Understanding the association between fatigue and neurocognitive functioning in patients with glioma: a cross-sectional multinational study

IF 2.4 Q2 CLINICAL NEUROLOGY

Neuro-oncology practice Pub Date : 2024-02-09 DOI:10.1093/nop/npae011

J. G. Röttgering, J. W. Taylor, M. Brie, T. Luks, S. Hervey-Jumper, S. Phan, P. Bracci, E. Smith, P. C. de Witt Hamer, L. Douw, C. Weyer-Jamora, M. Klein

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Abstract

Fatigue and neurocognitive impairment are highly prevalent in patients with glioma, significantly impacting health-related quality of life. Despite the presumed association between these two factors, evidence remains sparse. Therefore, we aimed to investigate this relationship using multinational data. We analyzed data on self-reported fatigue and neurocognitive outcomes from postoperative patients with glioma from the University of California San Francisco (n = 100, UCSF) and Amsterdam University Medical Center (n = 127, Amsterdam UMC). We used multiple linear regression models to assess associations between fatigue and seven (sub)domains of neurocognitive functioning and latent profile analysis to identify distinct patterns of fatigue and neurocognitive functioning. UCSF patients were older (median age 49 vs. 43 years, p = 0.002), had a higher proportion of grade 4 tumors (32% vs. 18%, p = 0.03), and had more neurocognitive deficits (p = 0.01). While the number of clinically fatigued patients was similar between sites (64% vs. 58%, p = 0.12), fatigue and the number of impaired neurocognitive domains were not correlated (p = 0.16-0.72). At UCSF, neurocognitive domains were not related to fatigue, and at Amsterdam UMC attention and semantic fluency explained only 4 to 7% of variance in fatigue. Across institutions, we identified four distinct patterns of neurocognitive functioning, which were not consistently associated with fatigue. Although individual patients might experience both fatigue and neurocognitive impairment, the relationship between the two is weak. Consequently, both fatigue and neurocognitive functioning should be independently assessed and treated with targeted therapies.

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了解胶质瘤患者疲劳与神经认知功能之间的关系：一项横断面多国研究

疲劳和神经认知障碍在胶质瘤患者中非常普遍，严重影响了与健康相关的生活质量。尽管推测这两个因素之间存在关联，但证据仍然稀少。因此，我们旨在利用多国数据研究这两者之间的关系。我们分析了加州大学旧金山分校（n = 100，UCSF）和阿姆斯特丹大学医学中心（n = 127，Amsterdam UMC）胶质瘤术后患者自我报告的疲劳和神经认知结果的数据。我们使用多元线性回归模型来评估疲劳与神经认知功能的七个（子）领域之间的关联，并使用潜在特征分析来确定疲劳与神经认知功能的不同模式。加州大学旧金山分校的患者年龄更大（中位年龄为 49 岁对 43 岁，p = 0.002），4 级肿瘤的比例更高（32% 对 18%，p = 0.03），神经认知功能缺陷更多（p = 0.01）。虽然临床疲劳患者的数量在不同地点相似（64% vs. 58%，p = 0.12），但疲劳与神经认知领域受损的数量并不相关（p = 0.16-0.72）。在加州大学旧金山分校，神经认知领域与疲劳无关，而在阿姆斯特丹医科大学，注意力和语义流畅性只能解释疲劳变异的 4% 到 7%。在不同的研究机构中，我们发现了四种不同的神经认知功能模式，它们与疲劳的关系并不一致。虽然个别患者可能会同时出现疲劳和神经认知功能障碍，但两者之间的关系并不密切。因此，应该对疲劳和神经认知功能进行独立评估，并采用针对性疗法进行治疗。

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来源期刊

Neuro-oncology practice CLINICAL NEUROLOGY-

CiteScore

5.30

自引率

11.10%

发文量

期刊介绍： Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving