Postacute Cognitive Rehabilitation for Adult Brain Tumor Patients

Weyer-Jamora, Christina; Brie, Melissa S; Luks, Tracy; Smith, Ellen M. Lavoie; Hervey-Jumper, Shawn L.; Taylor, Jennie

doi:10.1093/neuros/nyaa552

Cited by 33 publications

(23 citation statements)

References 107 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It has been reported that neurological/neuropsychological deficits can recover after glioma surgery, and the postoperative follow-up period for recovery was 3-6 months [1,37]. A review of the usefulness of post-acute rehabilitation for brain tumors showed that the duration of intervention was 6 to 10 weeks [38]. Currently, there is no consensus on the possible recovery period after glioma surgery, but it is assumed that functional recovery reaches a plateau by 6 months postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

et al. 2021

View full text Add to dashboard Cite

IntroductionThe outcome of awake surgery has been evaluated based on functional factors, return to work, and oncological aspects, and there have been no reports directly examining QOL. This study aimed to investigate the outcome of QOL following awake surgery and to determine the functional factors influencing QOL. Methods Seventy patients with WHO grade II/III gliomas were included. For the assessment of QOL, we used the SF-36 and calculated summary and sub-component scores. Three summary component scores, including physical (PCS), mental (MCS), and role/social summary (RCS) component scores, were computed based on sub-component scores. Additionally, various assessments of neurological/neuropsychological function were performed. We performed univariate and multiple regression analyses to investigate the functional factors influencing the SF-36. Results PCS and MCS were maintained, but only RCS was low to 42.0 ± 16.1. We then focused on the RCS and its subcomponents: general health (GH), role physical (RP), social functioning (SF), and role emotional (RE). Multiple regression analysis showed following significant correlations between the sub-component scores and brain functions: GH to executive function and movement (p = 0.0033 and 0.032), RP to verbal fluency and movement (p = 0.0057 and 0.0010), and RE to verbal fluency (p = 0.020). Furthermore, when the sub-component scores were compared between groups with and without functional deficits related to GH, RP, and RE, each score was significantly lower in the groups with functional deficits (p = 0.012, 0.014, and 0.0049, respectively). Conclusions In patients who underwent awake surgery, a subset of patients had low QOL because of poor RCS. Functional factors influencing QOL included executive function, verbal fluency, and movement.

show abstract

Section: Discussionmentioning

confidence: 99%

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Given the emerging research for the use of cognitive rehabilitation for addressing cognitive and QoL concerns in LrGG (50)(51)(52)(53), this study underscores the value of including cognitive and QoL assessments as part of LrGG care, as well as highlighting the groundwork needed to refine cognitive treatments. More specifically, while still in its infancy for use in LrGG, cognitive rehabilitation models may want to consider how clinical factors such as age, T2 FLAIR volumes, tumor molecular characteristics, and treatment effects may jointly influence treatment response.…”

Section: Discussionmentioning

confidence: 80%

T2 FLAIR Hyperintensity Volume Is Associated With Cognitive Function and Quality of Life in Clinically Stable Patients With Lower Grade Gliomas

et al. 2022

Self Cite

View full text Add to dashboard Cite

Survival outcomes for patients with lower grade gliomas (LrGG) continue to improve. However, damage caused both by tumor growth and by the consequences of treatment often leads to significantly impaired cognitive function and quality of life (QoL). While neuropsychological testing is not routine, serial clinical MRIs are standard of care for patients with LrGG. Thus, having a greater understanding of MRI indicators of cognitive and QoL impairment risk could be beneficial to patients and clinicians. In this work we sought to test the hypothesis that in clinically stable LrGG patients, T2 FLAIR hyperintensity volumes at the time of cognitive assessment are associated with impairments of cognitive function and QoL and could be used to help identify patients for cognitive and QoL assessments and interventions. We performed anatomical MR imaging, cognitive testing and QoL assessments cross-sectionally in 30 clinically stable grade 2 and 3 glioma patients with subjective cognitive concerns who were 6 or more months post-treatment. Larger post-surgical T2 FLAIR volume at testing was significantly associated with lower cognitive performance, while pre-surgical tumor volume was not. Older patients had lower cognitive performance than younger patients, even after accounting for normal age-related declines in performance. Patients with Astrocytoma, IDH mutant LrGGs were more likely to show lower cognitive performance than patients with Oligodendroglioma, IDH mutant 1p19q co-deleted LrGGs. Previous treatment with combined radiation and chemotherapy was associated with poorer self-reported QoL, including self-reported cognitive function. This study demonstrates the importance of appreciating that LrGG patients may experience impairments in cognitive function and QoL over their disease course, including during periods of otherwise sustained clinical stability. Imaging factors can be helpful in identifying vulnerable patients who would benefit from cognitive assessment and rehabilitation.

show abstract

“…An impairment in at least one cognitive domain is seen in the majority of patients with intrinsic brain tumors such as low and high-grade gliomas [9]. Cognitive impairments experienced by cancer patients are associated with lower rates of return to work and poor quality of life therefore investigations focused on speech, cognition, and behavior have direct implications on clinical outcomes [8][9][10][11][12]. Patients who are considering enrollment in a non-therapeutic clinical research study, in which their doctor has a dual role as a treating physician and principal investigator, require special considerations.…”

Section: Neuro-oncology Contextmentioning

confidence: 99%

“…In the adult neuro-oncology patient population, over 70% of patients experience cognitive, language, or behavioral impairments, which negatively impacts outcomes [8][9][10][11][12]. Therefore, obtaining informed research consent may pose a challenge.…”

Section: Language and Cognitive Impairmentsmentioning

confidence: 99%

“…Following informed consent, the teach-back method is a useful technique [5]. When obtaining consent in patients with aphasia, it may be challenging to utilize the teach-back method [4,12]. One may consider augmenting the teach-back process with the addition of a checklist that includes salient topics that the patient needs to exemplify understanding.…”

Section: Proposalsmentioning

confidence: 99%

See 1 more Smart Citation

Neuro-Oncology Patients as Human Research Subjects: Ethical Considerations for Cognitive and Behavioral Testing for Research Purposes

Kaur

Egladyous

Valdivia

et al. 2022

Cancers

View full text Add to dashboard Cite

Language, cognition, and behavioral testing have become a fundamental component of standard clinical care for brain cancer patients. Many existing publications have identified and addressed potential ethical issues that are present in the biomedical setting mostly centering around the enrollment of vulnerable populations for therapeutic clinical trials. Well-established guides and publications have served as useful tools for clinicians; however, little has been published for researchers who share the same stage but administer tests and collect valuable data solely for non-therapeutic investigational purposes derived from voluntary patient participation. Obtaining informed consent and administering language, cognition, and behavioral tasks for the sole purpose of research involving cancer patients that exhibit motor speech difficulties and cognitive impairments has its own hardships. Researchers may encounter patients who experience emotional responses during tasks that challenge their existing impairments. Patients may have difficulty differentiating between clinical testing and research testing due to similarity of task design and their physician’s dual role as a principal investigator in the study. It is important for researchers to practice the proposed methods emphasized in this article to maintain the overall well-being of patients while simultaneously fulfilling the purpose of the study in a research setting.

show abstract

Postacute Cognitive Rehabilitation for Adult Brain Tumor Patients

Cited by 33 publications

References 107 publications

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

T2 FLAIR Hyperintensity Volume Is Associated With Cognitive Function and Quality of Life in Clinically Stable Patients With Lower Grade Gliomas

Neuro-Oncology Patients as Human Research Subjects: Ethical Considerations for Cognitive and Behavioral Testing for Research Purposes

Contact Info

Product

Resources

About