63 Pre-Radiotherapy Cognitive Profiles in Patients with Brain Metastases across clusters, chi-square tests were performed for categorical data and MannWhitney U-test for continuous data. Results Clinical characteristics 58 patients (31 men) were included in the analyses. The median age was 66 years. Most patients had two or more BMs (72%) and BMs most often originated from lung cancer (50%). More than half of patients (62%) presented with symptoms at time of the BMs diagnosis which mostly included epilepsy, motor symptoms and/ or headache. The majority of patients (74%) was receiving or had received previous anti-tumor therapy (i.e. chemo- or immunotherapy; Supplementary Materials). Subjective cognitive complaints During the semi-structured interview, the majority of patients reported cognitive fatigue (62%; Supplementary Table 3). Additionally, both motor and sensory problems were frequently reported (38% and 22%, respectively). Cognitive complaints were reported across all domains with 59% of patients reporting cognitive problems in at least one domain. Subjective decline compared to previously experienced premorbid functioning was reported in at least one cognitive domain by 69%, with decline in two or more domains reported by 55%. Both subjective complaints and cognitive decline were most frequently reported for memory (38% and 40%, respectively) and attention & executive functioning (38% and 43%, respectively; Figure 1). Mean self-reported stress levels were 27 (SD=26), with 11% of patients reporting levels of ≥50. The majority of patients (64%) reported their stress was related to the cancer diagnosis and upcoming treatment. Neurocognitive data Neurocognitive functioning Group-level: On the domain-level, group performance was worse compared to the normative population for memory, processing speed and psychomotor speed. On the contrary, performance on visuospatial functioning was better than the norm population. On the task-level, patients’ cognitive performance was significantly lower than the norm data for multiple memory tests (Hopkins Verbal Learning Test – Revised (HVLT-R), semantic fluency), processing speed (STROOP naming), psychomotor speed (Grooved Pegboard dominant and non-dominant hand), and social cognition (FEEST total). Contrarily, mean Z-scores were better than the norm population for tests on attention (Trail Making Test, switching), memory (VAT – delayed), and visuospatial functioning (Hooper Visual Organization Test fragmented). 3
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