Abstract
AIMS: Patients with glioblastoma suffer a high incidence of cognitive deficits. Cognition is the result of multiple neural mechanisms and glioblastoma is diffusely infiltrative with the capacity to invade multiple functional areas in the brain. We hypothesise that cognitive deterioration and recovery in these patients will be multidimensional in nature and therefore different components of cognition will show distinct recovery profiles following surgery. METHOD: 28 patients with high-grade glioma, recruited at a single centre underwent preoperative (T0), early postoperative (within one week) (T1) and delayed (six to eight weeks) (T2) testing of their cognition with a neurocognitive screening tests; Oxford Cognitive Screen and Cambridge Attention, Memory and Perception Screen (OCS-Bridge) tool. Varimax principal component analysis was performed to determine if there are low-dimensional domains of cognition examined by the tests. Changes in cognitive scores between time points was calculated and correlated with principal component scores (PCs). RESULTS: We found six principal components which explained 71% of the variance in OCS scores. and six different com- ponents explained 63% of the variance in Bridge scores. Cognitive deterioration was largely multidimensional with few significant correlations between PC change scores at T1 except tests loading on to visual field and spatial neglect. Cognitive recovery measured with T2 change scores were not significantly correlated between attention, praxis and language domains and between verbal working memory and visual memory and attention. CONCLUSIONS: Longitudinal cognitive signatures of deterioration and recovery are heterogenous between patients. This high- lights the importance of targeting potentially distinct neural mechanisms for the rehabilitation of these patients.