Department of Supportive Care, Montpellier Cancer Institute (ICM) - University of Montpellier, 208 avenue des Apothicaires, 34298, Montpellier, France.
Department of Neurosurgery, Montpellier University Hospital - INSERM U1051, Montpellier, France.
J Neurooncol. 2020 Mar;147(1):185-194. doi: 10.1007/s11060-020-03414-x. Epub 2020 Jan 30.
The study investigated the prospective memory (PM) functioning among patients with brain metastases (BM), eligible for neurosurgy/radiosurgery, and its relationships with depression and quality of life (QoL).
This case-healthy-control, cross-sectional study, comprised 160 participants, including 49 patients with BM from various cancers treated with neurosurgery or radiosurgery. They were compared with 111 matched controls on a set of neuropsychological tests, including the MoCA global cognitive test and an experimental PM task 'PROMESSE'. Participants also completed a depression scale (BDI-II), a generic (SF-12) and a specific (QLQ-C30) QoL instrument for cancer patients. Multivariate analyses were conducted on various PM outcomes, in particular on event-based (EBPM) and time-based (TBPM) PM performances.
After adjusting for age and socio-cultural level, patients with BM performed worse than the control on the PM task (p < .0001) [OR 1.05; 95%CI (1.01-1.08)], whatever the location of BM (frontal versus temporal lobe). Patients with infratentorial BM exhibited better TBPM performances than patients with supratentorial BM (p = .02). The global PM performance was positively correlated with the MoCA (r = .45) and the SF-12 global score (r = .34), and negatively with the BDI-II score (r = - .20), the number of BM (r = - .34) and the volumetric of the BM (r = - 29). The TBPM performance was linked to the global QoL (r = .40) in patients.
The study showed a significant PM deficit in patients with BM eligible for a neurosurgy/radiosurgery, which is linked to damaged QoL and which likely maintains some depressive affects. Prospective memory rehabilitation program should especially focus on TBPM for post-operative patients with BM.
本研究调查了接受神经外科/放射外科治疗的脑转移瘤（BM）患者的前瞻性记忆（PM）功能，并探讨了其与抑郁和生活质量（QoL）的关系。
本病例-健康对照、横断面研究纳入了 160 名参与者，包括 49 名来自不同癌症的 BM 患者，他们接受了神经外科或放射外科治疗。将他们与 111 名匹配的对照组在一系列神经心理学测试上进行比较，包括 MoCA 整体认知测试和前瞻性记忆任务“PROMESSE”。参与者还完成了抑郁量表（BDI-II）、通用（SF-12）和特定（QLQ-C30）癌症患者生活质量量表。对各种 PM 结果，特别是基于事件的（EBPM）和基于时间的（TBPM）PM 表现，进行了多变量分析。
在调整年龄和社会文化水平后，BM 患者在 PM 任务上的表现明显差于对照组（p < 0.0001）[比值比（OR）1.05；95%置信区间（CI）（1.01-1.08）]，无论 BM 的位置（额叶与颞叶）如何。幕下 BM 患者的 TBPM 表现优于幕上 BM 患者（p = 0.02）。总体 PM 表现与 MoCA（r = 0.45）和 SF-12 总体评分（r = 0.34）呈正相关，与 BDI-II 评分（r = -0.20）、BM 数量（r = -0.34）和 BM 体积（r = -0.29）呈负相关。TBPM 表现与患者的总体 QoL 呈正相关（r = 0.40）。
本研究表明，接受神经外科/放射外科治疗的 BM 患者存在明显的 PM 缺陷，这与受损的 QoL 有关，可能与某些抑郁情绪有关。前瞻性记忆康复计划应特别关注术后 BM 患者的 TBPM。
