gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Cognitive deficits in patients with brain tumours – bridging the diagnostic gap? Montreal Cognitive Assessment (MoCA) test as a brief screening tool for cognitive deficits

Kognitives Defizit bei Hirntumorpatienten – Füllen der diagnostischen Lücke? Montreal Cognitive Assessment (MoCA) Test als kurzes Screening-Instrument für kognitive Defizite

Meeting Abstract

  • presenting/speaker Andreas Pfnür - University of Ulm, Neurosurgery, Günzburg, Deutschland
  • Nadja Grübel - University of Ulm, Neurosurgery, Günzburg, Deutschland
  • Andrej Pala - University of Ulm, Neurosurgery, Günzburg, Deutschland
  • Monika Deininger - University of Ulm, Neurosurgery, Günzburg, Deutschland
  • Christian Rainer Wirtz - University of Ulm, Neurosurgery, Günzburg, Deutschland
  • Jan Coburger - University of Ulm, Neurosurgery, Günzburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocP066

doi: 10.3205/21dgnc354, urn:nbn:de:0183-21dgnc3545

Veröffentlicht: 4. Juni 2021

© 2021 Pfnür et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Neurocognitive deficits are common symptoms in patients with primary brain tumors. They may affect patients’ daily routine similar to neurological deficits, however these symptoms might be missed or underestimated in routine clinical assessment. The aim of our study was to screen patients’ for latent neurocognitive deficits by Montreal Cognitive Assessment (MoCA) test additional to clinical routine assessment.

Methods: Adult patients harboring supratentorial glioma were preoperatively (0-2 days) and postoperatively (3-7 days) assessed by using MoCA test. The data was collected in the time between 2016 and 2020. MoCA results <26 indicate neurocognitive deficits. Retrospectively, clinical and sociodemographic data was collected such as gender, age, neurological symptoms and Karnofsky performance score (KPS), any subjective and objective description of potential neurocognitive symptoms in patients records were screened. We compared rate of significant neurocognitive deficits using Pearson chi-square test. Pearson correlation was used to compare MoCA test result and KPS at the day of admission, to compare pre- and postoperative results signed rank test was used.

Results: We assessed results of 55 MoCA tests in 35 patients. The median age of the patients was 55. 23 patients had high-grade glioma and 12 patients had low-grade glioma. In only 13 patients objective cognitive deficits were documented, while 29 patients had a significant deficit according to MoCA test result (p=0.01). Comparing subjective deficits, 31 patients claimed to have no subjective deficit while actually 10 had a test result <26 (p=0.01). Using signed rank test, there was no significant difference between the MoCA test result pre- and postoperative. Patients older than 55 years showed postoperative significantly more cognitive deficits (MoCA<26 points) than patients younger than 55 years (p<0.05). Pearson correlation showed a positive relation between the preoperative MoCA test result and the KPS.

Conclusion: The preliminary data indicates that subtle neurocognitive deficits may be missed in clinical routine without routine neurocognitive screening procedures. The MoCA test could be a helpful tool in the clinical neurosurgical routine.