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Prediction of neurocognitive outcome in adult
brain tumor patients
Kaleita TA, Wellisch DK, Cloughesy TF, Ford JM, Freeman D, Belin TR, Goldman
J
Department of Psychiatry, the UCLA Neuro-Oncology Program and the
Henry E. Singleton Brain Cancer Research Program, David Geffen School of
Medicine at UCLA, Los Angeles, CA, USA. tkaleita@ucla.edu
Purpose. To determine the relative contributions of patient, disease and
therapy specific factors on neurocognitive outcome of brain tumor
patients.
Patients and Methods. Seventy-nine patients (mean age = 41.1 years;
range: 17-75 years; 54% male, 46% female) with glioblastoma multiforme (37%),
anaplastic astrocytoma (17%), low grade astrocytoma (13%), and oligodendroglioma
(10%) predominantly in the frontal regions (45%) were evaluated in an outpatient
neuro-oncology clinic.
A neuropsychological test battery emphasized elements of
attention/concentration.
Multiple regression analyses determined relationships between functional
outcomes and demographic and clinical predictors.
Results. Key predictors of neurocognitive functioning included age of
the patient (36-59 years, p < 0.01; >/= 60 years, p < 0.05) and frontal
region tumor location (p < 0.01).
As expected, older patients did not perform as well as younger patients in
absolute terms on neuropsychological tests; decrements persisted when
comparisons were based on age-standardized versions of neurocognitive
outcomes.
Major depressive disorder was marginally associated with outcomes, while
surgical interventions and radiotherapy did not show strong associations with
test performances.
Conclusions. Primary malignant brain disease was found to be less
negative on neurocognitive outcomes for younger than for either middle-aged or
older patients.
Treatments were not as predictive of neurocognitive outcomes as age.
No single test outcome measure was as sensitive to neurocognitive status as the
empirically derived index of attention and concentration.
PMID: 15072475 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15072475
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