Skip to main content

Advertisement

SpringerLink
Log in

Investigation of cognitive impairments in people with brain tumors

  • Baseline Neuropsychological Investigations and Batteries
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Study of brain tumors (BT) has revealed the importance of cognitive and behavioral assessment to clinical care and prognosis. This paper overviews recent literature, focusing on the main points of interest and current methods, providing recommendations for advancing research. Histological aspects, disease progression, treatment-related neurotoxicity, and co-morbidities determine the cognitive patterns of BT. Mental slowing with prominent executive and memory compromise usually mark the advanced phases of disease, whereas normal cognitive performance or subtle behavioral symptoms characterize the early disease course, irrespective of tumor location. Neurocognitive assessment may indicate brain damage in otherwise neurologically normal patients, explain pathological behavior, and provide reliable measures of outcome, contributing to improving the management of patients. Scarce attention has been devoted to social cognitive deficits which are expected to impair autonomy and relationships. Interest in non-pharmacological treatment of cognitive impairment is a growing area although methodological difficulties persist. Homogeneous patient populations, longitudinal study designs including baseline evaluations, and measurement of the lowest and highest levels of cognitive performance seem indispensable to advancing the study of the cognitive and behavioral changes provoked by BT. Future investigations are also expected to clarify the clinical significance of such changes, their effect on quality of life, and the efficacy of specific rehabilitation treatments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Keime-Guibert F, Chinot O, Taillandier L, Cartalat-Carel S, Frenay M, Kantor G, Guillamo JS, Jadaud E, Colin P, Bondiau PY, Meneï P, Loiseau H, Bernier V, Honnorat J, Barrié M, Mokhtari K, Mazeron JJ, Bissery A, Delattre JY (2007) Radiotherapy for glioblastoma in the elderly. New Engl J Med 356:1527–1535

    Article  PubMed  CAS  Google Scholar 

  2. Hottinger AF, Yoon H, Deangelis LM, Abrey LE (2009) Neurological outcome of long-term glioblastoma survivors. J Neurooncol 95:301–305

    Article  PubMed  Google Scholar 

  3. Bosma I, Vos MJ, Heimans JJ, Taphoorn MJ, Aaronson NK, Postma TJ, van der Ploeg HM, Muller M, Vandertop WP, Slotman BJ (2007) The course of neurocognitive functioning in high-grade glioma patients. J Neurooncol 9:53–62

    Google Scholar 

  4. Hahn CA, Dunn RH, Logue PE, King JH, Edwards CL, Alperin EC (2003) Prospective study of neuropsychologic testing and quality-of-life assessment of adults with primary malignant brain tumors. Int J Radiat Oncol Biol Phys 55:992–999

    Article  PubMed  CAS  Google Scholar 

  5. Crossen JR, Garwood D, Glatstein E, Newvelt EA (1994) Neurobehavioral sequalae of cranial irradiation in adults: a review of radiation-induced encephalopathy. J Clin Oncol 12:627–642

    PubMed  CAS  Google Scholar 

  6. Douw L, Klein M, van den Fagel SS, Heuvel J, Taphoorn MJ, Aaronson NK, Postma TJ, Vandertop WP, Mooij JJ, Boerman RH, Beute GN, Sluimer JD, Slotman BJ, Reijneveld JC, Heimans JJ (2009) Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol 8:810–818

    Article  PubMed  Google Scholar 

  7. Giovagnoli AR, Boiardi A (1994) Cognitive impairment and quality of life in long-term survivors of malignant brain tumors. Ital J Neurol Sci 15(9):481–488

    Google Scholar 

  8. Taphoorn MJ, Klein M (2004) Cognitive deficits in adult patients with brain tumors. Lancet Neurol 66:159–168

    Google Scholar 

  9. Douw L, van Dellen E, de Groot M, Heimans JJ, Klein M, Stam CJ, Reijneveld JC (2010) Epilepsy is related to theta band brain connectivity and network topology in brain tumor patients. BMC Neurosci 11:103. doi:10.1186/1471-2202-11-103

  10. Kahana MJ (2006) The cognitive correlates of human brain oscillations. J Neurosci 26(6):1669–1672

    Google Scholar 

  11. Giovagnoli AR, Casazza M, Ciceri E, Avanzini G (2006) Preserved memory in temporal lobe epilepsy patients after surgery for low-grade tumour. A pilot study. Neurol Sci 28:171–174

