Predicting disease progression in high-grade glioma with neuropsychological parameters: The value of personalized longitudinal assessment

Elke Butterbrod, J. Bruijn, Meriam Braaksma, Geert-Jan Rutten, Cees Tijssen, Monique Hanse, Margriet Sitskoorn, Karin Gehring

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Purpose: 
Progressive disease in patients with high-grade glioma may be reflected in cognitive decline. However, the cognitive functions most sensitive to progression may differ between patients. We investigated whether decline on a personalized selection of tests predicted progressive disease according to RANO criteria in high-grade glioma patients.
Methods: 
Starting one day before surgery, patients underwent neuropsychological assessment every three months during standard treatment and clinical follow-up. We first made a personalized selection of three tests that showed the highest Reliable Change Index (RCI) values, i.e., most positive change, at the first post-surgical assessment for each patient. In subsequent follow up, a decline of RCI ≤ − 1 on at least two of the three tests in the selection was considered cognitive decline. We performed a discrete Cox proportional hazards model including a time-dependent coefficient cognitive decline (vs. stability) and covariate age to predict progressive disease.
Results: 
Twenty five patients were included. Cognitive decline on the personalized test selection preceded or had occurred by the time progression was established in 9/15 patients with RANO confirmed progressive disease (60%). Decline was absent in 8/10 patients (80%) with stable disease during participation. The independent hazard ratio for progression in case of cognitive decline was 5.05 (p < 0.01) compared to stable performance.
Conclusions: 
Using only three patient-specific neuropsychological tests, we found a fivefold increased chance of disease progression in case of cognitive decline as compared to stable performance. Brief, patient-tailored cognitive assessment may be a noninvasive addition to disease monitoring without overburdening patients and clinical care.
Original languageEnglish
Number of pages8
JournalJournal of Neuro-Oncology
DOIs
Publication statusE-pub ahead of print - 2019

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Glioma
Ambulatory Surgical Procedures
Proportional Hazards Models
Cognitive Dysfunction

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@article{2d55018198d84c858bab225bda5e518d,
title = "Predicting disease progression in high-grade glioma with neuropsychological parameters:: The value of personalized longitudinal assessment",
abstract = "Purpose: Progressive disease in patients with high-grade glioma may be reflected in cognitive decline. However, the cognitive functions most sensitive to progression may differ between patients. We investigated whether decline on a personalized selection of tests predicted progressive disease according to RANO criteria in high-grade glioma patients.Methods: Starting one day before surgery, patients underwent neuropsychological assessment every three months during standard treatment and clinical follow-up. We first made a personalized selection of three tests that showed the highest Reliable Change Index (RCI) values, i.e., most positive change, at the first post-surgical assessment for each patient. In subsequent follow up, a decline of RCI ≤ − 1 on at least two of the three tests in the selection was considered cognitive decline. We performed a discrete Cox proportional hazards model including a time-dependent coefficient cognitive decline (vs. stability) and covariate age to predict progressive disease.Results: Twenty five patients were included. Cognitive decline on the personalized test selection preceded or had occurred by the time progression was established in 9/15 patients with RANO confirmed progressive disease (60{\%}). Decline was absent in 8/10 patients (80{\%}) with stable disease during participation. The independent hazard ratio for progression in case of cognitive decline was 5.05 (p < 0.01) compared to stable performance.Conclusions: Using only three patient-specific neuropsychological tests, we found a fivefold increased chance of disease progression in case of cognitive decline as compared to stable performance. Brief, patient-tailored cognitive assessment may be a noninvasive addition to disease monitoring without overburdening patients and clinical care.",
author = "Elke Butterbrod and J. Bruijn and Meriam Braaksma and Geert-Jan Rutten and Cees Tijssen and Monique Hanse and Margriet Sitskoorn and Karin Gehring",
year = "2019",
doi = "10.1007/s11060-019-03249-1",
language = "English",
journal = "Journal of Neuro-Oncology",
issn = "0167-594X",
publisher = "Kluwer Academic Publishers",

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Predicting disease progression in high-grade glioma with neuropsychological parameters: The value of personalized longitudinal assessment. / Butterbrod, Elke; Bruijn, J.; Braaksma, Meriam; Rutten, Geert-Jan; Tijssen, Cees ; Hanse, Monique; Sitskoorn, Margriet; Gehring, Karin.

