Cognitive issues in patients with IDH mutant gliomas: from neuroscience to clinical neuropsychology.
J Neurooncol
; 162(3): 525-533, 2023 May.
Article
in En
| MEDLINE
| ID: mdl-36940053
ABSTRACT
PURPOSE:
The understanding of cognitive symptoms in patients with IDH-Mutant gliomas (IDH-Mut) is rapidly developing. In this article, we summarize the neuroscientific knowledge base regarding the influence of IDH-Mut tumors and their treatment on cognition and provide guidance regarding the management of these symptoms in patients.METHODS:
We performed a review of peer reviewed publications relevant to IDH-Mut glioma and cognitive outcomes and provide an overview of the literature as well as a case example to clarify management strategies.RESULTS:
At the time of presentation, patients with IDH-Mut gliomas have a favorable cognitive profile as compared with those with IDH-wild type (WT) tumors. The relatively low cognitive burden may reflect the slower growth rate of IDH-Mut tumors, which is less disruptive to both local and widespread neural networks. Human connectomic research using a variety of modalities has demonstrated relatively preserved network efficiency in patients with IDH-Mut gliomas as compared with IDH-WT tumors. Risk of cognitive decline from surgery can potentially be mitigated by careful integration of intra-operative mapping. Longer term cognitive risks of tumor treatment, including chemotherapy and radiation, are best managed by instituting neuropsychological assessment as part of the long-term care of patients with IDH-Mutant glioma. A specific timeline for such integrative care is provided.CONCLUSIONS:
Given the relative recency of the IDH-mutation based classification of gliomas, as well as the long time course of this disease, a thoughtful and comprehensive strategy to studying patient outcomes and devising methods of cognitive risk reduction is required.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Brain Neoplasms
/
Glioma
Type of study:
Guideline
Language:
En
Journal:
J Neurooncol
Year:
2023
Type:
Article
Affiliation country:
United States