    Google Scholar 

  12. Klein M, Engelberts NH, van der Ploeg HM, Kasteleijn-Nolst Trenité DG, Aaronson NK, Taphoorn MJ, Baaijen H, Vandertop WP, Muller M, Postma TJ, Heimans JJ (2003) Epilepsy in low-grade gliomas: the impact on cognitive function and quality of life. Ann Neurol 54:514–520

  13. Tucha O, Smely C, Preier M, Lange KW (2000) Cognitive deficits before treatment among patients with brain tumors. Neurosurgery 47:324–333

    Article  PubMed  CAS  Google Scholar 

  14. Olson JD, Riedel E, DeAngelis LM (2000) Long-term outcome of low-grade oligodendroglioma and mixed glioma. Neurology 54:1442–1448

    Article  PubMed  CAS  Google Scholar 

  15. Taphoorn MJB, Klein Schiphorst A, Snoek FJ, Lindeboom J, Wolbers JG, Karim ABMF, Huijgens PC, Heimans JJ (1994) Cognitive functions and quality of life in patients with low-grade gliomas: the impact of radiotherapy. Ann Neurol 36:48–54

    Google Scholar 

  16. Klein M, Heimans JJ, Aaronson NK. van der Ploeg HM, Grit J, Muller M, Postma TJ, Mooij JJ, Boerman RH, Beute GN, Ossenkoppele GJ, van Imhoff GW, Dekker AW, Jolles J, Slotman BJ, Struikmans H, Taphoorn MJ (2002) Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low grade gliomas: a comparative study. Lancet 360:1361–1368

    Google Scholar 

  17. Laack NN, Brown PD, Ivnik RJ, Furth AF, Ballman KV, Hammack JE, Arusell RM, Shaw EG, Buckner JC, North Central Cancer Treatment Group (2005) Cognitive function after radiotherapy for supratentorial low-grade gliomas: a north central cancer treatment group prospective study. Int J Radiat Oncol Biol Phys 63:1175–1183

    Google Scholar 

  18. Brown PD, Buckner JC, O’Fallon JR, Iturria NL, Brown CA, O’Neill BP, Scheithauer BW, Dinapoli RP, Arusell RM, Curran WJ, Abrams R, Shaw EG (2003) Effects of radiotherapy on cognitive function in patients with low-grade glioma measured by the folstein mini-mental state examination. J Clin Oncol 21:2519–2524

    Article  PubMed  Google Scholar 

  19. Duffau H, Capelle I, Denvil D, Sichez N, Gatignol P, Lopes M, Mitchell MC, Sichez JP, Van Effenterre R (2003) Functional recovery after surgical resection of low-grade gliomas in eloquent brain: hypothesis of brain compensation. J Neurol Neurosurg Psychiatry 74:901–907

    Article  PubMed  CAS  Google Scholar 

  20. Gregor A, Cull A, Traynor E, Stewart M, Lander F, Love S (1996) Neuropsychometric evaluation of long-term survivors of adult brain tumours: relationship with tumour and treatment parameters. Radiother Oncol 41:55–59

    PubMed  CAS  Google Scholar 

  21. Imperato JP, Paleologos NA, Vick NA (1990) Effects of treatment on long-term survivors with malignant gliomas. Ann Neurol 28:818–922

    Article  PubMed  CAS  Google Scholar 

  22. Kleinberg L, Wallner K, Malkin MG (1993) Good performance status of long-term disease-free survivors of intracranial gliomas. Int J Radiat Oncol Biol Phys 26:129–133

    Article  PubMed  CAS  Google Scholar 

  23. Scheibel RS, Meyers CA, Levin VA (1996) Cognitive dysfunction following surgery for intracerebral glioma: influence of histopathology, lesion location, and treatment. J Neurooncol 30:61–69

    Article  PubMed  CAS  Google Scholar 

  24. Steinbach JP, Blaicher HP, Herrlinger U, Wick W, Nagele T, Meyermann R, Tatagiba M, Bamberg M, Dichgans J, Karnath HO, Weller M (2006) Surviving glioblastoma for more than 5 years: the patient’s perspective. Neurology 66(2):239–242

    Article  PubMed  CAS  Google Scholar 

  25. Corn BW, Wang M, Fox S, Michalski J, Purdy J, Simpson J, Kresl J, Curran WJ Jr, Diaz A, Mehta M, Movsas B (2009) Health related quality of life and cognitive status in patients with glioblastoma multiforme receiving escalating doses of conformal three dimensional radiation on RTOG 98-03. J Neurooncol 95:247–257

    Article  PubMed  Google Scholar 

  26. Brown PD, Jensen AW, Felten SJ, Ballman KV, Schaefer PL, Jaeckle KA, Cerhan JH, Buckner JC (2006) Detrimental effects of tumor progression on cognitive function of patients with high-grade glioma. J Clin Oncol 24:5427–5433

