 72.5 at 6 months (Δ = +10.6; P <.001), with sustained improvement over 1 year. No significant differences in anxiety outcomes were observed by age.

CONCLUSION: ABM is associated with significant improvements in QoL but also with persistent or increased anxiety in a subset of patients. These findings highlight the need for structured psychological support before and after surgery to optimize patient well-being and ensure a more holistic recovery.