Neural network alterations underlie cognitive deficits in brain tumor patients.

PURPOSE OF REVIEW: Brain tumor patients suffer from cognitive deficits, regardless of tumor grade or location. Deficits have a general character, falling in the domains of attention, working memory, information processing speed, and executive functioning. This review explores a new, brain network-based view of these deficits in brain tumor patients. RECENT FINDINGS: Network theory has evolved within the fields of mathematics and sociology and has resulted in its application to many complex systems, such as social networks, traffic flow networks, and biological protein networks. In the brain, a network can be constructed by assessing either functional or anatomical connections between brain areas, and subsequently extracting their overarching network patterns. Important brain network features are local specialization, operationalized by local clustering, and global integration or path length. Widespread disturbances in network topology are found in brain tumor patients, which relate to their cognitive problems. Furthermore, changes in network topology in response to oncological interventions, particularly tumor resection, go hand in hand with cognitive outcome. SUMMARY: Cognitive deficits in brain tumor patients are reflected in whole-brain network disturbances. Possible future clinical use of these findings mostly concerns prognostics and tailoring treatment strategies.

Depression in glioma: a primer for clinicians and researchers.

Depression is one of the leading causes of global disability, and a considerable hidden morbidity among patients with glioma. In this narrative review, we summarise what is currently known about depression in glioma, the main unanswered questions and the types of studies that should be prioritised in order to find out. We conclude by calling for a prospective Phase II study of antidepressants in depressed glioma patients, to test methodologies for a multicentre randomised controlled trial.

Health-related quality of life in patients with brain tumors: limitations and additional outcome measures.

Health-related quality of life (HRQOL) is a multidimensional concept used to measure patients' functioning and well-being. In recent decades, HRQOL has become an important (secondary) outcome measure in clinical trials for brain tumor patients. It could be questioned, however, whether HRQOL is the only useful outcome measure for assessing the level of functioning and well-being of these patients. As described in this review, several general methodological issues can hamper the interpretation of HRQOL data collected in the oncology setting. Additionally, because brain tumor patients have a progressive brain disease resulting in cognitive impairments, patient-reported outcomes may not always be the most informative and accurate measures of HRQOL in brain tumor patients. Supplementary or alternative measures, such as proxy-rated HRQOL measures and measures of instrumental activities of daily living, may provide a more complete picture of brain tumor patients' functioning in daily life.