Longitudinal cognitive follow-up in low grade gliomas.
Background In patients with low-grade glioma (LGG), the tumor and its treatment with conformal radiation therapy (RT) and chemotherapy can disrupt cognitive function. However, the contribution of disease and treatment to long-term cognitive outcome remains to be elucidated. In this study, we performed longitudinal cognitive follow-up in a subgroup of patients who received RT, chemotherapy, or no treatment. Methods Twenty-five LGG patients underwent neuropsychological evaluations at study entry, and 6 and 12 months subsequently; 9 patients had RT +/- chemotherapy prior to enrollment and 16 had no treatment. Results At the initial evaluation, treated patients had impaired performance on motor speed only, but scored 1 standard deviation below normative values on tests of executive functions; untreated patients had no cognitive impairment. Repeated measures analyses of variance showed a significant variation over time (P = 0.03) in nonverbal memory (delayed recall); treated patients' performance improved at the 6-month follow-up to a level comparable to untreated patients, but both groups declined slightly by the 12-month evaluation. In a subset of patients (N = 16) available for an additional cognitive evaluation, significant changes between the 12-month and the long-term follow-up were seen in phonemic verbal fluency, mood and quality of life; untreated patients seen at short intervals improved slightly while treated patients seen at longer intervals declined. Conclusions Longitudinal follow-up showed that both disease duration and treatment with RT +/- chemotherapy contributed to a mild decrement in nonverbal recall and in some aspects of executive functions and quality of life in this group of LGG patients.
Correa
Denise D
DD
Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
Shi
Weiji
W
Thaler
Howard T
HT
Cheung
Angeles M
AM
DeAngelis
Lisa M
LM
Abrey
Lauren E
LE
D000328:Adult; D001932:Brain Neoplasms / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003071:Cognition / Q000502:physiology*; D005260:Female; D005910:Glioma / Q000473:pathology / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life; D020266:Radiotherapy, Conformal / Q000379:methods; D013997:Time Factors