Exploring Current Approaches to Neurocognitive Rehabilitation After Brain Tumor Resection

Introduction: There is growing evidence that patients who undergo resection of a brain tumor face significant deficits in cognitive function due to mass effect and treatment sequelae. However, there has been little investigation of what can be done to alleviate these deficits and improve quality of life in these patients. These efforts have focused on the utilization of active rehabilitation targeting domains such as memory, attention, language, and learning. This study aims to explore evidence for the use of cognitive rehabilitation in patients undergoing resection of brain tumor.

Methods: We designed a search string focused on CNS tumors and rehabilitation programs. In PubMed this involved: “("Chordoma"[Mesh] OR "Neuroectodermal Tumors"[Mesh] OR "Central Nervous System Neoplasms"[Mesh] OR "Cranial Nerve Neoplasms"[Mesh] OR “brain tumor”[Title/Abstract] OR “intracranial tumor”[Title/Abstract] OR “cortical tumor”[Title/Abstract] OR “brain cancer”[Title/Abstract])AND("psycho* rehab*"[Title/Abstract] OR "neurocogn* rehab*"[Title/Abstract] OR "cogn* rehab*"[Title/Abstract])AND("Tool*"[Title/Abstract] OR "Instrument*"[Title/Abstract] OR "program*"[Title/Abstract] OR "application*"[Title/Abstract])AND english[Filter])NOT(Review[Publication Type]).” This was translated and the authors searched PubMed, Embase, and Cochrane databases. Results were screened to include any interventions implemented for at least 10 patients and exclude any studies of pediatric, neurotrauma, neurodegenerative, or non-brain neoplasm populations.

Results: Database exploration identified 70 abstracts that were screened by SM and DT. Thirty-eight of these studies were excluded. Twenty-one of the 32 studies in full text review met exclusion criteria. Eleven studies met all inclusion criteria. Eight of these papers described clinical trials of directed rehabilitation programs aimed at improving cognitive function for patients with brain tumors. The remaining 3 studies described pilot studies that implemented new technologies including virtual reality and app-based tools for improving functions.

Conclusion : The authors found 11 specific interventions that have been attempted to improve postoperative cognitive function. There is a clear need for more investigation of neurocognitive rehabilitation programs for patients undergoing resection of brain tumors.