Kognitive Reserve Index neuro-onkologischer Patienten

Neuro-oncological diseases often result in brain damage, leading to neurological deficits. The Cognitive Reserve Index Questionnaire (CRIq) is a validated tool that gauges cognitive reserve, reflecting the brain's resilience to neuropathological damage and its compensatory mechanisms. This study aims to conduct a comprehensive analysis of variations in CRIq scores and the underlying factors among diverse brain tumors.

In this pilot series, all patients attending our neuro-oncology outpatient clinic over a 7-month period (October 2022 - April 2023) were requested to complete the CRIq questionnaire. Data analysis adhered to the established "Instructions for the administration of the CRIq" (Nucci et al., 2012) and was correlated with epidemiological data. Patients were categorized by age, marital and parental status, tumor malignancy, WHO Grading System, treatment modality and tumor localization. Statistical analyses were performed using Prism for Windows 10 (Version 8.4.2).

The study encompassed a cohort of 173 neuro-oncological patients. Among them, 105 individuals (60.7%) fully completed the CRIq questionnaire, allowing for CRI calculation. Of these participants, 64 were female and 41 were male, with a mean age of 52.7 ± 14.43 years. Approximately 90.5% of patients had intracranial tumors, with 58% classified as malignant. CRI scores were distributed as follows: 0.95% low, 2.85% medium-low, 67.62% medium, 19.04% medium-high, and 9.52% high (as defined by Nucci et al.). Age and parental status had a statistically significant impact on CRI, while gender did not. Interestingly, a significant increase in CRI scores was observed in highly malignant diseases such as glioblastoma (mean CRI score of 116.63 ± 13.18) compared to less malignant ones like low-grade gliomas (mean CRI score of 99.57 ± 8.18) (two-tailed p-value of 0.0063, Mann-Whitney test).

The utilization of the CRIq appears promising in assessing cognitive reserve in neuro-oncological patients. Interestingly, among intracranial gliomas, a discernible pattern emerged wherein CRI scores exhibited an upward trend relative to tumor grade. Specifically, patients with glioblastomas displayed a statistically significant increase in CRI scores compared to those with low-grade gliomas. Ongoing investigations involving cognitive testing and volumetric assessments are being conducted to elucidate the mechanisms driving this phenomenon and uncover its potential implications for disease prognosis.