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.

中文翻译：

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在一项前瞻性临床试验中，对放疗前的原发性脑肿瘤患者进行多领域神经认知分类。


简介 我们在一项前瞻性试验中研究了原发性脑肿瘤患者在放疗 (RT) 之前的多领域基线神经认知，包括功能的临床预测因素以及放疗前和放疗后损伤之间的关联。方法 对 37 名患者进行多领域神经心理测试（记忆、执行功能、语言、注意力、处理），在 RT 前和 3-(n = 21)、6-(n = 22) 和 12-(n = 14) RT 后几个月。损伤率是指标准化 T 评分低于正常平均值 ≤ 1.5 个标准差的患者比例。使用全局缺陷评分（GDS；值越高表示损伤越严重）来计算所有领域的每位患者损伤。测试了基线 GDS 和临床变量之间的关联。每个时间点的总体 GDS 损伤率为 GDS 评分 > 0.5 的患者分数。结果 在 4 项记忆（所有 p ≤ 0.03）和 3 项执行功能测试中的 2 项（p = 0.01，p = 0.027）中发现了具有统计学意义的基线神经认知障碍。每个患者的基线 GDS 与肿瘤体积 (p = 0.048)、肿瘤类型 (p = 0.043)、癫痫病史 (p = 0.007) 和抗癫痫药物的使用 (p = 0.009) 显着相关。 3、6 和 12 个月时具有与基线相同的损伤状态的患者百分比分别为 88%、85% 和 85%。结论 记忆和执行功能障碍是 RT 之前最常见的认知缺陷。肿瘤较大、组织学更具侵袭性且使用抗癫痫药物的患者具有较高的基线 GDS 值。 GDS 是涵盖多域神经认知功能的有前途的工具，基线 GDS 可以识别那些有认知障碍风险的人。