71 Pre-Radiotherapy Cognitive Profiles in Patients with Brain Metastases is needed on social cognition in the long-term to gain better understanding of the underlying mechanisms and the potential effects of brain radiotherapy. In the current study we employed an elaborate cognitive test battery comprising 10 neuropsychological tests. While signs of cognitive fatigue were present in about 20% of patients throughout the NCA, the current patient sample was able to complete more than 90% of the tests and most finished within the intended ninety minutes. This illustrates that performing a comprehensive NCA within this vulnerable patient sample is feasible. The comparison between the comprehensive and the core battery indicated that the core battery cannot adequately detect the severity of cognitive deficits. That is, the extent of cognitive deficits (i.e. number of impaired domains) is often underestimated when solely using the core battery. The differences mainly stemmed from performance variations on the STROOP task, which measures attention, executive function, and information processing speed, while minimal differences were observed in the memory domain. Hence, the STROOP task holds significant potential for assessing cognitive performance in this population. Next, we will investigate the value of the comprehensive battery in assessing treatment-related cognitive decline in order to develop a concise yet comprehensive battery for future use in this heterogeneous population. Study limitations Selection bias may have played a role in our study as only those patients both willing and fit enough to perform a comprehensive NCA were included in the studies. We compared patient and clinical characteristics between the patients included in the less intense COIMBRA versus the APRICOT study. Only KPS was slightly higher in the patients of the APRICOT study, indicating no major differences in patient selection between the studies (Supplementary Materials). Additionally, we grouped tests based on their shared conceptual background (“domain”) in order to enhance power and aid interpretation, even though performance on one task relies on more than one cognitive concept. For comparability, we reanalyzed the data using the domain categorization defined by the ICCTF, which indicated that differences between the comprehensive and core battery remained unchanged. CONCLUSION In the current study we demonstrated the pre-existing cognitive vulnerability of BMs patients as nearly all patients experienced some degree of neurocognitive dysfunction prior to brain radiotherapy. This neurocognitive dysfunction could be clustered into meaningful cognitive profiles, but future studies with larger samples 3
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