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.

中文翻译：

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高级别胶质瘤患者神经心理功能的长期随访：认知状态能否预测手术后患者的预后？

背景 受高级别胶质瘤 (HGG) 影响的患者预后较差，中位生存期为 12-16 个月。这种不良预后会影响患者对剩余寿命的感知，神经心理状态会强烈影响这些患者的日常功能。长时间监测神经心理功能（NPF）的变化可以提供更好的临床信息并优化神经肿瘤管理。我们工作的目的是 (1) 调查 HGG 患者在手术前和手术后随访期间的复杂神经心理电池的可行性；(2) 研究受 HGGs 影响的患者的神经心理特征及其与手术后不同时间的疾病状态（复发/死亡）的关系。方法 研究了 2011 年至 2017 年间接受 HGG 手术的 102 名患者。前瞻性地记录所有临床数据。NPF 在神经肿瘤学随访期间通过 Milano-Bicocca Battery (MIBIB) 进行评估。对所进行测试的神经心理学结果进行统计分析。结果 第一，MIBIB适用于HGG肿瘤患者手术前后及长期随访；它还显示了代表主要认知领域的集群结构。其次，我们发现在 52% 的神经心理学测试中，死亡和/或肿瘤复发前的神经心理学特征急剧下降。结论 可以在手术前和手术后随访期间对 HGG 患者施用复杂的神经心理学电池。