28.01.2020 | Original Article - Tumor - Glioma
Long-term follow-up of neuropsychological functions in patients with high grade gliomas: can cognitive status predict patient’s outcome after surgery?
- Zeitschrift:
- Acta Neurochirurgica
Wichtige Hinweise
Electronic supplementary material
The online version of this article (https://doi.org/10.1007/s00701-020-04230-y) contains supplementary material, which is available to authorized users.
Barbara Zarino and Andrea Di Cristofori contributed equally to the study and should therefore be considered as first co-authors
This article is part of the Topical Collection on Tumor - Glioma.
Portions of this work were presented in abstract form proceedings at the 2018 EANO Congress in Stockholm and published on a dedicated Supplement of Neuro-Oncology (Neuro-Oncology, Volume 20, Issue suppl_3, September 2018).
Comments
In this study, the authors address the question of long-term follow-up of neuropsychological functions in patients with high grade gliomas (HGG). In particular, it is assessed how can cognitive status predict patient’s outcome after surgery. The conclusion is that there is a correlation between neuropsychological deterioration and HGG relapse and/or death, which may reflect a progressive damage to cognitive functions due to tumor infiltration and progression. This present study nice completes some other reports in the current literature. It has been previously acknowledged that cognitive impairment occurs in the majority of treatment-naive glioma patients, suggesting that neurocognitive dysfunction is related to the tumor (doi.org/10.1007/s11060-017-2503-z). Moreover, and more important, patient-tailored cognitive assessment may be a non-invasive addition to disease monitoring without overburdening patients and clinical care (doi.org/10.1007/s11060-019-03249-1). One could imagine that machine learning based prediction models would be developed in the near future. Yet, much heterogeneity is present among reports and should be of our concern to strive for standardised battery test in the frame of multicentric trials.
Constantin Tuleasca
Lausanne, Lille, France
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Abstract
Background
Patients affected by a high-grade glioma (HGG) have a poor prognosis with a median survival of 12–16 months. Such poor prognosis affects the perception of the remaining life by patients and the neuropsychological status can strongly affect every-day functioning of these patients. Monitoring changes of neuropsychological functioning (NPF) overtime may provide better clinical information and optimize the neuro-oncological management. The aims of our work were (1) to investigate the feasibility of a complex neuropsychological battery in HGG patients before and during follow-up after surgery; (2) to study the neuropsychological profile of patients affected by HGGs and their relation with the disease status (relapse/death) across time after surgery.
Methods
One hundred two patients who received surgery for HGG between 2011 and 2017 were studied. All clinical data were prospectively recorded. NPF was assessed during the neuro-oncological follow-up through the Milano-Bicocca Battery (MIBIB). Statistical analysis was performed on the neuropsychological results of the tests administered.
Results
First, MIBIB proved to be suitable for patients with HGG tumors before and after surgery, and during long-term follow-up; it also showed a cluster structure representative of the principal cognitive domains. Second, we found a steep decline in the neuropsychological profile before death and/or tumor relapse for the 52% of the neuropsychological tests administered.
Conclusion
Complex neuropsychological batteries can be administered to HGG patients before and during follow-up after surgery. There is a correlation between neuropsychological deterioration and tumor relapse and/or death, which may reflect a progressive damage to cognitive functions due to tumor infiltration and progression.
