Cognitive dysfunction might be improved in association with recovered neuronal viability after intracranial meningioma resection

• Meningiomas (MG) are the most frequent causative neoplasms of mental disorder.
• Iomazenil (IMZ) is a radioligand for the central benzodiazepine receptor (CBZR).
• We used IMZ-SPECT to investigate changes in the brains of 10 patients with MG.
• CBZR viability recovered after tumor resection at peri-tumor regions.
• CBZR viability after tumor resection may reflect restored cognitive dysfunction.

Intracranial meningiomas are the most common types of neoplasms that cause mental disorders. Although higher brain function can be restored and even improved in some patients after tumor resection, the mechanisms remain unclear. We investigated changes in the brains of patients after resection of an intracranial meningioma using 123I-Iomazenil (IMZ)-single photon emission computed tomography (SPECT).Ten patients underwent IMZ-SPECT within 4 weeks before and 3 months after intracranial meningioma resection. Changes in IMZ accumulation in brain parenchyma were assessed as ratios of counts in the lesion-to-contralateral hemisphere (L/C ratios).Mean Mini-Mental State Examination scores before and after resection of 19.9±11.4 vs. 26.5±3.8, respectively (p=0.03) indicated that the cognitive function of these patients was significantly improved after tumor resection. The average L/C ratios calculated from image counts of IMZ were 0.92±0.05 and 0.98±0.02 before and after surgery, respectively. The L/C ratio of IMZ accumulation was significantly decreased after tumor resection (p=0.0003). In contrast, regional cerebral blood flow calculated from 123I-Iodoamphetamine-SPECT images did not significantly differ after tumor resection.The recovered binding potential of IMZ in brain parenchyma surrounding the tumor bulk after resection indicates that the viability of central benzodiazepine receptors was reversibly depressed and recoverable after release from compression by the tumor. The recovered neuronal viability revealed by IMZ-SPECT might be responsible for the improved cognitive function after intracranial meningioma resection.