P04.88 Phasic alertness deficits in brain tumor patients

• Published in: Neuro-oncology (Charlottesville, Va.) Va.), 2018-09, Vol.20 (suppl_3), p.iii301-iii301
• Main Authors: de Dreu, M, Schouwenaars, I, Ramsey, N, Rutten, G, Jansma, M
• Format: Article
• Language: English
• Subjects: Poster Presentations
• ISSN: 1522-8517; 1523-5866
• DOI: 10.1093/neuonc/noy139.322

Abstract Background Brain tumor patients often have cognitive deficits, which can greatly affect their socio-professional life. Previous studies have shown that a healthy brain already shows changes in activation before it has to perform a task, so called ‘phasic alertness’. In this study we examined if brain tumor patients show abnormal brain activity associated with deficits in phasic alertness. For this purpose we compared the level as well as the distribution of activation over two brain networks regions that are associated with phasic alertness. Material and Methods 20 healthy controls (HC), 27 meningioma patients (MG), 15 low grade glioma patients (LGG), and 16 high grade glioma patients (HGG), age (SEM) = 36 (2.5), 55 (2.3), 42 (3.4), 49 (3.5) performed a visual perception task with a cue warning the subject when a stimulus would appear. Bilateral ROIs were defined to represent activated regions of the central executive network (CEN) and the default mode network (DMN). Univariate (for average level of activation) and multivariate analysis (for activation pattern) were performed for CEN and DMN separately. Results Patients were significantly slower than HC (F(3) = 6.9, p < 0.001, MG v HC: t(45) = -5.1, p < 0.000, LGG v HC: t(33) = -2.2, p = 0.04, HGG v HC: t(34) = -2.9, p = 0.006). Univariate analysis showed no significant difference in signal changes in CEN and DMN (F(3) = 1.66, p = 0.18; F(3) = 1.02, p = 0.39). Multivariate analysis did show significant differences in the distribution of signal changes over the CEN and DMN (CEN: F(27,194) = 1.93, p = 0.006; DMN: F(21,200) = 1.91, p = 0.01). Each patient group showed comparable signal distribution changes in CEN (MG v HC: F(9,37) = 3.61, p = 0.003, LGG v HC: F(9,25) = 3.09, p = 0.01, HGG v HC F(9,26) = 2.14, p = 0.06),and in DMN (MG v HC: F(.7,39) = 2.08, p = 0.07, LGG v HC: F(7,27) = 2.38, p = 0.05, HGG v HC: F(7,28) = 2.45, p = 0.04. Conclusion Our results suggest that meningiomas as well as gliomas, independent of the grade, may disturb normal anticipatory brain activity patterns associated with phasic alertness. These results may reflect a compensatory change in strategy to prepare for a cognitive challenge. Our findings could also play a role in cognitive deficits and mental fatigue as reported by patients with a brain tumor.