scholarly journals P05.01 the efficacy of donepezil on cognitive function in postoperative brain tumor patients

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii33-iii34
Author(s):  
Y Diansari ◽  
Y Harun ◽  
S Marisdina ◽  
Y Felistia
Keyword(s):  
Cognitive Impairment ◽  
Brain Tumor ◽  
Cognitive Function ◽  
Acetylcholinesterase Inhibitor ◽  
Primary Brain Tumor ◽  
Adult Brain ◽  
Cognitive Domain ◽  
Cognitive Test ◽  
Tumor Patients ◽  
Old Patients

Abstract BACKGROUND Cognitive impairment is frequently found in brain tumor patients. More than 90% of patients with brain tumor have at least one cognitive domain disturbance. Decline in cognitive function could happen before due to the tumor or after the treatment because of surgery, radiotherapy or chemotherapy. Until now there is no available standard treatment for patients with cognitive impairment due to brain tumor. Moreover, Donepezil is an acetylcholinesterase inhibitor known to be useful for improving cognitive function in patients with dementia. This clinical study aims to determine the cognitive effects of donepezil therapy in patients with brain tumors following surgery. MATERIAL AND METHODS This is a pilot study with total of 20 adult brain tumor patients were double blinded randomly assigned to receive a single daily dose (5mg for 12 weeks) of donepezil or placebo. The inclusion criteria were patients with primary brain tumor who had undergone surgery with cognitive impairment at the initial evaluation and age range 18 to 65 years old. Patients with previous cognitive problem, other diseases that can cause cognitive decline e.g. stroke and history of taking donepezil, memantine, methylphenidate, ginkgo biloba, and modafinil were excluded. A cognitive test using Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesia Version (MoCA-INA) assessing memory, attention, language, visuospatial, verbal fluency, and executive functions were administered before random assignment and at 4, 8 and 12 weeks. A cognitive composite score (primary outcome) and individual cognitive domains were evaluated. Furthermore, side effects and adverse events were also recorded. RESULTS Of this mostly middle-age (30–60 years old), female, meningioma as primary brain tumor with frontal and temporal lobe are the most frequent locations. After 12 weeks of treatment, the composite scores did differ significantly between groups (MMSE P=0.027, MoCA-INA P=0.024). Furthermore, the significant differences favouring donepezil were observed for orientation and recall domains using MMSE with p value 0.017 and 0.006 respectively. Visuospatial (P=0.034) and delayed recall domains (P=0.004) were significant through MoCA-INA evaluation. In addition, Mean MMSE score for pre-donepezil administration was 14.60 ± 4.47 and after 3 months was 20.40 ± 4.24 (P=0.000). Mean MoCA-INA score for pre-donepezil administration was 9.30 ± 3.65 and after 3 months was 15.30 ± 4.24 (P=0.000). However, there was no differences in the placebo group (MMSE P= 0.066, MoCA-INA P=0.313). CONCLUSION Three months treatment with donepezil significantly improve the cognitive functions among post-operative brain tumor patients with no reported side effect. Moreover, further research is needed for longer duration of follow-up and possibility of increased doses.

scholarly journals Donepezil for Irradiated Brain Tumor Survivors: A Phase III Randomized Placebo-Controlled Clinical Trial

2015 ◽  
Vol 33 (15) ◽  
pp. 1653-1659 ◽  
Author(s):  
Stephen R. Rapp ◽  
L. Doug Case ◽  
Ann Peiffer ◽  
Michelle M. Naughton ◽  
Michael D. Chan ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Cognitive Function ◽  
Adult Brain ◽  
Composite Score ◽  
Phase Iii ◽  
Cognitive Test ◽  
Controlled Clinical Trial ◽  
Motor Speed ◽  
Whole Brain Irradiation ◽  
Brain Irradiation

