Computerized neuropsychological screening in clinical care for patients with low-grade gliomas: Incidence and severity of cognitive deficits

摘要

Objective: Although there is a vast body of literature on cognition in patients with low-grade gliomas (LGG; WHO grade I or II), this study is first using a brief (30 min) computerized neuropsychological screening battery (cNPS; i.e., CNS Vital Signs) as clinical care to examine cognitive function in LGG patients at group and individual level. Methods: LGG patients underwent cNPS 1 day pre-surgery (N=69), with follow-up 3 months post-surgery (N=54). Results: Pre-operatively, patients demonstrated significantly lower means on 6 out of 7 domains assessed: memory, reaction time, cognitive flexibility, processing speed, complex attention, and executive function, compared to healthy controls (HC; 1,069 American subjects). Effect sizes were small, Cohen’s ds ranging from -.21 to -.36. Post-surgery, there were no differences between patients and HC anymore, except for memory where performance was still lower function, compared to healthy controls (HC; 1,069 American subjects). Effect sizes were small, Cohen’s ds = -.49. Preoperatively, 24% of the patients scored low, and another 25% scored very low (i.e., respectively 1.5 or 2 standard deviation below average) in at least one domain. Post-surgery, respectively 30% and 15% of the patients scored within the low or very low range on at least one domain. Conclusions: In line with studies using conventional neuropsychological tests, the cNPS demonstrated that pre-surgery, LGG patients are faced with mild cognitive dysfunction in several domains. Post-surgery, performance did not differ from HC, except for the memory domain for which performance still deviated from HC. Practice effects and surgery effects will be further examined. Selection bias was minimal and results are generalizable to LGG patients undergoing surgery.