Ivan Caramanna1, Andrew Bottomley2, A Josephine Drijver3, Jos Twisk4, Martin van den Bent5, Ahmed Idbaih6, Wolfgang Wick7, Madeline Pe2, Martin Klein8, Jaap C Reijneveld9. 1. Department of Medical Psychology and Brain Tumor Center Amsterdam at Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. 2. Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium. 3. Department of Neurology and Brain Tumor Center Amsterdam at Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. 4. Department of Methodology and Applied Biostatistics, And the Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands. 5. Brain Tumor Center at Erasmus MC Cancer Institute, Rotterdam, the Netherlands. 6. Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut Du Cerveau et de La Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, F-75013, Paris, France. 7. Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) & Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany. 8. Department of Medical Psychology and Brain Tumor Center Amsterdam at Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands. Electronic address: m.klein@amsterdamumc.nl. 9. Department of Neurology and Brain Tumor Center Amsterdam at Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Department of Neurology, Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands.
Abstract
BACKGROUND: Neurocognitively impaired patients with brain tumour are presumed to have reduced cognitive awareness preventing them from adequately valuing and reporting their own functioning, for instance, when providing patient-reported outcomes (PROs) such as health-related quality of life instruments. In this cross-sectional study, we aimed at assessing the concordance of neurocognitive complaints (NCCs) and objective neurocognitive functioning (NCF) as a measure of cognitive awareness. METHODS: NCF was assessed using an internationally accepted clinical trial battery. NCC was assessed using the cognitive functioning questionnaire from the Medical Outcome Study (MOS) and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire cognitive functioning subscale. Patients were divided in cognitively impaired and unimpaired groups, based on their NCF performance. Pearson's correlation coefficients between NCF and NCCs were calculated. The same procedure was used to evaluate the correlation of NCF and QLQ-C30 CF subscale. RESULTS: Data from EORTC trials 26091 and 26101 were pooled into a data set of 546 patients. Twenty percent of patients could be characterised as unimpaired (109) and 80% as impaired (437). Impaired patients reported more cognitive complaints on the MOS scale than unimpaired patients. Correlations between NCF and NCCs were weak but significant for impaired patients and non-significant for unimpaired ones. Similar results were found for the correlation between NCF test performance and the QLQ-C30 CF subscale. CONCLUSION: Correlations between NCF test scores and complaints were weak but suggesting that neurocognitive impairment in patients with HGG does not preclude cognitive awareness. However, considering the findings of this study, we would suggest not to use PROs as a surrogate of performance-based neurocognitive evaluation.
BACKGROUND:Neurocognitively impairedpatients with brain tumour are presumed to have reduced cognitive awareness preventing them from adequately valuing and reporting their own functioning, for instance, when providing patient-reported outcomes (PROs) such as health-related quality of life instruments. In this cross-sectional study, we aimed at assessing the concordance of neurocognitive complaints (NCCs) and objective neurocognitive functioning (NCF) as a measure of cognitive awareness. METHODS: NCF was assessed using an internationally accepted clinical trial battery. NCC was assessed using the cognitive functioning questionnaire from the Medical Outcome Study (MOS) and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire cognitive functioning subscale. Patients were divided in cognitively impaired and unimpaired groups, based on their NCF performance. Pearson's correlation coefficients between NCF and NCCs were calculated. The same procedure was used to evaluate the correlation of NCF and QLQ-C30 CF subscale. RESULTS: Data from EORTC trials 26091 and 26101 were pooled into a data set of 546 patients. Twenty percent of patients could be characterised as unimpaired (109) and 80% as impaired (437). Impaired patients reported more cognitive complaints on the MOS scale than unimpaired patients. Correlations between NCF and NCCs were weak but significant for impaired patients and non-significant for unimpaired ones. Similar results were found for the correlation between NCF test performance and the QLQ-C30 CF subscale. CONCLUSION: Correlations between NCF test scores and complaints were weak but suggesting that neurocognitive impairment in patients with HGG does not preclude cognitive awareness. However, considering the findings of this study, we would suggest not to use PROs as a surrogate of performance-based neurocognitive evaluation.
Authors: Quirien Oort; Linda Dirven; Sietske A M Sikkes; Neil Aaronson; Florien Boele; Christine Brannan; Jonas Egeter; Robin Grant; Martin Klein; Irene M Lips; Yoshitaka Narita; Hitomi Sato; Monika Sztankay; Günther Stockhammer; Andrea Talacchi; Bernard M J Uitdehaag; Jaap C Reijneveld; Martin J B Taphoorn Journal: Neurooncol Pract Date: 2022-02-26