    Article  PubMed  Google Scholar 

  27. Armstrong CL, Goldstein B, Shera D, Ledakis GE, Tallent EM (2003) The predictive value of longitudinal neuropsychological assessment in the early detection of brain tumor recurrence. Cancer 97:649–656

    Article  PubMed  Google Scholar 

  28. Bosma I, Vos M, Heimans JJ, Taphoorn MJ, Aaronson NK, Postma TJ, van der Ploeg HM, Muller M, Vandertop WP, Slotman BJ, Klein M (2007) The course of neurocognitive status in high-grade glioma patients. Neuro-Oncol 9:53–62

    Article  PubMed  Google Scholar 

  29. Meyers CA, Hess KR, Yung WK, Levin VA (2000) Cognitive function as a predictor of survival in patients with recurrent malignant glioma. J Clin Oncol 18:646–650

    PubMed  CAS  Google Scholar 

  30. Herman MA, Tremont-Luktas I, Meyers CA, Trask DD, Froseth C, Renschler MF, Mehta MPJ (2003) Neurocognitive and functional assessment of patients with brain metastases. Am J Clin Oncol 26:273–279

    PubMed  Google Scholar 

  31. Meyers CA, Smith JA, Bezjak A, Mehta MP, Liebmann J, Illidge T, Kunkler I, Caudrelier JM, Eisenberg PD, Meerwaldt J, Siemers R, Carrie C, Gaspar LE, Curran W, Phan SC, Miller RA, Renschler MF (2004) Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: results of a randomized phase III trial. J Clin Oncol 22:157–165

    Article  PubMed  CAS  Google Scholar 

  32. Correa DD, De Angelis LM, Shi W, Thaler H, Glass A, Abrey LE (2004) Cognitive functions in survivors of primary central nervous system lymphoma. Neurology 62:547–548

    Article  Google Scholar 

  33. Harder H, Holtel H, Bromberg JEC, Poortmans P, Haaxma-Reiche H, Kluin-Nelemans HC, Menten J, van den Bent MJ (2004) Cognitive status and quality of life for primary CNS lymphoma. Neurology 62:544–547

    Article  PubMed  CAS  Google Scholar 

  34. Correa DD, Rocco-Donovan M, De Angelis LM, Dolgoff-Kaspar R, Iwamoto F, Yahalom J, Abrey LE (2009) Prospective cognitive follow-up in primary CNS lymphoma patients treated with chemotherapy and reduced-dose radiotherapy. J Neurooncol 91:315–321

    Article  PubMed  CAS  Google Scholar 

  35. Teixidor P, Gatignol P, Leroy M, Masuet-Aumatell C, Capelle L, Duffau H (2007) Assessment of verbal working memory before and after surgery for low-grade glioma. J Neurooncol 81:305–313

    Article  PubMed  Google Scholar 

  36. Duffau H (2009) Surgery of low-grade gliomas: towards a functional neurooncology. Curr Opin Oncol 21:249–543

    Article  Google Scholar 

  37. Talacchi A, Santini B, Savazzi S, Gerosa M (2010) Cognitive effects of tumour and surgical treatment in glioma patients. J Neurooncol 103:541–549

    Article  PubMed  Google Scholar 

  38. Scheibel RS, Valentine AD, O’Brien S, Meyers CA (2004) Cognitive dysfunction and depression during treatment with interferon-alpha and chemotherapy. J Neuropsychiatry Clin Neurosci 16:185–191

    Article  PubMed  CAS  Google Scholar 

  39. Wen PY (2003) Central nervous system complications of cancer therapy. In: Shiff D, Wen PY (eds) Cancer neurology in clinical practice. Humana Press, Totowa, pp 215–231

    Google Scholar 

  40. Giovagnoli AR, Franceschetti S, Reati F, Parente A, Maccagnano C, Villani F, Spreafico R (2011) Theory of mind in frontal and temporal lobe epilepsy: cognitive and neural aspects. Epilepsia 52:1995–2002

    Google Scholar 

  41. Anderson SW, Damasio H, Tranel D (1990) Neuropsychological impairments associated with lesion caused by tumor or stroke. Arch Neurol 47:397–405

    Article  PubMed  CAS  Google Scholar 

  42. Cappa SF, Cipollotti L (2008) Cognitive and behavioural disorders associated with space occupying lesions. In: Cappa SF, Abutalebi J, Demonet J-F, Fletcher PC, Garrard P (eds) Cognitive neurolgoy. A clinical textbook. Oxford University Press, New York, pp 161–182

