Journal of Neuro-Oncology

, Volume 100, Issue 3, pp 427–437 | Cite as

Computer-based assessment of cognitive functions in brain tumor patients

  • Klaus Fliessbach
  • Sabine Rogowski
  • Christian Hoppe
  • Michael Sabel
  • Mathias Goeppert
  • Christoph Helmstaedter
  • Pasquale Calabrese
  • Gabriele Schackert
  • Joerg-Christian Tonn
  • Matthias Simon
  • Uwe Schlegel
Clinical Study – Patient Study

Abstract

NeuroCogFX is a short yet comprehensive computer-based neuropsychological battery of tests developed to investigate neurological patients for cognitive dysfunction after potentially neurotoxic therapy. NeuroCogFX had been standardized in a group of 242 healthy controls (Fliessbach et al., Fortschr Neurol Psychiatr 74:643–650, 2006). The present study was conducted to assess the practicability, reliability, and validity of NeuroCogFX in brain tumor patients without active disease after tumor-directed therapy. To evaluate its validity, neuropsychological testing with NeuroCogFX was completed parallel to a battery of established neuropsychological tests in 54 patients with different types of brain tumors and without active disease for at least 6 months. Retest reliability was assessed in a different sample of 49 patients with gliomas. Results showed good practicability with a median test duration of 28 min (range 16–51 min). Most subtests showed medium-sized retest reliability in healthy controls and tumor patients, with the exception of the 2-back test and reaction time measures in tumor patients. Convergent validity was confirmed for the domains psychomotor speed, verbal memory, and verbal short-term memory. NeuroCogFX enables serial scientific neuropsychological assessment of brain tumor patients. It can be carried out within a short period of time by non-academic personnel and is therefore applicable to large cohorts, e.g., within clinical trials.

Keywords

Neuropsychological test Neurotoxicity Computerized (computer-based, computer-assisted) testing Follow-up examination 

Notes

Conflict of Interest Statement

With kind permission of the University of Bonn Medical Centre NeuroCogFX is marketed by three of the authors (C. Hoppe, K. Fliessbach, C. Helmstaedter).

