Clinico-pathological correlations in malignant brain tumors

Abstract

Objective. The aim of our study was to evaluate the cognitive impairment in patients diagnosed with malignant brain tumors. Material and methods. We enrolled in our study 105 patients diagnosed with astrocytomas, hospitalized in the Clinic of Neurology between January 2006 and December 2010. Depending on the histology of the tumor, the study-group was composed of 19 cases diagnosed with diffuse astrocytomas, 13 cases with anaplastic astrocytomas and 73 cases with glioblastomas. Each patient was evaluated by neurological and neuro-imagistic exam (computed tomography and/or nuclear magnetic resonance). Each patient was evaluated in the term of disability using Karnofsky Performance Status, which is a scale commonly used in patients with cancer to quantify functional status. Presurgical cognitive functions of the patients were assessed using Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), The results were analyzed using Student’s T test and Chi-Squared test, considering statistically significant p<0.05. Results. In the terms of mean age, the statistical analysis didn’t show a significant difference between the three groups of patients. Also, we observed that the mean level of education in glioblastomas group was significantly lower than that of anaplastic astrocytomas. On MMSE, the average scores obtained by the patients were: 27.2 points in patients with diffuse astrocytomas, 26.7 points in patients with anaplastic astrocytomas and 25,1 points in patients with glioblastomas. On MoCA, the average scores were: 24.6 points in patients with diffuse astrocytomas, 24.2 points in patients with anaplastic astrocytomas and 21.8 points in patients with glioblastomas. Conclusion. In our study, the patients diagnosed with glioblastomas showed a statistically significant cognitive decline than the patients with diffuse astrocytomas or anaplastic astrocytomas, respectively. Between patients with grade II tumors and those diagnosed with anaplastic astrocytomas there were no statistically significant differences in terms of scores obtained from the assessment of cognitive functions.

Keywords

• astrocytoma
• glioblastoma
• cognitive decline
• neuropsychological assessment