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Assessment of neuropsychological function in brain tumor treatment: a comparison of traditional neuropsychological assessment with app-based cognitive screening.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Romero-Garcia, Rafael  ORCID logo  https://orcid.org/0000-0002-5199-4573
Owen, Mallory 
McDonald, Alexa 
Woodberry, Emma 
Assem, Moataz 

Abstract

BACKGROUND: Gliomas are typically considered to cause relatively few neurological impairments. However, cognitive difficulties can arise, for example during treatment, with potential detrimental effects on quality of life. Accurate, reproducible, and accessible cognitive assessment is therefore vital in understanding the effects of both tumor and treatments. Our aim is to compare traditional neuropsychological assessment with an app-based cognitive screening tool in patients with glioma before and after surgical resection. Our hypotheses were that cognitive impairments would be apparent, even in a young and high functioning cohort, and that app-based cognitive screening would complement traditional neuropsychological assessment. METHODS: Seventeen patients with diffuse gliomas completed a traditional neuropsychological assessment and an app-based touchscreen tablet assessment pre- and post-operatively. The app assessment was also conducted at 3- and 12-month follow-up. Impairment rates, mean performance, and pre- and post-operative changes were compared using standardized Z-scores. RESULTS: Approximately 2-3 h of traditional assessment indicated an average of 2.88 cognitive impairments per patient, while the 30-min screen indicated 1.18. As might be expected, traditional assessment using multiple items across the difficulty range proved more sensitive than brief screening measures in areas such as memory and attention. However, the capacity of the screening app to capture reaction times enhanced its sensitivity, relative to traditional assessment, in the area of non-verbal function. Where there was overlap between the two assessments, for example digit span tasks, the results were broadly equivalent. CONCLUSIONS: Cognitive impairments were common in this sample and app-based screening complemented traditional neuropsychological assessment. Implications for clinical assessment and follow-up are discussed.

Description

Keywords

Cognitive function, Glioma, Neuropsychiatry, Neuropsychology, Neurosurgery

Journal Title

Acta Neurochir (Wien)

Conference Name

Journal ISSN

0001-6268
0942-0940

Volume Title

Publisher

Springer Science and Business Media LLC
Sponsorship
Cancer Research UK (A25117)
NIHR Academy (NIHRDH-CDF-2018-11-ST2-003)
Medical Research Council (MC_U105559837)
Medical Research Council (MC_UU_00005/10)