Cognitive Performance and Mental Exhaustion in Non-Enhancing Glioma Patients

Overview

This study evaluated the association between mental fatigue and cognitive functioning in 101 patients with presumed lower-grade gliomas (LGG) prior to surgical treatment. Results indicate a significant relationship between higher mental fatigue and poorer cognitive performance, particularly in attention, executive function, and memory domains.

Background

Diffuse gliomas are invasive primary brain tumors graded 2 to 4, with lower-grade gliomas (LGG) classified as grade 2–3 IDH-mutated astrocytomas and oligodendrogliomas. Advances in treatment have prolonged survival, increasing the importance of addressing symptom burden, quality of life, and cognition. Fatigue, especially mental fatigue, is a common and persistent symptom in LGG patients and may impact cognitive processes. Understanding the interplay between mental fatigue and cognitive impairment is crucial for optimizing patient counseling and rehabilitation.

Data Highlights

Key Findings

• Mental fatigue measured by MFI-20 correlated negatively with cognitive functioning scores on EORTC QLQ-C30.
• Higher mental fatigue was associated with poorer performance on tests of attention, executive function, and memory.
• 70.3% of patients had confirmed IDH-mutated LGG, ensuring a relatively homogenous cohort.
• Neuropsychological impairments were identified prior to any surgical or oncological treatment, isolating tumor-related effects.
• Self-reported cognitive functioning scores below 75 indicated clinically important cognitive deficits in a substantial subset of patients.

Clinical Implications

Clinicians should consider mental fatigue as a significant factor impacting cognitive performance in LGG patients even before treatment initiation. Early assessment of mental fatigue and cognitive function can guide individualized rehabilitation strategies. Addressing mental fatigue may improve cognitive outcomes and overall quality of life in this patient population.

Conclusion

This study highlights a clear association between mental fatigue and cognitive impairment in patients with presumed LGG prior to surgery, underscoring the need for integrated symptom management. Further research should explore interventions targeting mental fatigue to enhance cognitive rehabilitation.

References

1. WHO Classification 2021 -- Central Nervous System Tumors
2. EORTC QLQ-C30 -- Quality of Life Questionnaire
3. MFI-20 -- Multidimensional Fatigue Inventory
4. Neuropsychological Tests -- RAVLT, D-KEFS, WAIS-IV