https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)61346-9.pdf

Primary brain tumours in adults

Purpose Patients with gliomas often experience cognitive deficits, including problems with attention and memory. This randomized, controlled trial evaluated the effects of a multifaceted cognitive rehabilitation program (CRP) on cognitive functioning and selected quality-of-life domains in patients with gliomas. Patients and Methods One hundred forty adult patients with low-grade and anaplastic gliomas, favorable prognostic factors, and both subjective cognitive symptoms and objective cognitive deficits were recruited from 11 hospitals in the Netherlands. Patients were randomly assigned to an intervention group or to a waiting-list control group. The intervention incorporated both computer-based attention retraining and compensatory skills training of attention, memory, and executive functioning. Participants completed a battery of neuropsychological (NP) tests and self-report questionnaires on cognitive functioning, fatigue, mental health–related quality of life, and community integration at baseline, after completion of the CRP, and at 6-month follow-up. Results At the immediate post-treatment evaluation, statistically significant intervention effects were observed for measures of subjective cognitive functioning and its perceived burden but not for the objective NP outcomes or for any of the other self-report measures. At the 6-month follow-up, the CRP group performed significantly better than the control group on NP tests of attention and verbal memory and reported less mental fatigue. Group differences in other subjective outcomes were not significant at 6 months. Conclusion The CRP has a salutary effect on short-term cognitive complaints and on longer-term cognitive performance and mental fatigue. Additional research is needed to identify which elements of the intervention are most effective.

/pdf/cognitive-rehabilitation-in-patients-with-gliomas-a-2jj9xv84w9.pdf

Cognitive Rehabilitation in Patients With Gliomas: A Randomized, Controlled Trial

Background
Symptom occurrence has been shown to predict treatment course and survival in patients with solid tumors. Primary brain tumor (PBT) patients are unique in the occurrence of neurologic symptoms. Currently, no instrument exists that measures both neurologic and cancer-related symptoms.

/pdf/validation-of-the-m-d-anderson-symptom-inventory-brain-tumor-3l03rzblsl.pdf

Validation of the M.D. Anderson Symptom Inventory Brain Tumor Module (MDASI-BT).

Unmet supportive care needs and interest in services among patients with a brain tumour and their carers.

The diagnosis and management of high-grade glioma has profound effects on patients and their families. Guidance issued by the UK National Institute of Health and Clinical Excellence in 2006 highlighted the lack of good studies of palliative care for patients with this disease. We describe new studies published from 2000 to 2007. High-grade glioma is undoubtedly a challenging research area, and many studies are poorly defined and have small and biased samples. Nevertheless the data reveal this to be a heterogeneous group of patients with complex needs that differ from those of patients with other cancers. Improvements in care require a united input from neurology and neurosurgery, oncology, and palliative care. The main research priorities are the development and assessment of psychosocial or supportive interventions and the investigation of service provision of specialist palliative and end-of-life care, which have hitherto been neglected.

https://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(08)70230-4.pdf

Psychosocial and supportive-care needs in high-grade glioma

Objective To report and discuss common neurologic problems in adults with brain tumors admitted for inpatient rehabilitation at an acute rehabilitation center. Design Retrospective, descriptive, case series of 51 consecutive adult patients (65% male), with a variety of tumor types (31.3% glioblastoma, 25.5% meningioma, and 25.5% metastatic). Outcome measures were the functional status as measured by the FIM scores, the length of rehabilitation stay, and discharge dispositions. Results The most common deficit was impaired cognition (80%), followed by weakness (78%), visual-perceptual deficit (53%), sensory loss (38%), and bowel and bladder dysfunction (37%). Less common problems, in decreasing incidence, were cranial nerve palsy, dysarthria, dysphagia, aphasia, ataxia, and diplopia. Thirty-eight (74.5%) patients had three or more concurrent neurologic deficits, and 20 (39.2%) patients had five or more deficits. Concurrent deficits among patients with hemi- and tetraparesis involved cognition (n = 29 patients), visual-perceptual function, sensation, cranial nerve palsy, and neurogenic bowel/bladder. The average admission FIM score of 67.2 increased to 87.1 at the time of discharge, with similar gains between patients with primary brain tumor and metastatic disease. Thirty-five patients were discharged home, seven to a nursing home, and one to hospice care; there were eight acute transfers. Conclusions Impaired cognition, weakness, and visual-perceptual deficits were the most common problems in this study population. Our study supports the benefits of comprehensive and interdisciplinary rehabilitation for patients with primary as well as metastatic brain tumors.

Incidence of neurologic deficits and rehabilitation of patients with brain tumors.

Delayed diagnosis of concomitant rotator cuff tear and brachial plexopathy in a patient with traumatic brain injury: a case report.

https://www.archives-pmr.org/article/S0003-9993(00)46281-7/pdf

Dilshad D. Blackinton

Papers

Incidence of neurologic deficits and rehabilitation of patients with brain tumors.

Delayed diagnosis of concomitant rotator cuff tear and brachial plexopathy in a patient with traumatic brain injury: a case report.

The Gastric Emptying Scan as a Tool for Surgical Management of Severe Bowel Dysfunction in Spinal Cord Injury: 2 Case Reports