Assessment of Executive Functioning in Patients with Meningioma and Low-Grade Glioma: A Comparison of Self-Report, Proxy-Report, and Test Performance

Abstract

Objective:This study aimed to examine: (1) patient–proxy agreement on executive functioning (EF) of patients with primary brain tumors, (2) the relationships between patient- and proxy-report with performance-based measures of EF, and (3) the potential influence of performance-based measures on the level of agreement.Methods:Meningioma and low-grade glioma patients and their informal caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF-A) 3 months after surgery. The two index scores of the BRIEF-A, Behavioral Regulation and Metacognition, were evaluated. Mean scores of patients and proxies were compared with normative values and with each other. Patient–proxy agreement was evaluated with Lin’s concordance correlation coefficients (CCCs) and Bland–Altman plots. Pearson correlation coefficients between reported EF and performance-based measures of EF were calculated. Multiple regression analysis was used to evaluate the potential influence of test performance on differences in dyadic reports.Results:A total of 47 dyads were included. Patients reported significantly more problems on the Metacognition Index compared to norms, and also in comparison with their proxies. Effect sizes indicated small differences. Moderate to substantial agreement was observed between patients and proxies, with CCCs of 0.57 and 0.61 for Metacognition and Behavioral Regulation, respectively. Correlations between reported EF and test performance ranged between −0.37 and 0.10. Dyadic agreement was not significantly influenced by test performance.Conclusions:Patient–proxy agreement was found to be moderate. No clear associations were found between reported EF and test performance. Future studies should further explore the existing and new methods to assess everyday EF in brain tumor patients.

Patient-reported functional executive challenges and caregiver confirmation in adult brain tumor survivors

“…The third hypothesis was confirmed: comparisons between patients' self-reported measures and caregivers' reports showed a high level of concordance between both types of ratings, for all executive domains considered. This result fits well with that of a recent study published by Van der Linden et al [40], which highlights a moderate level of agreement between patients with PBT and their proxies with the BRIEF-A. This study appears complementary to that study, which did not include survivors (on average, patients were recruited three months after surgery).…”

“…It should be noted that there are only two very recent studies devoted to this topic in adult PBT patients. One of them examined executive self-assessment exclusively [35], while the other did not include the study of survivors [40]. 1.…”

Language impairments and resting-state EEG in brain tumour patients: Revealing connections

“…This incongruence is observed in both directions: there are patients who report no problems and have impaired test performance, and patients who report language problems and have no impaired test performance. Although remarkable, a similar incongruence has been reported previously in brain tumour patients for language as well as cognitive functioning Gehring et al, 2015;Pranckeviciene et al, 2017;Van der Linden et al, 2020). This implies that a task-related explanation for the observed inconsistency is unlikely.…”

“…Although remarkable, this is in line with previous literature. A low congruence between subjective complaints and objective test results has been reported for language Pranckeviciene et al, 2017), and is a common finding for cognitive functioning in brain tumour patients Pranckeviciene et al, 2017;Van der Linden et al, 2020). In our study, incongruence is observed in both directions: (1) patients report no language problems, but have impaired test performance; (2) patients report language problems, but have no impaired test performance.…”

Cognition, psychosocial functioning, and health-related quality of life among childhood cancer survivors

“…As childhood cancer (CC) survival rates have been increasing considerably over the past few decades, special attention has been paid to adverse late effects. Even though cancer treatment protocols are continuously modified to reduce long-term sequelae (Mucci & Torno, 2015), cognitive late effects are often reported (Krull et al, 2018;van der Linden et al, 2020). Cognitive problems likely affect psychosocial behaviour and health-related quality of life (Ehrhardt et al, 2018;Tonning Olsson et al, 2020).…”