Neurocognitive and functional asse ssment of patients with brain metastases:a pilot study

摘要

The outcome of patients with brain me tastases is generally poor.Surviva l alone is not necessarily a good measure of clinical outcome.Measures of neurocognitiv e function and the impact of the disease and treatments on functional status also need to be considered.Although these parameters have been measured in patients wi th primary brain tumors,they have not been as thoroughly evaluated in patients with brain metastases.The Mini-Mental State Exam ination provides limited assessmen t of neurocognitive domains impaired in brain tumor patients.It is less sensitive to mild impairment ,does not avoid memorized learning f rom repeat administration,and does not have validated alternative forms necessary for non-English speaking patients.To determine the feasibility of using a more comprehensive neurocognitive test battery,motor,verbal,executive,and daily functions were assessed in30patients with brain metastases.The test battery included the Hopkins Verbal Learning Tests,Controlled Oral Word Association T est,Grooved Pegboard Test,Trailmaking Tests A and B,and t he Barthel Index.In this study,there was complete patient compliance,w ith average test completion time of 23±6minutes.Despite high functional status,most patients demonstrated impairment in memory and fine motor domains.Neurocognitive test batte ries can and should be used in patient s with brain metastases enrolled in c linical trials.