Article
Prospective longitudinal evaluation of cognitive functions in adult patients with supratentorial WHO Grade II glioma
Prospektive longitudinale Evaluation der kognitiven Funktionen bei erwachsenen Patienten mit WHO Grad II Gliomen
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Authors
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M. Ruge
- Neurochirurgische Klinik und Poliklinik, Ludwig-Maximilians Universität München
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B. Leroch
- Neurochirurgische Klinik und Poliklinik, Ludwig-Maximilians Universität München
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Schlippenbach C. v.
- Arbeitsgruppe Neuropsychologie der Klinik für Physikalische Medizin, Klinikum Großhadern, Ludwig-Maximilians Universität, München
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J. Ilmberger
- Arbeitsgruppe Neuropsychologie der Klinik für Physikalische Medizin, Klinikum Großhadern, Ludwig-Maximilians Universität, München
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J.-C. Tonn
- Neurochirurgische Klinik und Poliklinik, Ludwig-Maximilians Universität, München
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F. Kreth
- Neurochirurgische Klinik und Poliklinik, Ludwig-Maximilians Universität, München
| Published: | May 4, 2005 |
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Outline
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Objective
Severe cognitive impairment in adult patients with supratentorial WHO Grade II glioma has been reported from a few cross-sectional studies. However, no prospective longitudinal data have been published so far. The current prospective pilot study was conducted to check the applicability of the applied cognitive test instruments for longitudinal evaluation and to present preliminary clinical and neuropsychological outcome scores. All patients underwent highly localised treatment strategies such as microsurgery and/or interstitial radiosurgery.
Methods
In this study, adult patients with supratentorial WHO Grade II glioma were included, which all showed a controlled tumour status during evaluation time (2001 – 2002). Beside detailed clinical evaluation (Karnofsky Performance Scale (KPS), seizure status (frequency, semiology), use of anticonvulsants) standardized cognitive test instruments (Münchner Verbaler Gedächtnistest (MGT), Testbatterie zur Aufmerksamkeitsprüfung (TAP)) were applied prior to therapy. Clinical and neuropsychological follow-up examination was performed 3 and 12 months after treatment. Test scores below 1 (2) standard deviation(s) of the norm values of a healthy control group were defined as mild (severe) impairment.
Results
Twenty adult patients (mean age: 43.6 years) were included. While KPS (median 90) and use of anticonvulsants remained stable, the frequency of seizures declined (12/20 to 6/20). Initial mild (severe) impairment of memory was seen in 4/20 patients and slightly worse results were seen after twelve months (2 patients with severe impairment of memory function). Initial attention was mildly impaired in 8/20 patients and slight improvement was observed after 12 months (4/20 patients). All these differences were statistically not significant (p>0.05). Use of anticonvulsants showed a negative effect on attention (p=0.04), whereas memory function was not influenced by anticonvulsants or seizures. No correlation was found between KPS, memory function and attention.
Conclusions
During the early period of the disease, severe impairment of memory function and attention are rare. Localised treatment concepts such as microsurgery and/or interstitial radiosurgery have no negative effect on KPS, memory function, and attention; A favourable impact on seizure status should be considered. The negative effect of anticonvulsants on attention is underscored.