    Chapter  Google Scholar 

  43. Costello A, Shallice T, Gullan R, Beany R (2004) The early effects of radiotherapy on intellectual and cognitive functioning in patients with frontal brain tumors: the use of a new neuropsychological methodology. J Neurooncol 67:351–359

    Article  PubMed  Google Scholar 

  44. Yoshii Y, Tominaga D, Sugimoto K, Tsuchida Y, Hyodo A, Yonaha H, Kushi S (2008) Cognitive function of patients with brain tumor in pre- and postoperative stage. Surg Neurol 69:51–61

    Article  PubMed  Google Scholar 

  45. Jones-Gotman M, Smith ML, Risse GL, Westerveld M, Swanson SJ, Giovagnoli AR, Lee T, Mader-Joaquim MJ, Piazzini A (2010) The contribution of neuropsychology to diagnostic assessment in epilepsy. Epilepsy Behav 18:3–12

    Article  PubMed  Google Scholar 

  46. Giovagnoli AR, Silvani A, Colombo E, Boiardi A (2005) Facets and determinants of quality of life in recurrent high-grade glioma patients. J Neurol Neurosurg Psychiatry 76:562–568

    Article  PubMed  CAS  Google Scholar 

  47. Meyers CA, Hess KR (2003) Multifaceted end points in brain tumor clinical trials: cognitive deterioration precedes MRI progression. Neuro-Oncology 5:89–95

    PubMed  Google Scholar 

  48. Vigliani M-A, Sichez N, Poisson M, Delattre J-Y (1996) A prospective study of cognitive functions following conventional radiotherapy for supratentorial gliomas in young adults: 4-year results. Int J Radiat Oncol Biol Phys 35:527–533

    Google Scholar 

  49. Fliessbach K, Rogowski S, Hoppe C, Sabel M, Goeppert M, Helmstaedter C, Calabrese P, Schackert G, Tonn J-C, Simon M (2010) Computer-based assessment of cognitive functions in brain tumor patients. J Neurooncol 100:427–437

    Article  PubMed  Google Scholar 

  50. Shaw P, Lawrence EJ, Radbourne C, Bramham J, Polkey CE, David AS (2004) The impact of early and late damage to the human amygdala on “theory of mind” reasoning. Brain 127:1535–1548

    Article  PubMed  CAS  Google Scholar 

  51. Shaw P, Lawrence E, Bramaham J, Brierley B, Radbourne C, David AS (2007) A prospective study of the effects of anterior temporal lobectomy on emotion recognition and theory of mind. Neuropsychologia 45:2783–2790

    Article  PubMed  CAS  Google Scholar 

  52. Gallagher HL, Happé F, Brunswick N, Fletcher PC, Frith U, Frith CD (2000) Reading the mind in cartoons and stories: an fMRI study of “theory of mind” in verbal and nonverbal tasks. Neuropsychologia 38:11–21

    Article  PubMed  CAS  Google Scholar 

  53. Gerhing K, Sitskoorn MM, Gundy CM, Sikkes SAM, Klein M, Potsma TJ, van den Bent MJ, Beute GN, Enting RH, Kappelle AC, Boogerde W, Veninga T, Twijnstra A, Boerman DH, Taphoorn MJB, Aaronson NK (2009) Cognitive rehabilitation in patients with gliomas: a randomized controlled trial. J Clin Oncol 27:3712–3722

    Article  Google Scholar 

  54. Gerhing K, Aaronson NK, Taphoorn MJ, Sitskoorn MM (2010) Interventions for cognitive deficits in patients with a brain tumor: an update. Expert Rev Anticancer Ther 10:1779–1795

    Article  Google Scholar 

  55. Hassler MR, Elandt K, Preusser M, Lehrner J, Binder P, Dieckmann K, Rottenfusser A, Marosi C (2010) Neurocognitive training in patients with high-grade glioma: a pilot study. J Neurooncol 97:109–115

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare they have no conflict of interest.

Author information

Authors and Affiliations

  1. Laboratory of Cognitive and Behavioral Neurology, Fondazione IRCCS Istituto Neurologico “C. Besta”, Milano, Italy

    Anna Rita Giovagnoli

Authors
  1. Anna Rita Giovagnoli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anna Rita Giovagnoli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Giovagnoli, A.R. Investigation of cognitive impairments in people with brain tumors. J Neurooncol 108, 277–283 (2012). https://doi.org/10.1007/s11060-012-0815-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-012-0815-6

Keywords

Search

Navigation