Purpose Neurotoxic effects of brain irradiation include cognitive impairment in 50% to 90% of patients. Prior studies have suggested that donepezil, a neurotransmitter modulator, may improve cognitive function. Patients and Methods A total of 198 adult brain tumor survivors ≥ 6 months after partial- or whole-brain irradiation were randomly assigned to receive a single daily dose (5 mg for 6 weeks, 10 mg for 18 weeks) of donepezil or placebo. A cognitive test battery assessing memory, attention, language, visuomotor, verbal fluency, and executive functions was administered before random assignment and at 12 and 24 weeks. A cognitive composite score (primary outcome) and individual cognitive domains were evaluated. Results Of this mostly middle-age, married, non-Hispanic white sample, 66% had primary brain tumors, 27% had brain metastases, and 8% underwent prophylactic cranial irradiation. After 24 weeks of treatment, the composite scores did not differ significantly between groups (P = .48); however, significant differences favoring donepezil were observed for memory (recognition, P = .027; discrimination, P = .007) and motor speed and dexterity (P = .016). Significant interactions between pretreatment cognitive function and treatment were found for cognitive composite (P = .01), immediate recall (P = .05), delayed recall (P = .004), attention (P = .01), visuomotor skills (P = .02), and motor speed and dexterity (P < .001), with the benefits of donepezil greater for those who were more cognitively impaired before study treatment. Conclusion Treatment with donepezil did not significantly improve the overall composite score, but it did result in modest improvements in several cognitive functions, especially among patients with greater pretreatment impairments.

scholarly journals Lifetime affect and midlife cognitive function: prospective birth cohort study

2014 ◽  
Vol 204 (3) ◽  
pp. 194-199 ◽  
Author(s):  
M. Richards ◽  
J. H. Barnett ◽  
M. K. Xu ◽  
T. J. Croudace ◽  
D. Gaysina ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Birth Cohort ◽  
Cognitive Test ◽  
Birth Cohort Study ◽  
Memory Problems ◽  
Affective Symptoms ◽  
Health And Development ◽  
Childhood Cognitive Ability ◽  
Objectively Measured

BackgroundRecurrent affective problems are predictive of cognitive impairment, but the timing and directionality, and the nature of the cognitive impairment, are unclear.AimsTo test prospective associations between life-course affective symptoms and cognitive function in late middle age.MethodA total of 1668 men and women were drawn from the Medical Research Council National Survey of Health and Development (the British 1946 birth cohort). Longitudinal affective symptoms spanning age 13–53 years served as predictors; outcomes consisted of self-reported memory problems at 60–64 years and decline in memory and information processing from age 53 to 60–64 years.ResultsRegression analyses revealed no clear pattern of association between longitudinal affective symptoms and decline in cognitive test scores, after adjusting for gender, childhood cognitive ability, education and midlife socioeconomic status. In contrast, affective symptoms were strongly, diffusely and independently associated with self-reported memory problems.ConclusionsAffective symptoms are more clearly associated with self-reported memory problems in late midlife than with objectively measured cognitive performance.

Swallowing assessment in primary brain tumor patients with dysphagia

Neurology ◽  
1994 ◽  
Vol 44 (10) ◽  
pp. 1927-1927 ◽  
Author(s):  
H. B. Newton ◽  
C. Newton ◽  
D. Pearl ◽  
T. Davidson
Keyword(s):  
Brain Tumor ◽  
Primary Brain Tumor ◽  
Tumor Patients ◽  
Swallowing Assessment

Rehabilitation pathways in adult brain tumor patients in the first 12 months of disease. A retrospective analysis of services utilization in 719 patients

2016 ◽  
Vol 24 (11) ◽  
pp. 4801-4806 ◽  
Author(s):  
Andrea Pace ◽  
Veronica Villani ◽  
Cristiano Parisi ◽  
Stefano Di Felice ◽  
Margaux Lamaro ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Retrospective Analysis ◽  
Adult Brain ◽  
Tumor Patients ◽  
Services Utilization

scholarly journals Prostate-Specific Antigen and Testosterone Levels as Biochemical Indicators of Cognitive Function in Prostate Cancer Survivors and the Role of Diabetes

2021 ◽  
Vol 10 (22) ◽  
pp. 5307
Author(s):  
Alicja Popiołek ◽  
Bartosz Brzoszczyk ◽  
Piotr Jarzemski ◽  
Aleksandra Chyrek-Tomaszewska ◽  
Radosław Wieczór ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Prostate Specific Antigen ◽  
Verbal Memory ◽  
Demographic Data ◽  
Specific Antigen ◽  
Hormonal Treatment ◽  
Cognitive Test ◽  
Prostate Cancer Survivors

