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Psychosocial Aspects
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Neuro-oncol 2006,
Epub 2006 Oct 3. DOI:10.1215/15228517-2006-012
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Abstract |
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The course of neurocognitive
functioning in high-grade glioma patients
Ingeborg Bosma1*,
Maaike J. Vos1,
Jan J. Heimans1,
Martin J.B. Taphoorn2,
Neil K. Aaronson3,
Tjeerd J. Postma1,
Henk M. van der Ploeg4,
Martin Muller3,
W. Peter Vandertop5,
Ben J. Slotman6,
Martin Klein4
1 Department of
Neurology, VU University Medical Center, 1081 HV Amsterdam, The
Netherlands. 2 Department of Neurology, Medical Center
Haaglanden, 2501 CK The Hague, and University Medical Center Utrecht,
3508 GA Utrecht, The Netherlands. 3 Division of
Psychosocial Research and Epidemiology, The Netherlands Cancer
Institute, 1066 CX Amsterdam, The Netherlands. 4 Department
of Medical Psychology, VU University Medical Center, 1081 HV
Amsterdam, The Netherlands. 5 Department of Neurosurgery,
VU University Medical Center, 1081 HV Amsterdam, The Netherlands. 6
Department of Radiation Oncology, VU University Medical Center, 1081
HV Amsterdam, The Netherlands. -- * To whom correspondence
should be addressed. E-mail: i.bosma@vumc.nl. --
Received December 9, 2005. Accepted April 25, 2006.
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We evaluated the course of neurocognitive
functioning in newly diagnosed high-grade glioma patients
and specifically the effect of tumor recurrence.
Following baseline assessment (after surgery and before
radiotherapy), neurocognitive functioning was evaluated at
8 and 16 months.
Neurocognitive summary measures were calculated to detect
possible deficits in the domains of (1) information processing,
(2) psychomotor function, (3) attention, (4) verbal memory,
(5) working memory, and (6) executive functioning.
Repeated-measures analyses of covariance were used to
evaluate changes over time.
Thirty-six patients were tested at baseline only.
Follow-up data were obtained for 32 patients: 14 had a
follow-up at 8 months, and 18 had an additional follow-up
at 16 months.
Between baseline and eight months, patients deteriorated in
information-processing capacity, psychomotor speed, and
attentional functioning.
Further deterioration was observed between 8 and 16
months.
Of 32 patients, 15 suffered from tumor recurrence before
the eight-month follow-up.
Compared with recurrence-free patients, not only did patients with
recurrence have lower information-processing capacity, psychomotor
speed, and executive functioning, but they also exhibited a
more pronounced deterioration between baseline and eight-month
follow-up.
This difference could be attributed to the use of
antiepileptic drugs in the patient group with recurrence.
This study showed a marked decline in neurocognitive functioning in
HGG patients in the course of their disease.
Patients with tumor progression performed worse on
neurocognitive tests than did patients without progression,
which could be attributed to the use of antiepileptic
drugs.
The possibility of deleterious effects is important to
consider when prescribing antiepileptic drug treatment.
Key Words: high-grade glioma,
neurocognitive functioning, neuropsychological assessment, tumor
recurrence, prospective study
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© Copyright 2006 by the Society for
Neuro-Oncology
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Abstract
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