Cognitive functioning in a cohort of high-grade glioma patients

Skufca Smrdel, Andreja Cirila; Podlesek, Anja; Skoblar Vidmar, Marija; Markovic, Jana; Jereb, Jana; Okorn, Manja Kuzma; Smrdel, Uros

Cognitive functioning in a cohort of high-grade glioma patients

Volume 57 (2023): Issue 2 (June 2023)

By:

Andreja Cirila Skufca Smrdel, Anja Podlesek, Marija Skoblar Vidmar, Jana Markovic, Jana Jereb, Manja Kuzma Okorn and Uros Smrdel

Open Access

|Jun 2023

Figures & Tables

Number of patients with different combinations of IDH1 mutation expression and methyl guanine methyl transferase (MGMT) methylation

	MGMT-met	MGMT-unmet	Total
IDH1-mut	5	10	15
IDH1-wt	49	26	75
Total	54	36	90

Cognitive functioning regarding to isocitrate dehydrogenase 1 (IDH1) mutation

	IDH1–wt		IDH-mut		Result of the statistical test	IDH1–wt	IDH1-mut	Result of the statistical test

	N	Mean Z score (SD)	N	Mean Z score (SD)		% of impaired	% of impaired
TMT A	53	3.12¹ (3.84)	15	2.06 (2.23)	U = 345.000, z = −0.77, df = 66, p= 0.437	72	46	χ²(1) = 3.67, V = 0.20, p = 0.055
TMT B	33	2.82¹ (3.11)	13	2.76 (2.57)	U = 221.500, z = −0.17, df = 66, p = 0.864	82	60	χ²(1) = 3.87, V = 0.21, p = 0.050
SCOWA	66	−1.28 (0.87)	15	−0.86 (0.84)	t = −1.69, df = 79, p = 0.095	51	27	χ²(1) = 2.89, V = 0.18, p = 0.089
SVLT-ir	65	−1.98 (1.06)	15	−1.15 (1.12)	t = −2.729, df = 78, p = 0.008	71	33	χ²(1) = 7.60, V = 0.29, p = 0.006
SVLT-sr	65	−2.20 (1.29)	15	−1.37 (1.22)	t = −2.25, df = 78, p = 0.027	84	53	χ²(1) = 7.06, V = 0.28, p = 0.008
SVLT-dr	65	−2.14 (1.27)	15	−0.98 (1.34)	t = −3.13, df = 78, p =0.002	69	33	χ²(1) = 6.98, V = 0.28, p = 0.008
SVLT-recog	65	−3.06¹ (3.54)	15	−1.24 (1.91)	U = 611.000, z = −2.25, df = 78, p = 0.023	29	26	χ²(1) = 3.00, V = 0.18, p = 0.083

Demographic and medical data

Variable	Levels	f (%)	Descriptive statistics
Gender	Male	57 (63%)
Gender	Female	33 (37%)
Age	< 50 years	17 (19%)	M = 58.78, SD = 11.31min = 30, max = 84
	50–70years	60 (67%)
	> 70 years	13 (14%)
Education	≤9 years	14 (16%)
	10–13 years	48 (53%)
	14–19 years	26 (29%)
	≥20 years	2 (2%)
Tumour grade	Grade III	12 (13%)
Tumour grade	Grade IV	78 (87%)
Tumour location	Frontal	34 (38%)
	Parietal	21 (23%)
	Temporal	26 (29%)
	Occipital	4 (4%)
	central	3 (3%)
	Diffuse	2 (2%)
Hemisphere	Right	38 (42%)
	Left	44 (49%)
	Both	8 (9%)
Surgery type	Biopsy	11 (12%)
	Reduction	49 (54%)
	Gross tumour resection	30 (33%)
Karnoffsky performance status	70	32 (36%)
	80	37 (41%)
	90	18 (20%)
	100	3 (3%)
Corticosteroids (Yes/no, mg)	Yes	66 (73%)	M = 5.55, SD = 4.73min 0, max 24
Corticosteroids (Yes/no, mg)	No	24 (27%)	M = 5.55, SD = 4.73min 0, max 24
Radio-chemotherapy (intention to treat)	Yes	90 (100%)
Radio-chemotherapy (intention to treat)	No	0 (0%)
Time to beginning of adjuvant treatment (in weeks)	≤ 6 weeks	60 (67%)	M = 5.98, SD = 2.25min 3, max 15
Time to beginning of adjuvant treatment (in weeks)	≥ 7 weeks	30 (33%)	M = 5.98, SD = 2.25min 3, max 15
Epilepsy	Yes	27 (30%)
Epilepsy	No	63 (70%)
IDH1 mutation	IDH1 mutation	15 (17%)
IDH1 mutation	IDH1 wild type	75 (83%)
MGMT methylation*	Yes	36 (42%)
MGMT methylation*	No	50 (58%)

