Evaluation Of Cognitive-Communication Deficits Following Treatment Of Primary Brain Tumor Patients

Abstract

In 2016, the Central Brain Tumor Registry of the United States reported an incidence of 379,848 for primary brain and other central nervous system (CNS) tumors. It is well understood that brain tumors and their subsequent treatments lead to a variety of impairments pre-, during, and post-treatment. In turn, these impairments ultimately lead to changes in quality of life and daily functioning. However, this is a limitedly studied topic, specifically from a speech-language pathology perspective. The goal of this study was to address the lack of data regarding deficits of importance to speech-language professionals (i.e., cognitive and linguistic impairments), by documenting common symptomology and deficits experienced within the brain tumor population through self- report and standardized assessment measures. Furthermore, we sought to determine the impact of such deficits on daily functioning. We obtained patient self-report and standardized assessment results from 28 adult participants with a diagnosis of a primary brain tumor, completion of at least one cycle of treatment (e.g., tumor resection/biopsy, chemotherapy, and/or radiation), and self- reported cognitive, linguistic, and/or socio-emotional deficits. Results indicated that following treatment, individuals with brain tumors self-report more deficits in cognitive, linguistic, physical, and socio-emotional domains than are objectively identified on standardized assessments. Participants provided qualitative descriptions of their symptoms within their daily lives to further describe the frequency, severity, and functional impact. Cognitive symptoms were the most commonly endorsed within this study population. As a result, development and testing of appropriate, effective assessment and treatment methods are important next steps. The model utilized within this study, including self-reported data, determining functional impact of deficits, and standardized assessments, allows rehabilitation professionals to focus on patient-centered care, where an individual’s participation should be a primary focus of intervention. We encourage the use of the Mayo-Portland Adaptability Inventory (MPAI) as an appropriate measurement tool for this population—when used in conjunction with in-depth interviewing—as it correlated with self-reported symptomology in people with primary brain tumors and provides a standardized score. The other cognitive-linguistic assessments (i.e., Cognitive Linguistic Quick Test and Comprehensive Aphasia Test) utilized within this study do not appear to be sensitive enough to thoroughly document the functional impact of post- treatment deficits in the brain tumor population. Further research is required to determine appropriate assessment and treatment options at different points throughout the continuum of care that individuals with brain tumors experience.