In: Journal of Neuro-Oncology, 2019.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Predicting disease progression in high-grade glioma with neuropsychological parameters:

T2 - The value of personalized longitudinal assessment

AU - Butterbrod, Elke

AU - Bruijn, J.

AU - Braaksma, Meriam

AU - Rutten, Geert-Jan

AU - Tijssen, Cees

AU - Hanse, Monique

AU - Sitskoorn, Margriet

AU - Gehring, Karin

PY - 2019

Y1 - 2019

N2 - Purpose: Progressive disease in patients with high-grade glioma may be reflected in cognitive decline. However, the cognitive functions most sensitive to progression may differ between patients. We investigated whether decline on a personalized selection of tests predicted progressive disease according to RANO criteria in high-grade glioma patients.Methods: Starting one day before surgery, patients underwent neuropsychological assessment every three months during standard treatment and clinical follow-up. We first made a personalized selection of three tests that showed the highest Reliable Change Index (RCI) values, i.e., most positive change, at the first post-surgical assessment for each patient. In subsequent follow up, a decline of RCI ≤ − 1 on at least two of the three tests in the selection was considered cognitive decline. We performed a discrete Cox proportional hazards model including a time-dependent coefficient cognitive decline (vs. stability) and covariate age to predict progressive disease.Results: Twenty five patients were included. Cognitive decline on the personalized test selection preceded or had occurred by the time progression was established in 9/15 patients with RANO confirmed progressive disease (60%). Decline was absent in 8/10 patients (80%) with stable disease during participation. The independent hazard ratio for progression in case of cognitive decline was 5.05 (p < 0.01) compared to stable performance.Conclusions: Using only three patient-specific neuropsychological tests, we found a fivefold increased chance of disease progression in case of cognitive decline as compared to stable performance. Brief, patient-tailored cognitive assessment may be a noninvasive addition to disease monitoring without overburdening patients and clinical care.

AB - Purpose: Progressive disease in patients with high-grade glioma may be reflected in cognitive decline. However, the cognitive functions most sensitive to progression may differ between patients. We investigated whether decline on a personalized selection of tests predicted progressive disease according to RANO criteria in high-grade glioma patients.Methods: Starting one day before surgery, patients underwent neuropsychological assessment every three months during standard treatment and clinical follow-up. We first made a personalized selection of three tests that showed the highest Reliable Change Index (RCI) values, i.e., most positive change, at the first post-surgical assessment for each patient. In subsequent follow up, a decline of RCI ≤ − 1 on at least two of the three tests in the selection was considered cognitive decline. We performed a discrete Cox proportional hazards model including a time-dependent coefficient cognitive decline (vs. stability) and covariate age to predict progressive disease.Results: Twenty five patients were included. Cognitive decline on the personalized test selection preceded or had occurred by the time progression was established in 9/15 patients with RANO confirmed progressive disease (60%). Decline was absent in 8/10 patients (80%) with stable disease during participation. The independent hazard ratio for progression in case of cognitive decline was 5.05 (p < 0.01) compared to stable performance.Conclusions: Using only three patient-specific neuropsychological tests, we found a fivefold increased chance of disease progression in case of cognitive decline as compared to stable performance. Brief, patient-tailored cognitive assessment may be a noninvasive addition to disease monitoring without overburdening patients and clinical care.

U2 - 10.1007/s11060-019-03249-1

DO - 10.1007/s11060-019-03249-1

M3 - Article

JO - Journal of Neuro-Oncology

JF - Journal of Neuro-Oncology

SN - 0167-594X

ER -