Long term follow-up of neuropsychological functions in patients with high grade gliomas: can cognitive status predict patients' outcome after surgery?


Acta Neurochirurgica


September, 2019


Zarino, B., Di Cristofori, A., Abete Fornara, G., Bertani, G.A., Locatelli, M., Caroli, M., Rampini, P., Cogiamanian, F., Crepaldi, D., and Carrabba, G.

Background:Patients affected by a high grade glioma (HGG) have a poor prognosis with a median survival of 12-16 months. Such poor prognosis affects the perception of the remaining life by patients; while the neuropsychological status can strongly affect every-day functioning and the quality of life of these patients. Monitoring changes of neuropsychological functioning (NPF) overtime may provide better clinical information and optimize the neuro-oncological management. However, NPF can be assessed by a battery of dedicated tests which are generally time-consuming and stressful. Aim of our work was to describe theNPF of patients affected by HGGs, in order to study whether the NPF was able to predict changes in the disease status of patients across time after surgery.

Methods:102 patients that received surgery for HGG between 2011 and 2017 were studied. All clinical data were prospectively recorded. NPF was assessed during the neuro-oncological follow-up through the Milano-Bicocca Battery. Statistical analysis was performed on the neuropsychological results. 

Results:First, starting from an extensive neuropsychological battery, we statistically selected few tests able to explore all the cognitive domains. Second, we demonstrated that 5 cognitive tests predicted tumor progression: the Token, the Object Naming, the Digit Span, the Corsi Block and the Semantic Fluency tests. The time course of these variables showed a steep decline few weeks before tumor relapse/death.

Conclusion:With our study we demonstrated that the administration of selected neuropsychological tests allows to explore all the neuropsychological domains. There is a strict correlation between neuropsychological deterioration and tumor relapse.