Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters: The value of longitudinal patient-specific neuropsychological assessment

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

Research output: Contribution to conferencePosterOther research output

Abstract

Objective: 
To investigate to what extent post-surgical cognitive decline on a subset of patient-tailored neuropsychological tests predicts disease progression on radiological grounds in individuals with newly diagnosed high-grade glioma (HGG). 
Participants and Methods: 
35 patients who underwent resection for confirmed HGG were included. Neuropsychological assessment, including the CNS Vital Signs battery, Letter Fluency and Digit Span test, and clinical radiological evaluation with MRI, were conducted 3-monthly, starting 1 day before surgery. For each patient, we selected the 3 tests that showed the highest Reliable Change Index (RCI), i.e. most improvement, from pre- to first post-surgical assessment for further monitoring over time. Follow-up assessments continued for up to 24 months after surgery or until disease progression. An RCI value of ≤ -1 on at least 2 of the 3 selected tests at any of the follow up assessments was considered cognitive decline. A discrete Cox proportional hazard model with dichotomous time-dependent coefficient (cognitive decline) to predict radiological disease progression was conducted in R. 
Results: 
25 patients were eligible for analysis. Cognitive decline preceded or had occurred at time of progression in 10 of the 15 patients (67%) who showed radiological disease progression during follow up, and was absent in 8 out of 10 patients (80%) who did not show disease progression. The model showed a hazard ratio (HR) for disease progression of 4.144; 95% CI 1.388 - 12.37, p= .01 (model χ2 [1] = 7.02, p<.01).
Conclusions: 
Our data suggested a four-fold increase in risk of disease progression if the change on patient-specific tests during follow up met the criterion for cognitive decline. We recommend further exploration of the value of patient-tailored, brief longitudinal neuropsychological assessment alongside current methods for disease monitoring.
Original languageEnglish
Pages205-206
Publication statusPublished - 2019
EventInternational Neuropsychological Society - Annual Meeting 2019 - New York, United States
Duration: 18 Feb 201921 Feb 2019
https://www.the-ins.org/meetings/ny2019/

Conference

ConferenceInternational Neuropsychological Society - Annual Meeting 2019
CountryUnited States
CityNew York
Period18/02/1921/02/19
Internet address

Fingerprint

Glioma
Vital Signs
Ambulatory Surgical Procedures
Proportional Hazards Models
Cognitive Dysfunction

Cite this

Butterbrod, E., Bruijn, J., Braaksma, M., Rutten, G-J., Tijssen, C., Hanse, M., ... Sitskoorn, M. (2019). Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters: The value of longitudinal patient-specific neuropsychological assessment. 205-206. Poster session presented at International Neuropsychological Society - Annual Meeting 2019, New York, United States.
Butterbrod, Elke ; Bruijn, Jimme ; Braaksma, Meriam ; Rutten, Geert-Jan ; Tijssen, Cees ; Hanse, Monique ; Gehring, Karin ; Sitskoorn, Margriet. / Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters : The value of longitudinal patient-specific neuropsychological assessment. Poster session presented at International Neuropsychological Society - Annual Meeting 2019, New York, United States.
@conference{ac82516266664edfb9c707908e8621c7,
title = "Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters: The value of longitudinal patient-specific neuropsychological assessment",
abstract = "Objective: To investigate to what extent post-surgical cognitive decline on a subset of patient-tailored neuropsychological tests predicts disease progression on radiological grounds in individuals with newly diagnosed high-grade glioma (HGG). Participants and Methods: 35 patients who underwent resection for confirmed HGG were included. Neuropsychological assessment, including the CNS Vital Signs battery, Letter Fluency and Digit Span test, and clinical radiological evaluation with MRI, were conducted 3-monthly, starting 1 day before surgery. For each patient, we selected the 3 tests that showed the highest Reliable Change Index (RCI), i.e. most improvement, from pre- to first post-surgical assessment for further monitoring over time. Follow-up assessments continued for up to 24 months after surgery or until disease progression. An RCI value of ≤ -1 on at least 2 of the 3 selected tests at any of the follow up assessments was considered cognitive decline. A discrete Cox proportional hazard model with dichotomous time-dependent coefficient (cognitive decline) to predict radiological disease progression was conducted in R. Results: 25 patients were eligible for analysis. Cognitive decline preceded or had occurred at time of progression in 10 of the 15 patients (67{\%}) who showed radiological disease progression during follow up, and was absent in 8 out of 10 patients (80{\%}) who did not show disease progression. The model showed a hazard ratio (HR) for disease progression of 4.144; 95{\%} CI 1.388 - 12.37, p= .01 (model χ2 [1] = 7.02, p<.01).Conclusions: Our data suggested a four-fold increase in risk of disease progression if the change on patient-specific tests during follow up met the criterion for cognitive decline. We recommend further exploration of the value of patient-tailored, brief longitudinal neuropsychological assessment alongside current methods for disease monitoring.",
author = "Elke Butterbrod and Jimme Bruijn and Meriam Braaksma and Geert-Jan Rutten and Cees Tijssen and Monique Hanse and Karin Gehring and Margriet Sitskoorn",
year = "2019",
language = "English",
pages = "205--206",
note = "International Neuropsychological Society - Annual Meeting 2019 ; Conference date: 18-02-2019 Through 21-02-2019",
url = "https://www.the-ins.org/meetings/ny2019/",

}

Butterbrod, E, Bruijn, J, Braaksma, M, Rutten, G-J, Tijssen, C, Hanse, M, Gehring, K & Sitskoorn, M 2019, 'Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters: The value of longitudinal patient-specific neuropsychological assessment' International Neuropsychological Society - Annual Meeting 2019, New York, United States, 18/02/19 - 21/02/19, pp. 205-206.

