Cognition

Fatigue | Mood | Cognition | Epilepsy

Cognition

Cognitive impairment and adverse symptoms associated with brain cancer are increasingly important to patients and are identified as a major source of concern for survivors. Detailed symptom assessment is becoming recognised as part of routine patient care and treatment may only be considered if symptoms are managed, but successful management is hampered by insufficient knowledge mechanisms. Cognitive deficits can profoundly affect normal socioprofessional life and quality of life. However, not much is known about etiology and incidence of cognitive deficits. Only one study exists on pre- and postoperative cognitive functioning in patients with meningioma (Tucha at al. 2003).

Potential causes of cognitive impairment include:

  • Neurotoxic effects of treatment

  • Chemotherapy

  • Radiotherapy

  • Immunotherapy

  • Surgery

  • Effects of adjuvant medication

  • Co- or pre-existing neurologic or psychiatric illness e.g. epilepsy

  • Reactive mood and adjustment disorders

  • Sensory impairment and general frailty

  • Secondary gain

Recent studies have made clear that focal radiotherapy in patients with glioma is not the main reason for cognitive deficits. The tumour itself and other medical treatments contribute largely to the cognitive deficits. Cognitive function is now also recognised as an independent prognostic factor in the survival of glioma patients. Additionally, cognitive deterioration can be the first indicator of progressive disease after treatment.

References

Gehring K., Sitskoorn MM., Aaronson NK., Taphoorn MJ (2008) Interventions for cognitive deficits in adults with brain tumours. Lancet Neurol Jun; 7(6):548-60.

Meyers C, Perry, J eds. (2012). Cognition and Cancer. Cambridge University Press

Taphoorn MJ, Klein M (2004). Cognitive deficits in adult patients with brain tumours. Lancet Neurol 3: 159-168

Tucha O, Smely C, Preier M (2003). Preoperative and postoperative functioning in patients with frontal meningioma. J Neurosurg 98: 21-31