Long-term follow-up of neuropsychological functions in patients with high grade gliomas: can cognitive status predict patient’s outcome after surgery?

Barbara Zarino, Andrea Di Cristofori, Giorgia Abete Fornara, Giulio Andrea Bertani, Marco Locatelli, Manuela Caroli, Paolo Rampini, Filippo Cogiamanian, Davide Crepaldi, Giorgio Carrabba

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)803-812
Number of pages10
JournalActa Neurochirurgica
Volume162
Issue number4
DOIs
Publication statusPublished - Apr 1 2020

Keywords

  • Brain tumors
  • Cognitive functioning
  • Glioma surgery
  • High-grade glioma
  • Neuropsychology

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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