Patient characteristics, regarding isocitrate dehydrogenase 1 (IDH1) mutation

	IDH1-wt (N = 75)	IDH1-mut (N=15)	Result of the statistical test and effect size
Age mean (min/max/SD)	61.50 (31 / 84 / 9.21)	38.75 (30 / 67 / 3.86)	t = −5.97, df = 88, p< 0.001
Sex (female / male)	29 / 46	4 / 11	χ²(1) = 0.775, f = −0.93, p = 0.379
Education level (≤ 9 years /10–13 years / 14–19 years / ≥ 20 years)	11 / 40 / 22 / 2	3 / 8 / 4 / 0	τb(3) = −0.06, z = −0.83, p = 0.547
KPS (70/80/90/100)	31 / 34 / 7 / 3	1 / 3 / 11 / 0	τb(3) = 0.403, z = 18.95, p < 0.001
WHO grade (III / IV)	1 /74	11 /4	χ²(1) = 56.08, f = −0.789, p < 0.001
Corticosteroids mg (min/max/SD)	2 (0 / 16 / 6)	5 (0 / 24 / 4.5)	t = −1.16, df = 88, p = 0.251
biopsy/reduction/gross tumour resection	9 / 44 / 22	2 / 5 / 8	χ²(2) = 3.65, V = 0.210, p = 0.161
Tumour location (frontal / temporal / parietal / occipital / diffuse / central)	26 / 20 / 21 / 4 / 2 / 2	8 / 1 / 5 / 0 / 1 / 0	NA
Hemisphere (right / left / both)	21 / 27 / 6	17 / 17 / 2	χ²(2) = 1.14, V = 0.113, p = 0.566
MGMT (yes / no)	10 / 5	26 /49	χ²(1) = 5.33, f = 0.24, p = 0.021

Cognitive functioning regarding methyl guanine methyl transferase (MGMT) methylation

	MGMT-met		MGMT-unmet		Result of the statistical test	MGMT-met	MGMT –unmet	Result of the statistical test

	N	Mean Z score (SD)	N	Mean Z score (SD)		% of impaired	% of impaired
TMT A	26	2.67 (3.01)	42	3.03¹ (3.90)	U = 530.000, z = −0.20, df = 67, p = 0.840	69	66	χ²(1) = 0.08, V = 0.03, p = 0.782
TMT B	20	3.22 (2.30)	26	2.48¹ (3.37)	U = 334.000, z = 1.64, df = 45, p = 0.101	86	74	χ²(1) = 1.88, V = 0.14, p = 0.170
SCOWA	33	−1.25 (0.87)	48	−1.18¹ (0.89)	U = 756.000, z = −0.35, df = 70, p = 0.729	50	44	χ²(1) = 0.27, V = 0.05, p = .605
SVLT-ir	32	−1.85 (1.27)	48	−1.82¹ (1.01)	U = 771.000, z = 0.03, df = 78, p = 0.975	64	67	χ²(1) = 0.01, V = 0.01, p = 0.928
SVLT-sr	32	−2.03 (1.32)	48	−2.06 (1.32)	t = 0.09, df = 78, p = 0.926	75	81	χ²(1) = 0.54, V = 0.08, p = 0.460
SVLT-dr	32	−1.98 (1.52)	48	−1.89 (1.25)	t = −0.30, df = 78, p = 0.763	66	61	χ²(1) = 0.29, V = 0.06, p = 0.592
SVLT-recog	32	−2.731 (4.24)	48	−2.72¹ (2.71)	U = 784.000, z = 0.828, df = 78, p = 0.407	58	61	χ²(1) = 0.07, V = 0.03, p = 0.792

