Assessment of neuropsychological function in brain tumor treatment: a comparison of traditional neuropsychological assessment with app-based cognitive screening

Abstract

Background Gliomas are typically considered to cause relatively few neurological impairments. However, cognitive difcul ties can arise, for example during treatment, with potential detrimental efects on quality of life. Accurate, reproducible, and accessible cognitive assessment is therefore vital in understanding the efects of both tumor and treatments. Our aim is to compare traditional neuropsychological assessment with an app-based cognitive screening tool in patients with glioma before and after surgical resection. Our hypotheses were that cognitive impairments would be apparent, even in a young and high functioning cohort, and that app-based cognitive screening would complement traditional neuropsychological assessment. Methods Seventeen patients with difuse gliomas completed a traditional neuropsychological assessment and an app-based touchscreen tablet assessment pre- and post-operatively. The app assessment was also conducted at 3- and 12-month follow up. Impairment rates, mean performance, and pre- and post-operative changes were compared using standardized Z-scores. Results Approximately 2–3 h of traditional assessment indicated an average of 2.88 cognitive impairments per patient, while the 30-min screen indicated 1.18. As might be expected, traditional assessment using multiple items across the difculty range proved more sensitive than brief screening measures in areas such as memory and attention. However, the capac ity of the screening app to capture reaction times enhanced its sensitivity, relative to traditional assessment, in the area of non-verbal function. Where there was overlap between the two assessments, for example digit span tasks, the results were broadly equivalent. Conclusions Cognitive impairments were common in this sample and app-based screening complemented traditional neu ropsychological assessment. Implications for clinical assessment and follow-up are discussed.