Multi-domain neurocognitive classification of primary brain tumor patients prior to radiotherapy on a prospective clinical trial.

ABSTRACT:

Introduction

We investigated multi-domain baseline neurocognition of primary brain tumor patients prior to radiotherapy (RT), including clinical predictors of function and association between pre-RT and post-RT impairment on a prospective trial.

Methods

A multi-domain neuropsychological battery (memory, executive functioning, language, attention, processing) was performed on 37 patients, pre-RT and 3-(n?=?21), 6-(n?=?22) and 12-(n?=?14) months post-RT. Impairment rate was the proportion of patients with standardized T-scores???1.5 standard deviations below normative means. Per-patient impairment across all domains was calculated using a global deficit score (GDS; higher value indicates more impairment). Associations between baseline GDS and clinical variables were tested. Global GDS impairment rate at each time point was the fraction of patients with GDS scores?>?0.5.

Results

Statistically significant baseline neurocognitive impairments were identified on 4 memory (all p???0.03) and 2 out of 3 (p?=?0.01, p?=?0.027) executive functioning tests. Per-patient baseline GDS was significantly associated with tumor volume (p?=?0.048), tumor type (p?=?0.043), seizure history (p?=?0.007), and use of anti-epileptics (p?=?0.009). The percentage of patients with the same impairment status at 3-, 6-, and 12-months as at baseline were 88%, 85%, and 85% respectively.

Conclusions

Memory and executive functioning impairment were the most common cognitive deficits prior to RT. Patients with larger tumors, more aggressive histology, and use of anti-epileptics had higher baseline GDS values. GDS is a promising tool to encompass multi-domain neurocognitive function, and baseline GDS can identify those at risk of cognitive impairment.

SUBMITTER: Karunamuni R 

PROVIDER: S-EPMC7025809 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature