UCSF

Abstract Neurocognitive function and quality of life are important clinical outcome measures for patients with lower grade glioma. Here, we performed neurocognitive testing and quality of life assessments in radiologically and clinically stable grade 2 and 3 glioma patients who are not receiving active treatment.

METHODS

Patients completed a computerized battery of standardized neurocognitive tests in the NIH Toolbox and quality of life assessments with the FACT-BR. We acquired patient demographic information, current performance status, current anti-epileptic therapy, treatment history, extent of resection at diagnosis and recurrence, tumor location, and histologic and molecular tumor characteristics. Tumor volumes were measured on T2 FLAIR MRIs.

RESULTS

We have enrolled 15 patients. All patients had previous resection (10 partial, 5 gross total), 11 received chemotherapy, and 6 prior radiation. Median age at testing was 41 years old (range 26 – 65). As a group, patients were impaired on processing speed and fluid cognition. Two patients were impaired on picture vocabulary, 6 on list sorting, 11 on processing speed, 6 on sequence memory, 4 on inhibitory control, 2 on dimensional change, 7 on fluid cognition, and 0 on crystallized cognition. Higher age was significantly associated with poorer age-corrected oral-reading, and sequence memory. Insula and parietal lesions were associated with slower processing speed. Previous chemotherapy treatment was associated with poorer dimensional change. On imaging, larger tumor volumes were associated with poorer list sorting, processing speed, and sequence memory. On the FACT-BR, older patients, patients with prior radiation or those with higher grade were associated with poorer social/family well-being.

CONCLUSION

The NIH Toolbox and FACT-BR are effective, accessible tools to assess neurocognitive function and quality of life in glioma patients. By correlating these assessments with patient and tumor characteristics, it may be possible to identify patients at risk for specific deficits and provide opportunity for intervention.