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Cognitive rehabilitation for early post-surgery inpatients affected by primary brain tumor: a randomized, controlled trial
Authors:Chiara Zucchella  Annarita Capone  Valentina Codella  Alessandro Marco De Nunzio  Carmine Vecchione  Giorgio Sandrini  Andrea Pace  Francesco Pierelli  Michelangelo Bartolo
Affiliation:1. Neurorehabilitation Unit, IRCCS Neurological Mediterranean Institute NEUROMED, Via Atinense 18, 86077, Pozzilli, Isernia, Italy
2. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
3. Neurorehabilitation Unit, Laboratory of Multifactorial Biomechanics, IRCCS Neurological Mediterranean Institute NEUROMED, Via Atinense 18, 86077, Pozzilli, Isernia, Italy
4. Laboratory of Vascular Pathophysiology, IRCCS Neurological Mediterranean Institute NEUROMED, Via Atinense 18, 86077, Pozzilli, Isernia, Italy
5. Department of Medicine, University of Salerno, via S. Allende, 84081, Baronissi, Salerno, Italy
6. Neurorehabilitation Unit, IRCCS National Neurological Institute C. Mondino Foundation, via Mondino 2, 27100, Pavia, Italy
7. Department of Neurological Sciences, University of Pavia, via Mondino 2, 27100, Pavia, Italy
8. Neurology Unit, Regina Elena National Cancer Institute, via E. Chianesi 53, 00144, Rome, Italy
9. Department of Medical-Surgical Sciences and Biotechnology, University of Rome “La Sapienza”, Corso della Repubblica 79, 04100, Latina, Italy
Abstract:Cognitive impairment is one of the most common neurological disorders in neuro-oncological patients and exerts a deep negative impact on quality of life interfering with familiar, social and career-related activities. To test the effectiveness of early cognitive rehabilitation treatment for inpatients affected by primary brain tumors. Out of 109 consecutive patients enrolled in the study, 58 patients were randomly assigned to a rehabilitation group or to a control group. The rehabilitation consisted of 16 one-hour individual sessions of therapist-guided cognitive training, spread over 4 weeks, combining computer exercises and metacognitive training. Patients in the control group received usual care without cognitive training. All patients were evaluated by means of a comprehensive neuropsychological battery at the admission (T0) and after 4 weeks (T1). Patients in the rehabilitation group showed a significant improvement of cognitive functions. In particular, the domains that benefited most from the training were visual attention and verbal memory. The control group exhibited only a slightly, not statistically relevant, enhancement of cognitive performances. Cognitive rehabilitation for neuro-oncological inpatients resulted in a significant enhancement of cognitive performances after the training, also providing a foundation for early administration. Future research should be aimed to clarify the patients’ characteristics that predict neuropsychological improvement, to identify the most effective elements in rehabilitative programs and to study the effects of treatment extension to everyday life.
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