Highlights
- ●Neurocognitive deficits have been reported to hamper cognitive awareness.
- ●Awareness measured as the concordance of neurocognitive functioning and complaints.
- ●Patients divided in impaired and intact based on their neurocognitive performance.
- ●Three follow-up assessments every 12 weeks for a total of 36 weeks after baseline.
- ●Neurocognitive impaired patients with high-grade glioma (HGG) show signs of cognitive awareness.
Abstract
Background
Patients’ reduced awareness of neurocognitive functioning (NCF) may negatively affect
the reliability of patient-reported outcomes (PROs) and clinical decision-making.
This study evaluated cognitive awareness, defined as the association between NCF and
neurocognitive complaints, over the disease course of patients with recurrent high-grade
glioma (HGG).
Methods
We assessed NCF using the EORTC core clinical trial battery and neurocognitive complaints
using the Medical Outcome Study questionnaire. Patients were categorised as impaired
or intact, based on their neurocognitive performance. Spearman’s rank correlations
were calculated between NCF and neurocognitive complaints at baseline and each 12
weeks, until 36. The association between changes in NCF and neurocognitive complaints
scores between these follow-up assessments was determined using Pearson’s correlation.
Results
A total of 546 patients were included. Neurocognitively impaired patients (n = 437) had more neurocognitive complaints (range: 10.51 [p < 0.001] to 13.34 [p = 0.001]) than intact patients (n = 109) at baseline, at 12 and 24 weeks. In intact patients, NCF and neurocognitive
complaints were correlated for only one domain at baseline (0.202, p = 0.036), while in impaired patients correlations were more frequently found in various
domains and time points (range: 0.164 [p = 0.001] to 0.334 [p = 0.011]). Over the disease course, NCF and neurocognitive complaints were correlated
for only one domain at baseline (0.357, p = 0.014) in intact patients while in impaired patients they were correlated for more
domains and time points (range: 0.222 [p < 0.001] to 0.366 [p < 0.001]).
Conclusion
Neurocognitively impaired patients with recurrent HGG are aware of their neurocognitive
limitations at study entry and during follow-up, which should be considered in clinical
decision-making and when interpreting PRO results.
Keywords
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Article info
Publication history
Published online: March 07, 2023
Accepted:
February 27,
2023
Received in revised form:
February 25,
2023
Received:
January 17,
2023
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2023 Published by Elsevier Ltd.