References

  1. 1.
    Taphoorn MJ, Klein M (2004) Cognitive deficits in adult patients with brain tumours. Lancet Neurol 3:159–168CrossRefPubMedGoogle Scholar
  2. 2.
    Fliessbach K, Helmstaedter C, Urbach H, Althaus A, Pels H, Linnebank M, Juergens A, Glasmacher A, Schmidt-Wolf IG, Klockgether T, Schlegel U (2005) Neuropsychological outcome after chemotherapy for primary CNS lymphoma: a prospective study. Neurology 64:1184–1188PubMedGoogle Scholar
  3. 3.
    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 41:55–59PubMedGoogle Scholar
  4. 4.
    Calabrese P, Schlegel U (2009) Neurotoxicity of treatment. Recent Results Cancer Res 171:165–174CrossRefPubMedGoogle Scholar
  5. 5.
    Abrey LE, DeAngelis LM, Yahalom J (1998) Long-term survival in primary CNS lymphoma. J Clin Oncol 16:859–863PubMedGoogle Scholar
  6. 6.
    Correa DD, Maron L, Harder H, Klein M, Armstrong CL, Calabrese P, Bromberg JE, Abrey LE, Batchelor TT, Schiff D (2007) Cognitive functions in primary central nervous system lymphoma: literature review and assessment guidelines. Ann Oncol 18:1145–1151CrossRefPubMedGoogle Scholar
  7. 7.
    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 360:1361–1368CrossRefPubMedGoogle Scholar
  8. 8.
    Surma-aho O, Niemela M, Vilkki J, Kouri M, Brander A, Salonen O, Paetau A, Kallio M, Pyykkonen J, Jaaskelainen J (2001) Adverse long-term effects of brain radiotherapy in adult low-grade glioma patients. Neurology 56:1285–1290PubMedGoogle Scholar
  9. 9.
    Postma TJ, Klein M, Verstappen CC, Bromberg JE, Swennen M, Langendijk JA, Taphoorn MJ, Scheltens P, Slotman BJ, van der Ploeg HM, Aaronson NK, Heimans JJ (2002) Radiotherapy-induced cerebral abnormalities in patients with low-grade glioma. Neurology 59:121–123PubMedGoogle Scholar
  10. 10.
    Correa DD, DeAngelis LM, Shi W, Thaler HT, Lin M, Abrey LE (2007) Cognitive functions in low-grade gliomas: disease and treatment effects. J Neurooncol 81:175–184CrossRefPubMedGoogle Scholar
  11. 11.
    Corn BW, Yousem DM, Scott CB, Rotman M, Asbell SO, Nelson DF, Martin L, Curran WJ Jr (1994) White matter changes are correlated significantly with radiation dose. Observations from a randomized dose-escalation trial for malignant glioma (Radiation Therapy Oncology Group 83–02). Cancer 74:2828–2835CrossRefPubMedGoogle Scholar
  12. 12.
    Taphoorn MJ (2003) Neurocognitive sequelae in the treatment of low-grade gliomas. Semin Oncol 30:45–48CrossRefPubMedGoogle Scholar
  13. 13.
    Crossen JR, Garwood D, Glatstein E, Neuwelt EA (1994) Neurobehavioral sequelae of cranial irradiation in adults: a review of radiation-induced encephalopathy. J Clin Oncol 12:627–642PubMedGoogle Scholar
  14. 14.
    Schlegel U, Pels H, Oehring R, Blumcke I (1999) Neurologic sequelae of treatment of primary CNS lymphomas. J Neurooncol 43:277–286CrossRefPubMedGoogle Scholar
  15. 15.
    Correa DD, DeAngelis LM, Shi W, Thaler H, Glass A, Abrey LE (2004) Cognitive functions in survivors of primary central nervous system lymphoma. Neurology 62:548–555PubMedGoogle Scholar
  16. 16.
    Taylor BV, Buckner JC, Cascino TL, O’Fallon JR, Schaefer PL, Dinapoli RP, Schomberg P (1998) Effects of radiation and chemotherapy on cognitive function in patients with high-grade glioma. J Clin Oncol 16:2195–2201PubMedGoogle Scholar
  17. 17.
    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 21:2519–2524CrossRefPubMedGoogle Scholar
  18. 18.
    Fliessbach K, Hoppe C, Schlegel U, Elger CE, Helmstaedter C (2006) NeuroCogFX—a computer-based neuropsychological assessment battery for the follow-up examination of neurological patients. Fortschr Neurol Psychiatr 74:643–650CrossRefPubMedGoogle Scholar
  19. 19.
    Hoppe C, Fliessbach K, Schlegel U, Elger CE, Helmstaedter C (2009) NeuroCog FX: computerized screening of cognitive functions in patients with epilepsy. Epilepsy Behav 16:298–310CrossRefPubMedGoogle Scholar
  20. 20.
    McCaffrey RJ, Westervelt HJ (1995) Issues associated with repeated neuropsychological assessments. Neuropsychol Rev 5:203–221CrossRefPubMedGoogle Scholar
  21. 21.
    Zimmermann P, Fimm B (1997) Test for Assessing Attentional Performance (TAP). Version 1.5. Psytest. Herzogenrath, GermanyGoogle Scholar
  22. 22.
    Brickenkamp R, Zillmer E (1998) The d2 Test of Attention. Hogrefe & Huber Publishers, Seattle, WAGoogle Scholar
  23. 23.
    Reitan RM (1992) Trail Making Test: manual for administration and scoring. Reitan Neuropsychology Laboratory, Tucson, AZGoogle Scholar
  24. 24.
    Haerting C, Markowitsch HJ, Neufeld H, Calabrese P, Deisinger K, Kessler J (2000) Wechsler Memory Scale-Revised (WMS-R) (German Version). Huber, Bern, SwitzerlandGoogle Scholar
  25. 25.
    Rey A (1964) L’examen clinique en psychologie. Presses Universitaires de France, ParisGoogle Scholar
  26. 26.
    Rey A (1959) Manuel du test de copie d’une figure complexe de A. Rey. Les Editions du Centre de Psychologie Appliquée, ParisGoogle Scholar
  27. 27.
    Kessler J, Denzler P, Markowitsch HJ (1988) Demenz-Test. Germany, Beltz Test, GoettingenGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • Klaus Fliessbach
    • 1
  • Sabine Rogowski
    • 2
  • Christian Hoppe
    • 1
  • Michael Sabel
    • 3
  • Mathias Goeppert
    • 3
  • Christoph Helmstaedter
    • 1
  • Pasquale Calabrese
    • 4
  • Gabriele Schackert
    • 5
  • Joerg-Christian Tonn
    • 6
  • Matthias Simon
    • 7
  • Uwe Schlegel
    • 2
  1. 1.Department of EpileptologyUniversity of BonnBonnGermany
  2. 2.Knappschaftskrankenhaus Bochum-Langendreer, Department of NeurologyRuhr University BochumBochumGermany
  3. 3.Department of NeurosurgeryUniversity of DüsseldorfDüsseldorfGermany
  4. 4.Department of PsychologyUniversity of BaselBaselSwitzerland
  5. 5.Department of NeurosurgeryUniversity of DresdenDresdenGermany
  6. 6.Department of NeurosurgeryUniversity of MunichMunichGermany
  7. 7.Department of NeurosurgeryUniversity of BonnBonnGermany

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