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

Roshan Karunamuni, Kathryn R. Tringale, Jeffrey Burkeen, Michelle D. Tibbs, Minh Phuong Huynh-Le, Naeim Bahrami, Deborah Marshall, Tyler M. Seibert, Carrie R. McDonald, Jona A. Hattangadi-Gluth

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

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.

Original languageEnglish
Pages (from-to)131-138
Number of pages8
JournalJournal of Neuro-Oncology
Volume146
Issue number1
DOIs
StatePublished - 1 Jan 2020
Externally publishedYes

Keywords

  • Global deficit score
  • Neurocognitive function
  • Primary brain tumors
  • Radiotherapy

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