Symposia 8 Program Schedule
02/15/2024
04:00 pm - 05:25 pm
Room: West Side Ballroom - Salon 1
Symposia 8: Interventions for neuropsychological conditions
Simposium #2
For the love of work: Novel study of cognitive rehabilitation in primary brain tumor for improving work performance
Christina Weyer Jamora, University of California San Francisco, San Francisco, United States
Melissa Brie, University of California San Francisco, San Francisco, United States
Paige Bracci, University of California San Francisco, San Francisco, United States
Jennie Taylor, University of California San Francisco, San Francisco, United States
Ellen Smith, University of California San Francisco, San Francisco, United States
Category: Cognitive Intervention/Rehabilitation
Keyword 1: cognitive rehabilitation
Keyword 2: brain tumor
Objective:
Primary brain cancer survivors live longer, yet experience distress and cognitive impairments that negatively impact their quality of life (QOL), including at work. We present a novel study of tele-cognitive rehabilitation for improving work status in primary brain cancer survivors.
Participants and Methods:
Retrospective review of post-treatment, radiologically stable adult primary brain cancer patients who completed standardized neuropsychological, psychological, vocational, and QOL assessments. Wilcoxon rank sum and Fisher’s exact or Chi-square tests assessed between-group and within-group comparisons. Tests were two-sided and statistically significant for p<0.05.
Results:
79 patients with known baseline work status were assessed for between-group comparisons (working versus not). Working (n=38) and not working (n=41) subgroups had similar ages, tumor grade/type, and history of radiotherapy. Not working (n=41) had worse cognitive function (executive function, attention, verbal learning all p<0.05) and more engagement in survivorship services (p<0.04).
Of the 79 work-status known patients, 38 underwent vocationally focused tele-cognitive rehabilitation (median 11 sessions) treatment for within-group comparisons. 82% of the treatment group had improved work status compared to 34% in non-treatment. Baseline work status and age were not related to occupational improvements (all p >0.20). Higher dose high radiotherapy dose inversely related to rehab improvements (p<.05). Higher verbal memory (p= 0.05), processing speed (p=.06), executive functioning (p=0.02), IDH mutation status (p=.06), and motivation for treatment (p=.04) was associated with improvement. Those with depressive symptoms who engaged in clinically indicated psychotherapeutic services significantly improved their work status (p=.01).
Conclusions:
Occupational functioning improved after cognitive rehabilitation. Cognitive impairments, IDH mutation status, higher dose radiotherapy, and treatment motivation are important considerations. Individuals not working at baseline, despite more cognitive impairments, improved similarly to their working counterparts. Those with depression particularly benefitted from psychotherapeutic support. Vocationally focused tele-cognitive rehabilitation shows promise for improving the work-based abilities of primary brain tumor patients and warrants further investigation.
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