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Cognitive outcomes after multimodal treatment in adult glioma patients: A meta-analysis
De Roeck,Laurien Gillebert,R Céline van Aert,Robbie C M Vanmeenen,Amber Klein,Martin Taphoorn,Martin J B Gehring,Karin Lambrecht,Maarten Sleurs,Charlotte
De Roeck,Laurien
Gillebert,R Céline
van Aert,Robbie C M
Vanmeenen,Amber
Klein,Martin
Taphoorn,Martin J B
Gehring,Karin
Lambrecht,Maarten
Sleurs,Charlotte
Abstract
Purpose: Cognitive functioning is increasingly assessed as a secondary outcome in neuro-oncological trials. However, which cognitive domains or tests to assess, remains debatable. In this meta-analysis, we aimed to elucidate the longer-term test-specific cognitive outcomes in adult glioma patients. Methods: A systematic search yielded 7098 articles for screening. To investigate cognitive changes in glioma patients and differences between patients and controls ≥one-year follow-up, random-effects meta-analyses were conducted per cognitive test, separately for studies with a longitudinal and cross-sectional design. A meta-regression analysis with a moderator for interval testing (additional cognitive testing between baseline and one-year post-treatment) was performed to investigate the impact of practice in longitudinal designs. Results: Eighty-three studies were reviewed, of which 37 were analyzed in the meta-analysis, involving 4078 patients. In longitudinal designs, semantic fluency was the most sensitive test to detect cognitive decline over time. Cognitive performance on MMSE, digit span forward, phonemic and semantic fluency declined over time in patients who had no interval testing. In cross-sectional studies, patients performed worse than controls on the MMSE, digit span backward, semantic fluency, Stroop speed interference task, trail making test B and finger tapping. Conclusion: Cognitive performance of glioma patients one year after treatment is significantly lower compared to the norm, with specific tests potentially being more sensitive. Cognitive decline over time occurs as well, but can easily be overlooked in longitudinal designs due to practice effects (as a result of interval testing). It is warranted to sufficiently correct for practice effects in future longitudinal trials.
Description
LDR is supported by a strategic basic research PhD fellowship from the Flemish Foundation of Scientific Research (FWO-Vlaanderen, SB/1SE5722N). CS was supported by a senior postdoctoral fellowship from the Flemish Foundation of Scientific Research (FWO-Vlaanderen, grant no. 12Y6122N) during the data acquisition and analysis phase of this work.
Date
2023
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Publisher
Research Projects
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Keywords
Adult, Cognition, Cognition Disorders/diagnosis, Combined Modality Therapy, Cross-Sectional Studies, Glioma/complications, Humans, Neuropsychological Tests
Citation
De Roeck, L, Gillebert, R C, van Aert, R C M, Vanmeenen, A, Klein, M, Taphoorn, M J B, Gehring, K, Lambrecht, M & Sleurs, C 2023, 'Cognitive outcomes after multimodal treatment in adult glioma patients : A meta-analysis', Neuro-Oncology, vol. 25, no. 8, pp. 1395-1414. https://doi.org/10.1093/neuonc/noad045
License
info:eu-repo/semantics/openAccess