P18.05 Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Preliminary Data on Clinical Utility within the Brain Tumor Population

摘要

OBJECTIVE: The detrimental effects of brain tumors and related treatments on cognitive capacity are well documented. Since sustaining or improving quality of life is a goal of equal importance to prolonged survival rates, neurocognitive assessments have become integral to comprehensive neuro-oncology care. Existing screening tools are criticized because they are insensitive to cognitive changes caused by medical treatments. One measure that may offer unique utility is the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Research supports the clinical value and psychometric properties of the RBANS in various medical populations; however, there is minimal evidence for its use in the brain tumor population. The purpose of this study was to determine RBANS utility in a sample of brain tumor patients by assessing the incidence of cognitive impairment relative to normative data, as well as to an estimate of pre-morbid intelligence. Participants. Data was collected on 38 patients (53% male; mean age 51, range 27-81) with primary brain tumors, confirmed by histopathological diagnosis. Eighty-Two percent had received surgery as initial treatment, and 45% had undergone radiation, chemotherapy or both prior to assessment. METHODS: All patients were administered the RBANS and the Test of Premorbid Functioning (TOPF, an estimate of pre-morbid intelligence) according to standardized instructions. Composite and Index Standard Scores (SS) from the RBANS were compared to a normal distribution (SS ≤85 indicative of impairment) and TOPF (≥1 SD difference indicative of impairment) per patient. Correlations were completed to identify cognitive relationships within this cohort. RESULTS: Descriptive profiling of RBANS will be presented. Regarding demonstrated deficits, comparison with standardization norms (RBANS; 47% compositely impaired, 68% on at least one index, and 53% on multiple indexes) was strikingly similar compared to self (TOPF; 50%, 71%, 53%). However, patients had an increased likelihood of global impairment when compared to self (4 to 5 indexes impaired; 32% vs 8%). There was a positive correlation between quantity of deficits and TOPF (r = .636, p = .000), whereas there was a negative correlation when compared to RBANS normative distribution (r = -.351, p = .031). CONCLUSIONS: Accuracy and interpretation of neuropsychological assessment is crucial within the brain tumor population to correctly identify impairment, its influences on perception of illness, level of support, and recommendations for management. Our preliminary research demonstrates the utility of RBANS as an efficient tool to assess cognitive impairment in patients with primary brain tumors. Our data also supports the importance of comparison to self and estimated premorbid intelligence, rather than normative distribution, to ensure precision in estimation of impairment.