Prostate cancer (PC) is one of the most common malignancies in men. The increase in the number of PC survivors is associated with many problems including cognitive impairment. Early detection of such problems facilitates timely protective intervention. This study examined the association between prostate-specific antigen (PSA) or testosterone (T) levels and cognitive function in patients undergoing radical prostatectomy. Such a correlation could help identify patient groups at risk of cognitive impairment. Participants underwent clinical (demographic data, medical history, physical examination, and blood analyses) and neuropsychological assessment (cognitive test battery). Preoperative PSA or T levels were not associated with cognitive function. However, long-term follow-up after prostatectomy showed a strong correlation between PSA levels and the results of verbal memory and executive function tests. A trend toward significance was also observed for visuospatial memory. The levels of free T and total T were not correlated with cognitive function. Only the levels of free T after hormonal treatment were significantly correlated with executive functions. Comorbid diabetes affected these correlations. In conclusion, PSA levels at a distant postoperative time and free T level after hormonal treatment may be biomarkers of cognitive function.

scholarly journals Primary brain tumor patients admitted to a US intensive care unit: a descriptive analysis

CNS Oncology ◽  
2021 ◽  
pp. CNS77
Author(s):  
Jennifer H Kang ◽  
Christa B Swisher ◽  
Evan D Buckley ◽  
James E Herndon ◽  
Eric S Lipp ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Tumor ◽  
Hematological Malignancies ◽  
Descriptive Analysis ◽  
Primary Brain Tumor ◽  
Icu Mortality ◽  
Tumor Patients ◽  
Common Indication ◽  
Better Than

Purpose: To describe our population of primary brain tumor (PBT) patients, a subgroup of cancer patients whose intensive care unit (ICU) outcomes are understudied. Methods: Retrospective analysis of PBT patients admitted to an ICU between 2013 to 2018 for an unplanned need. Using descriptive analyses, we characterized our population and their outcomes. Results: Fifty-nine PBT patients were analyzed. ICU mortality was 19% (11/59). The most common indication for admission was seizures (n = 16, 27%). Conclusion: Our ICU mortality of PBT patients was comparable to other solid tumor patients and the general ICU population and better than patients with hematological malignancies. Further study of a larger population would inform guidelines for triaging PBT patients who would most benefit from ICU-level care.

Abstract P268: Greater Cognitive Impairment Among Older Adults With Type 1 Diabetes as Compared to Non-diabetic Controls: Results From the Study of Longevity in Diabetes (SOLID)

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Mary E Lacy ◽  
Paola Gilsanz ◽  
Chloe Eng ◽  
Michal S Beeri ◽  
Andrew J Karter ◽  
...  
Keyword(s):  
Older Adults ◽  
Type 1 Diabetes ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Cognitive Function ◽  
Episodic Memory ◽  
Regression Models ◽  
Cognitive Test ◽  
Race Ethnicity

Introduction: Studies have shown poorer cognitive function in children and adolescents with type 1 diabetes (T1D) as compared to non-diabetic peers. However, little is known about cognitive function in older adults with T1D. Hypothesis: We hypothesized that older adults with T1D and type 2 diabetes (T2D) would have greater cognitive impairment than age, sex, race/ethnicity, and education-matched controls without diabetes. Methods: We compared baseline cognitive impairment among older adults (aged ≥60) from the Study of Longevity in Diabetes (SOLID) with T1D (n=771), T2D (=234) and no diabetes (n=253). Cognitive tests assessed three cognitive domains identified via factor analysis (language, executive function, episodic memory). All cognitive test scores were standardized and cognitive impairment was defined as 1.5 SD below the mean. In logistic regression models adjusted for age, sex, education, and race/ethnicity, we examined the association between diabetes status (T1D, T2D or no diabetes) and cognition on each cognitive domain and on global cognition (average of scores on the 3 domains). Results: In adjusted regression models, compared to older adults without diabetes, those with T1D were more likely to have impaired cognitive function on the language (OR=2.13, 95% CI: 1.08, 4.17) and executive function domains (OR=2.66, 95% CI: 1.36, 5.22). No significant differences in global cognitive impairment or impairment on the episodic memory domain were observed for T1D and no significant differences on any domain were observed for T2D. Conclusions: Our findings suggest that older adults with T1D have greater cognitive impairment than their peers without diabetes; findings were specific to the language and executive function domains, with episodic memory being unaffected. No increase in cognitive impairment was observed for older adults with T2D. Additional research is needed to understand the causes and potentially modifiable factors associated with impaired cognition among older adults with T1D.

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