The APOE ε4 allele in relation to pre‐ and postsurgical cognitive functioning of patients with primary brain tumors

Abstract

Background Recent studies suggest a relationship between the APOE ε4 allele and cognitive outcome in patients treated for malignant brain tumors. Still, longitudinal investigations that include a pretreatment cognitive assessment are lacking and APOE’s effects in patients with benign tumors are understudied. This study investigated presurgical cognitive performance and postsurgical change in ε4‐carrying and non‐carrying patients with glioma and meningioma. Methods Neuropsychological test scores (CNS Vital Signs battery [seven measures], Digit Span Forward/Backward, Letter Fluency test) were obtained as part of a prospective study in which patients with meningioma and glioma underwent cognitive assessment 1 day before (T0, n = 505) and 3 (T3, n = 418) and 12 months after (T12, n = 167) surgery. APOE isoforms were identified retrospectively. ε4 carriers and non‐carriers were compared with regard to pretreatment cognitive performance on the group and individual level. Changes in performances over time were compared with longitudinal mixed model analysis in the total sample and the subgroup receiving adjuvant treatment. Results Carriers and non‐carriers did not differ with regard to pretreatment performance. No significant main effect of ε4 carrier status or interaction between time (T0–T12) and carrier status was found on any of the tests in the whole sample nor in the sample receiving adjuvant treatment. Conclusions This study found no evidence of increased vulnerability for pretreatment cognitive dysfunction or cognitive decline within 1 year after surgery in APOE ε4‐carrying meningioma and glioma patients. Investigations that include larger samples at longer‐term follow‐up are recommended to investigate potential late treatment effects.

Cognitive outcomes after multimodal treatment in adult glioma patients: A meta-analysis

“…Of all studies that reported information on methods for correction for practice effects, 30% ( k = 8/27) applied correction for practice effects (11% standardized regression-based change scores ( k = 3), 23 , 26 , 30 4% alternate testing forms ( k = 1), 19 15% reliable change index ( k = 4), 25 , 28 , 37 , 42 respectively). Fifty-one percent reported whether they had corrected scores for covariates (age, education, and/or gender).…”

Influences on cognitive outcomes in adult patients with gliomas: A systematic review

“…Not all studies have found genetics to influence cognitive outcomes. One study of 505 patients with HGG, LGG, or meningiomas found that carriers of the APOE ϵ-4 allele (mean age 54.9 years, SD 13.9 years) did not have an increased risk of pre-treatment cognitive dysfunction or cognitive decline within one year of debulking surgery relative to non-carriers (mean age 55.3 years, SD 13.1 years) ( 150 ). However, this does not exclude the presence of potential late treatment effects.…”

Predicting Cognitive Functioning in High-Grade Glioma: Evaluating Different Representations of Tumor Location in a Common Space

“…The current patient samples are described (in part) in previous studies (Meskal et al, 2015;van Loenen et al, 2018;Butterbrod et al, 2019Butterbrod et al, , 2020Butterbrod et al, , 2021De Baene et al, 2019a, 2019bLonkhuizen et al, 2019;Rijnen et al, 2019Rijnen et al, , 2020aRijnen et al, , 2020bvan der Linden et al, 2020;Boelders et al, 2023). This project was part of a study protocol registered at the Medical Ethics Committee Brabant (file number NW2020-32).…”