Patient characteristics regarding methyl guanine methyl transferase (MGMT) methylation

	MGMT-unmet (N=54)	MGMT-met (N = 36)	Result of the statistical test and effect size
Age mean (min/max/SD)	58.94 (31 / 84 / 10.42) 1	58,53 (30 / 78 / 12.67)	t = −0.17, df = 88, p = 0.86
Sex (female / male)	19 / 35	14 / 22	χ²(1) = 0.13, f = 0.04, p = 0.721
Education level (≤9 years /10–13 years / 14–19 years / ≥ 20 years)	8 / 19 / 11 / 0	9 / 29 / 15 / 2	τb (3) = −0.03, z = −1.41, p = 0.776
KPS (70/80/90/100)	20 / 23 / 9 / 2	12 / 14 / 9 /1	τb (3) =0.06, z = 2.82, p = 0.541
WHO grade (III / IV)	3 / 51	9 / 27	χ²(1) = 7.07, f= −0.28, p = 0.008
Corticosteroids mg (min/max/SD)	5.67 (0 /24 / 5,04)	5.48 (0 / 16 / 4.22)	t = 0.18, df = 88, p = 0.857
Biopsy/reduction/gross tumour resection	9 / 31 / 14	2 / 18 / 16	χ²(2) = 4.62, V = 0.23, p = 0.099
Tumour location (frontal / temporal / parietal / occipital / diffuse / central)	26 / 20 / 21 / 4 / 2 / 2	8 / 1 / 5 / 0 / 1 / 0	NA
Hemisphere (right / left / both)	28 / 40 / 7	10 / 4 / 1	χ²(2) = 4.46, V = 0.223, p = 0.107
IDH1 (yes / no)	5 / 49	10 / 26	χ²(1) = 5.33, f = 0.24, p = 0.021

Descriptive statistics for standardized test scores (z–values) and proportion of impaired patients in psychological cognitive functioning tests

Domain	Test	% impaired / all	N	% impaired / capable	Mean z score	SD of z scores
Visual – motor speed	TMT A	68	68	57	2.89	3.57
Executive function	TMT B	78	46	59	2.80	2.94
Verbal fluency	SCOWA	47	81	41	−1.21	0.88
Memory
immediate recall	SVLT-ir	64	80	60	−1.83	1.11
short delayed recall	SVLT-sr	79		76	−2.05	1.31
delayed recall	SVLT-dr	63		58	−1.92	1.35
recognition	SVLT-recog	60		52	−2.73	3.36

DOI: https://doi.org/10.2478/raon-2023-0009 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 201 - 210

Submitted on: Nov 29, 2022

Accepted on: Dec 31, 2022

Published on: Jun 21, 2023

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 times per year

Keywords:

Related subjects:

Haematology, oncology,

Radiology

© 2023 Andreja Cirila Skufca Smrdel, Anja Podlesek, Marija Skoblar Vidmar, Jana Markovic, Jana Jereb, Manja Kuzma Okorn, Uros Smrdel, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

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Cognitive functioning in a cohort of high-grade glioma patients

Figures & Tables

FIGURE 1.

Number of patients with different combinations of IDH1 mutation expression and methyl guanine methyl transferase (MGMT) methylation

Cognitive functioning regarding to isocitrate dehydrogenase 1 (IDH1) mutation

Demographic and medical data

Patient characteristics, regarding isocitrate dehydrogenase 1 (IDH1) mutation

Cognitive functioning regarding methyl guanine methyl transferase (MGMT) methylation

Patient characteristics regarding methyl guanine methyl transferase (MGMT) methylation

Descriptive statistics for standardized test scores (z–values) and proportion of impaired patients in psychological cognitive functioning tests

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