Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters: The value of longitudinal patient-specific neuropsychological assessment
Butterbrod,Elke Bruijn,Jimme Braaksma,Meriam Rutten,Geert-Jan Tijssen,Cees Hanse,Monique Gehring,Karin Sitskoorn,Margriet
Butterbrod,Elke
Bruijn,Jimme
Braaksma,Meriam
Rutten,Geert-Jan
Tijssen,Cees
Hanse,Monique
Gehring,Karin
Sitskoorn,Margriet
Abstract
Objective: To investigate to what extent post-surgical cognitive decline on a subset of patient-tailored neuropsychological tests predicts disease progression on radiological grounds in individuals with newly diagnosed high-grade glioma (HGG). Participants and Methods: 35 patients who underwent resection for confirmed HGG were included. Neuropsychological assessment, including the CNS Vital Signs battery, Letter Fluency and Digit Span test, and clinical radiological evaluation with MRI, were conducted 3-monthly, starting 1 day before surgery. For each patient, we selected the 3 tests that showed the highest Reliable Change Index (RCI), i.e. most improvement, from pre- to first post-surgical assessment for further monitoring over time. Follow-up assessments continued for up to 24 months after surgery or until disease progression. An RCI value of ≤ -1 on at least 2 of the 3 selected tests at any of the follow up assessments was considered cognitive decline. A discrete Cox proportional hazard model with dichotomous time-dependent coefficient (cognitive decline) to predict radiological disease progression was conducted in R. Results: 25 patients were eligible for analysis. Cognitive decline preceded or had occurred at time of progression in 10 of the 15 patients (67%) who showed radiological disease progression during follow up, and was absent in 8 out of 10 patients (80%) who did not show disease progression. The model showed a hazard ratio (HR) for disease progression of 4.144; 95% CI 1.388 - 12.37, p= .01 (model χ2 [1] = 7.02, p<.01). Conclusions: Our data suggested a four-fold increase in risk of disease progression if the change on patient-specific tests during follow up met the criterion for cognitive decline. We recommend further exploration of the value of patient-tailored, brief longitudinal neuropsychological assessment alongside current methods for disease monitoring.
Description
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Research Projects
Organizational Units
Journal Issue
Keywords
Citation
Butterbrod, E, Bruijn, J, Braaksma, M, Rutten, G-J, Tijssen, C, Hanse, M, Gehring, K & Sitskoorn, M 2019, 'Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters : The value of longitudinal patient-specific neuropsychological assessment', International Neuropsychological Society - Annual Meeting 2019, New York, United States, 18/02/19 - 21/02/19 pp. 205-206.
License
info:eu-repo/semantics/restrictedAccess