Work

NEURO-COGNITIVE

Year: 2013

Type: article

Abstract: BACKGROUND: The theory of cognitive reserve (CR) hypothesizes that individuals with higher CR maintain functional independence and activities of daily living despite accumulating substantial neuropathology.CR proxies of premorbid intelligence (IQ), occupation, and education have been used to describe the observation of high/low CR categories in survivors of primary brain tumor (PBT).This descriptive study explores CR categories within the context of neurocognitive performance of survivors with PBT.METHODS: Eligibility requirements included MMSE .24, completed tumor treatment, tumor stability.Forty recruited subjects meeting eligibility underwent one session of neurocognitive testing (HVLT-R, COWA, TMT, and SDMT), EXIT-25, demographic, and symptom assessments.NAART and Hollingshead Index of Social Classification (HI) served as CR proxies for IQ and occupational-educational attainment.Higher NAART and lower HI reflect higher CR, thus CR categories (low: +HI/-NAART, +HI/ + NAART; high: 2HI/2NAART, 2HI/ + NAART) were used to describe sample neurocognitive performance.Descriptive statistics, plots, correlations, chi-square, ANOVA were used to examine data.RESULTS: 40 subjects (22 female) with an average age of 50 years (SD 9.7) completed study battery.Tumor characteristics were: low-grade (n ¼ 5), high-grade glioma (n ¼ 35); time since diagnosis averaged 8.4 years (SD 6.0), recurrence since diagnosis, 32.5%, 100% completed radiation/chemotherapy.CR proxies averaged NAART 110 (SD 9.8), HI 31.75 (SD 11.6).Battery averages were: EXIT-25 5.9 (SD 3.6), HVLT-Immediate 23.8 (6.3), HVLT-Delayed 7.7 (SD 3.2), COWA 38.1 (SD 13.7), TMT-A 41.1 (27.0),TMT-B 98.2 (57.5),SDMT 43.9 (14.1).+HI/-NAART subjects had lower overall neurocognitive scores with 75% performing ,3 SD below norm, as compared to 36% +HI/ + NAART and 25% -HI/ + or-NAART subjects.CONCLUSIONS: Generally, those with lower CR demonstrated greater cognitive impairment than higher CR.This study demonstrates how CR categories may be used to delineate cognitive performance in survivors of PBT.These determinations may be useful to identify cognitive risk prior to treatment for prevention or early intervention management. NC-002.

Source: Neuro-Oncology

DOI: 10.1093/neuonc/not181