INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #15 HVLT-R Process Variables in Patients with Brain Tumors: Relationship with Measures of Executive Function Farah Aslanzadeh, VA Maryland Health Care System, Baltimore, United States Giuliana Zarrella, Virginia Commonwealth University, Richmond, United States Hana Gross, Massachusetts General Hospital, Boston, United States Amber Fox, Virginia Commonwealth University, Richmond, United States Nathaniel Somes, Massachusetts General Hospital, Boston, United States Ashlee Loughan, Virginia Commonwealth University School of Medicine, Richmond, United States Sarah Braun, Virginia Commonwealth University School of Medicine, Richmond, United States Michael Parsons, Massachusetts General Hospital, Boston, United States Category: Cancer Keyword 1: executive functions Keyword 2: assessment Objective: Executive functioning (EF) is frequently impacted among patients with brain tumors. Executive dysfunction can be observed across the testing battery, even on tests not specific to EF, by examining “process variables” (e.g., clustering and intrusion errors on tests of memory). Research in patients with brain tumors has explored the relationship between those process variables and overall learning and memory; however, less is known about their relationship with measures of EF. This study aims to 1) characterize performance on the HVLT-R process variables in a heterogeneous sample of brain tumor patients, 2) assess the association between HVLT-R process variables and established measures of EF in this population, and 3) examine whether frontal lobe tumor location is associated with performance on HVLT-R process variables. Participants and Methods: Patients with brain tumors completed neuropsychological evaluations that included the HVLT-R and at least 2 routinely used tests of EF at the Pappas Center for Neuro-Oncology at Massachusetts General Hospital. Process variables calculated from the HVLT-R included semantic clustering (learning, delayed, total), total intrusion errors, and total repetitions. Tests of EF were converted into normative (Z) scores using accepted standardization samples and averaged to create a composite EF Z-score. Pearson’s correlations measured the relationship between each of the HVLT-R process variables and the composite EF Z-score. Select HVLT-R process variables were compared to a previously published sample of healthy controls (HCs; Gaines et al., 2006) using summary t-tests. Independent sample t-tests examined differences in process variables between patients with and without frontal involvement. Results: One-hundred seven participants (M_age= 58.12, 61.7% Female) met inclusion criteria. Performance on composite EF (n=102, M=-0.73, SD=1.57) was positively correlated with total semantic clusters (M=13.03, SD=9.006; r=0.336, p=<0.001), but not total intrusions (M=1.32, SD=2.008; r=0.06, p=0.579) or total repetitions (M=2.0,1 SD=3.137; r=-0.06, p=0.542). Compared to HCs, patients with brain tumors produced significantly fewer semantic clusters on both learning (M=9.23, SD=6.631; t(255)=-3.37, p=<0.001) and delayed trials (M=3.79, SD=2.774; t(207.36)=-4.55, p=<0.001). There were no significant differences on intrusion errors (t(255)=0.74, p=0.941). There were no differences between patients with or without frontal lobe involvement on process variables (all p’s >0.05). Conclusions: Semantic clustering was associated with performance on the EF composite index and was less frequently used by patients with brain tumors compared to HCs. Intrusion and repetition errors were not related to EF measures. Clustering suggests an organized approach to learning, consistent with other measures of EF, whereas intrusions and repetitions may reflect dysfunction in multiple cognitive processes (e.g., memory, self-monitoring). Non-significant findings regarding the effect of frontal lobe involvement likely is attributable to the distributed network organization of EF. Our study is limited by the heterogeneity of the sample. Nonetheless, it suggests that the semantic clustering score on the HVLT-R could be used as an additional metric of EF in many large scale studies of cognition in patients with brain tumors given its frequent use in the neuro-oncology clinical trials batteries.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #15

HVLT-R Process Variables in Patients with Brain Tumors: Relationship with Measures of Executive Function

Farah Aslanzadeh, VA Maryland Health Care System, Baltimore, United States
Giuliana Zarrella, Virginia Commonwealth University, Richmond, United States
Hana Gross, Massachusetts General Hospital, Boston, United States
Amber Fox, Virginia Commonwealth University, Richmond, United States
Nathaniel Somes, Massachusetts General Hospital, Boston, United States
Ashlee Loughan, Virginia Commonwealth University School of Medicine, Richmond, United States
Sarah Braun, Virginia Commonwealth University School of Medicine, Richmond, United States
Michael Parsons, Massachusetts General Hospital, Boston, United States

Category: Cancer

Keyword 1: executive functions
Keyword 2: assessment

Objective:

Executive functioning (EF) is frequently impacted among patients with brain tumors. Executive dysfunction can be observed across the testing battery, even on tests not specific to EF, by examining “process variables” (e.g., clustering and intrusion errors on tests of memory). Research in patients with brain tumors has explored the relationship between those process variables and overall learning and memory; however, less is known about their relationship with measures of EF. This study aims to 1) characterize performance on the HVLT-R process variables in a heterogeneous sample of brain tumor patients, 2) assess the association between HVLT-R process variables and established measures of EF in this population, and 3) examine whether frontal lobe tumor location is associated with performance on HVLT-R process variables.

Participants and Methods:

Patients with brain tumors completed neuropsychological evaluations that included the HVLT-R and at least 2 routinely used tests of EF at the Pappas Center for Neuro-Oncology at Massachusetts General Hospital. Process variables calculated from the HVLT-R included semantic clustering (learning, delayed, total), total intrusion errors, and total repetitions. Tests of EF were converted into normative (Z) scores using accepted standardization samples and averaged to create a composite EF Z-score. Pearson’s correlations measured the relationship between each of the HVLT-R process variables and the composite EF Z-score. Select HVLT-R process variables were compared to a previously published sample of healthy controls (HCs; Gaines et al., 2006) using summary t-tests. Independent sample t-tests examined differences in process variables between patients with and without frontal involvement.

Results:

One-hundred seven participants (M_age= 58.12, 61.7% Female) met inclusion criteria. Performance on composite EF (n=102, M=-0.73, SD=1.57) was positively correlated with total semantic clusters (M=13.03, SD=9.006; r=0.336, p=<0.001), but not total intrusions (M=1.32, SD=2.008; r=0.06, p=0.579) or total repetitions (M=2.0,1 SD=3.137; r=-0.06, p=0.542). Compared to HCs, patients with brain tumors produced significantly fewer semantic clusters on both learning (M=9.23, SD=6.631; t(255)=-3.37, p=<0.001) and delayed trials (M=3.79, SD=2.774; t(207.36)=-4.55, p=<0.001). There were no significant differences on intrusion errors (t(255)=0.74, p=0.941). There were no differences between patients with or without frontal lobe involvement on process variables (all p’s >0.05).

Conclusions:

Semantic clustering was associated with performance on the EF composite index and was less frequently used by patients with brain tumors compared to HCs. Intrusion and repetition errors were not related to EF measures. Clustering suggests an organized approach to learning, consistent with other measures of EF, whereas intrusions and repetitions may reflect dysfunction in multiple cognitive processes (e.g., memory, self-monitoring). Non-significant findings regarding the effect of frontal lobe involvement likely is attributable to the distributed network organization of EF. Our study is limited by the heterogeneity of the sample. Nonetheless, it suggests that the semantic clustering score on the HVLT-R could be used as an additional metric of EF in many large scale studies of cognition in patients with brain tumors given its frequent use in the neuro-oncology clinical trials batteries.