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

2019. 205-206 Poster session presented at International Neuropsychological Society - Annual Meeting 2019, New York, United States.

Research output: Contribution to conferencePosterOther research output

TY - CONF

T1 - Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters

T2 - The value of longitudinal patient-specific neuropsychological assessment

AU - Butterbrod, Elke

AU - Bruijn, Jimme

AU - Braaksma, Meriam

AU - Rutten, Geert-Jan

AU - Tijssen, Cees

AU - Hanse, Monique

AU - Gehring, Karin

AU - Sitskoorn, Margriet

PY - 2019

Y1 - 2019

N2 - Objective: To investigate to what extent post-surgical cognitive decline on a subset of patient-tailored neuropsychological tests predicts disease progression on radiological grounds in individuals with newly diagnosed high-grade glioma (HGG). Participants and Methods: 35 patients who underwent resection for confirmed HGG were included. Neuropsychological assessment, including the CNS Vital Signs battery, Letter Fluency and Digit Span test, and clinical radiological evaluation with MRI, were conducted 3-monthly, starting 1 day before surgery. For each patient, we selected the 3 tests that showed the highest Reliable Change Index (RCI), i.e. most improvement, from pre- to first post-surgical assessment for further monitoring over time. Follow-up assessments continued for up to 24 months after surgery or until disease progression. An RCI value of ≤ -1 on at least 2 of the 3 selected tests at any of the follow up assessments was considered cognitive decline. A discrete Cox proportional hazard model with dichotomous time-dependent coefficient (cognitive decline) to predict radiological disease progression was conducted in R. Results: 25 patients were eligible for analysis. Cognitive decline preceded or had occurred at time of progression in 10 of the 15 patients (67%) who showed radiological disease progression during follow up, and was absent in 8 out of 10 patients (80%) who did not show disease progression. The model showed a hazard ratio (HR) for disease progression of 4.144; 95% CI 1.388 - 12.37, p= .01 (model χ2 [1] = 7.02, p<.01).Conclusions: Our data suggested a four-fold increase in risk of disease progression if the change on patient-specific tests during follow up met the criterion for cognitive decline. We recommend further exploration of the value of patient-tailored, brief longitudinal neuropsychological assessment alongside current methods for disease monitoring.

AB - Objective: To investigate to what extent post-surgical cognitive decline on a subset of patient-tailored neuropsychological tests predicts disease progression on radiological grounds in individuals with newly diagnosed high-grade glioma (HGG). Participants and Methods: 35 patients who underwent resection for confirmed HGG were included. Neuropsychological assessment, including the CNS Vital Signs battery, Letter Fluency and Digit Span test, and clinical radiological evaluation with MRI, were conducted 3-monthly, starting 1 day before surgery. For each patient, we selected the 3 tests that showed the highest Reliable Change Index (RCI), i.e. most improvement, from pre- to first post-surgical assessment for further monitoring over time. Follow-up assessments continued for up to 24 months after surgery or until disease progression. An RCI value of ≤ -1 on at least 2 of the 3 selected tests at any of the follow up assessments was considered cognitive decline. A discrete Cox proportional hazard model with dichotomous time-dependent coefficient (cognitive decline) to predict radiological disease progression was conducted in R. Results: 25 patients were eligible for analysis. Cognitive decline preceded or had occurred at time of progression in 10 of the 15 patients (67%) who showed radiological disease progression during follow up, and was absent in 8 out of 10 patients (80%) who did not show disease progression. The model showed a hazard ratio (HR) for disease progression of 4.144; 95% CI 1.388 - 12.37, p= .01 (model χ2 [1] = 7.02, p<.01).Conclusions: Our data suggested a four-fold increase in risk of disease progression if the change on patient-specific tests during follow up met the criterion for cognitive decline. We recommend further exploration of the value of patient-tailored, brief longitudinal neuropsychological assessment alongside current methods for disease monitoring.

M3 - Poster

SP - 205

EP - 206

ER -

Butterbrod E, Bruijn J, Braaksma M, Rutten G-J, Tijssen C, Hanse M et al. Predicting disease progression in newly diagnosed high-grade glioma with cognitive parameters: The value of longitudinal patient-specific neuropsychological assessment. 2019. Poster session presented at International Neuropsychological Society - Annual Meeting 2019, New York, United States.