Mekler Shelley, Virtue-Griffiths Sian, Pike Kerryn
School of Applied Psychology, Griffith Health, Griffith University, 1 Parklands Drive, Gold Coast, QLD, Australia.
School of Psychology & Public Health, La Trobe University, Melbourne, VIC, Australia.
Support Care Cancer. 2025 Mar 21;33(4):310. doi: 10.1007/s00520-025-09345-5.
PURPOSE: People with primary brain tumour (PBT) experience objective cognitive impairment, but subjective cognitive concerns have received less attention. This review sought to determine the type of self- and informant-reported cognitive concerns following PBT and to ascertain if they vary according to patient, tumour and/or treatment characteristics. Further objectives were to determine whether subjective reports aligned with objective findings or informant reports. METHODS: Literature searches were conducted using PsycINFO and Medline, limited to English-language and full-text format. Studies focusing on non-PBTs, objective cognition without subjective reports, or paediatric PBT were excluded. RESULTS: Eleven studies were included, representing the cognitive concerns of 957 PBT participants, with varying tumour types/treatment, and ranging from pre-surgery to an average of 5 years post-diagnosis. Subjective concerns regarding global perceived cognitive impairment, language, memory, executive function, and attention were common, but change in processing speed, visual function, and reading/spelling were also reported. Few studies investigated factors impacting subjective cognition, but there was some suggestion that left-lateralised and larger tumours resulted in more subjective concerns. The alignment between objective and subjective cognition varied, ranging from strong to weak, whereas the overlap between patient and informant reports was robust. CONCLUSIONS: Identifying the alignment between patient and informant reports is of significant benefit when considering treatment interventions and outcomes for people with PBT, particularly in instances where they may not be able to report their cognitive concerns. Overall, the importance of the patient perspective was highlighted, which can often be replaced by objective measures in clinical research.
目的:原发性脑肿瘤(PBT)患者存在客观认知障碍,但主观认知问题受到的关注较少。本综述旨在确定PBT后自我报告和他人报告的认知问题类型,并确定它们是否因患者、肿瘤和/或治疗特征而异。进一步的目标是确定主观报告是否与客观发现或他人报告一致。 方法:使用PsycINFO和Medline进行文献检索,限于英文和全文格式。排除关注非PBT、无主观报告的客观认知或儿科PBT的研究。 结果:纳入了11项研究,代表了957名PBT参与者的认知问题,肿瘤类型/治疗各不相同,从术前到诊断后平均5年。关于整体感知认知障碍、语言、记忆、执行功能和注意力的主观问题很常见,但也有关于处理速度、视觉功能和阅读/拼写变化的报告。很少有研究调查影响主观认知的因素,但有一些迹象表明,左侧和较大的肿瘤会导致更多的主观问题。客观和主观认知之间的一致性各不相同,从强到弱,而患者和他人报告之间的重叠性很强。 结论:在考虑PBT患者的治疗干预和结果时,确定患者和他人报告之间的一致性具有显著益处,特别是在他们可能无法报告自己的认知问题的情况下。总体而言,强调了患者视角的重要性,而这在临床研究中往往可以被客观测量所取代。
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