Monitoring cognition before, during and after awake brain tumor surgery; reliability of a cognitive screener

Abstract

Background: Cognitive assessment during awake brain tumor surgery is used to maximize the extent of tumor resection while minimizing the risk of cognitive damage in patients. Assessments of language functions are widely reported while other cognitive domains are underexposed. In this study, the current cognitive screener that is used at the UMC Utrecht Department of Neurosurgery is expanded to monitor a broader spectrum of cognitive domains. Furthermore, parallel versions have been made to assess cognitive functioning over time. Methods: Four cognitive screeners were administrated to healthy Dutch individuals (N=38). Each version tapped different domains: language (object naming, reading), executive functioning and attention (Stroop Test with and without Block), working memory (Digit Span Forward and Backwards), visual perception (Dot Counting Test with Background) and emotion recognition (How are They Feeling?: Colorcards). One way ANOVA and Kruskal-Wallis analysis were performed to determine significant group differences. Results: No significant differences between groups in the Stroop Test without Block (p=.025), Digit Span Forward (p=.531) and Backwards (p=.079), Reading (words/sentences) and Dot Counting Test were found. Significant differences between groups were found for the Snodgrass Naming Task between two versions (p=.017) and How are They Feeling?: Colorcards (p=.000). Conclusion: This study demonstrated the possibility to expand the cognitive screener and conducting reliable parallel versions to monitor cognitions in multiple timeframes, considering no significant differences between versions have been found in the majority of neuropsychological tests. This provide insight in which domains extensive test assessments is needed for optimal patient care. Investigations into an emotion recognition task is desired