65 Pre-Radiotherapy Cognitive Profiles in Patients with Brain Metastases Despite signs of cognitive fatigue in approximately 20% of patients, the current patient sample successfully completed over 90% of the tests of the comprehensive NCA within the intended 90 minutes (Supplementary Materials). Comparison of the comprehensive with the core test battery shows that in particular patients with two or more cognitive deficits are ‘misclassified’ into the group of patients with less cognitive deficits when using the core battery only (Supplementary Figure 3). Differences were mostly due to differences in deficits within the domains of attention, executive function and processing speed (based on STROOP performance), while almost no differences were found for memory (Table 1). Table 1. Number and percentage of patients with an impairment within a domain when either determined using the core versus the comprehensive battery. Cognitive domains Core, n (%) Comprehensive, n (%) Task contributing to difference Attention 4 (6.9) 9 (15.5) STROOP IV/III (n = 5) Executive function 12 (20.7) 13 (22.4) STROOP III/I (n = 1) Memory 28 (49.1) 30 (51.7) VAT immediate (n = 2) ROCFT delay (n = 1) Processing speed 9 (15.5) 19 (33.3) STROOP I (n = 8) STROOP II (n = 7) Psychomotor speed 22 (39.3) 22 (39.3) NA Visuospatial functioning NA 5 (9.1) Rey Copy (n = 5) Social cognition NA 10 (29.4) FEEST (n = 10) Note: Number of patients mentioned behind task names indicate the number of patients this specific task made a difference for when comparing the core with the comprehensive battery. As task deficits are not mutually exclusive, patients can exhibit deficits on more than one task within one domain both contributing to the difference between core and comprehensive. For example, one patient with a memory impairment had deficits on both the VAT immediate recall and the Rey delayed recall. Abbreviations: FEEST, Facial Expressions of Emotion – Stimuli and Tests; ROCFT, Rey Osterieth Complex Figure Test; VAT, Visual Association Test. Exploratory cluster analysis Cluster analysis was performed for 56/58 patients using the individual domain-level impairment for the cognitive domains, as two patients were excluded due to missing data regarding psychomotor speed and/or processing speed. Scores for social cognition were not included in this cluster analysis due to a substantial number of patients (n=24) with missing data (Supplementary Figure 2). The dendrogram provided evidence for two-, three-, four-, and five-cluster solution, with reasonable separation between clusters. A multivariate test of group differences was performed using canonical linear discriminant function analysis, which confirmed a maximum of four clusters could be adequately differentiated with 97% classification accuracy 3
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