NCOG-16. IDENTIFYING COGNITIVE IMPAIRMENT IN PATIENTS WITH PRIMARY MALIGNANT BRAIN TUMORS (PBMT) Article Swipe

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Cognition Neuropsychology Cognitive impairment Normative Clinical psychology Medicine Univariate analysis Neuropsychological assessment Verbal memory Psychology Psychiatry Multivariate analysis Internal medicine Epistemology Philosophy

Jason Weimer , Susan Misko , Jan Drappatz , Frank S. Lieberman , Heidi Donovan , Paula R. Sherwood , Terri S. Armstrong ·

YOU? · · 2016 · Open Access · · DOI: https://doi.org/10.1093/neuonc/now212.511 · OA: W2587826843

Cognitive impairment is one of the most disabling symptoms for individuals with PBMTs and has been identified as a major source of psychological distress by caregivers. Domain specific data regarding cognitive dysfunction following surgery is primarily from research conducted prior to the advent of current standards of care. The aims of this analysis were to identify specific domains of cognitive function most affected in the post-operative/treatment phases and to examine predictors of poor performance in those domains using a selected battery of neuropsychological tests. Neuropsychological assessments were performed by trained examiners on patients (n=86) with a PMBT diagnosis that were recruited as part of a caregiver intervention trial (R01-NR013170). Domain-specific z-scores were created using published normative data for matching age groups and analyzed using Pearson’s Chi-square and paired t-tests to evaluate univariate associations between age, gender, tumor location, type, grade and treatment status as potential predictors of cognitive impairment. Participants were mostly male (59.2%), middle aged (mean 54.4, SD 15), with glioblastomas (55.4%) in the middle (40.8%) or frontal (35.4%) areas of the brain. The majority of participants had surgery (88.8%), chemo (62.3%), or radiation (65.6%) prior to assessment. Participant mean domain scores for Executive Function (z=-1.8), Verbal Memory (z=-1.5) and Aphasia (z=-0.8) fell below normative values indicating cognitive impairment. Age was significantly associated with impairment in Executive Function (p =.004) and Verbal Memory (p=.06). Further details of tumor type, location, and genetics will be discussed. This analysis shows that older patients with PMBTs are at particular risk for developing cognitive impairment in the specific areas of executive function and verbal memory. Clinicians should be aware of these risk factors, screen patients regularly for cognitive dysfunction in these areas and provide guidance to family caregivers on strategies to reduce the psychological distress associated with these impairments.