Longitudinal Analysis of Depression and Anxiety Symptoms as Independent Predictors of Neurocognitive Function in Primary Brain Tumor Patients.

Published on Jul 4, 2020in International Journal of Radiation Oncology Biology Physics5.859
· DOI :10.1016/J.IJROBP.2020.07.002
Michelle D. Tibbs4
Estimated H-index: 4
(UCSD: University of California, San Diego),
Minh-Phuong Huynh-Le10
Estimated H-index: 10
(UCSD: University of California, San Diego)
+ 8 AuthorsJona A. Hattangadi-Gluth23
Estimated H-index: 23
(UCSD: University of California, San Diego)
ABSTRACT Background Primary brain tumor patients are vulnerable to depression and anxiety symptoms, which may affect their neurocognitive functioning. We performed a prospective longitudinal analysis to examine the association between depression and anxiety symptoms and domain-specific neurocognitive functioning in primary brain tumor patients receiving radiation therapy [RT]. Methods On a prospective trial, 54 primary brain tumor patients receiving RT underwent comprehensive neurocognitive evaluation at baseline (pre-RT), and 3, 6, and 12 months post-RT. Neurocognitive assessments measured attention/processing speed, verbal and visuospatial memory, and executive functioning, including Delis-Kaplan Executive Function System Trail-Making Test [DKEFS-TMT], DKEFS Verbal Fluency [DKEFS-VF], and Brief Visuospatial Memory Test-Revised [BVMT-R]. Depression and anxiety symptoms were also assessed at each time point with Beck Depression and Anxiety Inventories [BDI-II, BAI], respectively. Higher scores reflect more numerous or severe depression/anxiety symptoms. Univariable and multivariable linear mixed-effects models assessed associations between BDI-II and BAI scores and domain-specific neurocognitive scores over time, controlling for pre-existing depression/anxiety disorders and other patient, tumor, and treatment characteristics. Results Higher BAI scores were associated with worse attention/processing speed in univariable analyses: DKEFS-TMT Visual Scanning (p=0.003), Number Sequencing (p=0.011), and Letter Sequencing (p Conclusions Among primary brain tumor patients receiving RT, increased depression and anxiety were independently associated with worsened neurocognition, particularly in attention/processing speed. Depression and anxiety symptoms should be controlled for in prospective clinical trials and managed in the clinical setting to optimize neurocognitive functioning.
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