| Autor: |
Jacki Bambrough, Eva Bourama, Pietro Ivo D'Urso, Konstantina Karabatsou, Sheeba Ehsan, Abigail Methley, Alex Leggate, Federico Roncaroli, David Coope |
| Jazyk: |
angličtina |
| Rok vydání: |
2018 |
| Předmět: |
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| Popis: |
INTRODUCTION: Low-grade gliomas (LGG) can present with a wide spectrum of neuropsychological sequelae. This can significantly affect the quality of life of patients and their families and should be taken into consideration during all treatment decisions. METHODS: This study retrospectively analysed, prospectively gathered pre-operative neurocognitive status for all patients undergoing awake surgery for subsequently confirmed LGG in eloquent areas. Data was analysed to explore whether exact histological diagnosis with molecular profiles (to distinguish astrocytoma from oligodendroglioma) had a direct bearing on the neuropsychological profile. Clinical and demographic data including gender, age, handedness, education, tumour location, seizure status and medication were recorded for all cases. Wide-ranging and comprehensive neurocognitive testing was performed. RESULTS: Full results were achieved for 43 patients. Anticonvulsants were more common in the astrocytoma group than the oligodendroglioma group (p = 0.037). Where predicted Full Scale IQ was controlled for there were no significant differences between groups on Block Design (visuospatial ability); Similarities (verbal concept formation); Digit Span (working memory) or Verbal Fluency. There were significant differences in category fluency (p = 0.049), with the astrocytoma group attaining higher scores than the oligodendroglioma group. Where one-way ANCOVAs controlled for seizures the astrocytoma group demonstrated significantly higher scores in verbal (p = 0.04) and category fluency (p= 0.03); where anticonvulsant medication was controlled for differences between groups on these measures approached significance. DISCUSSION: This represents the only known study examining the neurocognitive impact of astrocytomas vs. oligodendrogliomas. By utilising a comprehensive battery of clinically based neuropsychological tests taking into account baseline function rather than test means, we are able to identify potential impairments more easily and identify significant differences more accurately. Greater awareness of a “functional neurooncological” approach allows personalised treatment regimens targeted to maximise both survival and quality of life with both pre and post-operative counselling and neurocognitive rehabilitation. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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