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<p>Over the course of the disease, patients with glioblastoma have a&#xa0;high risk of developing cognitive impairment, which significantly affects personal, social, and occupational domains and leads to a&#xa0;significant reduction in quality of life. Cognitive functioning may be impaired by direct tumor-related damage, disruption of neuronal networks, as well as by patient- and treatment-related factors, such as surgery, radiochemotherapy, age or level of education. Neuropsychological monitoring enables the assessment of changes in cognitive functioning over time, the identification of underlying causes, and the formulation of recommendations relevant to daily functioning. It also provides a&#xa0;basis for therapeutic decision-making, particularly in balancing treatment toxicity with the preservation of cognitive functioning. Neuropsychiatric comorbidities such as fatigue, sleep disturbances, depression, and anxiety should be specifically treated, as they can also affect cognitive functioning. In addition, concomitant medication represents a&#xa0;potentially modifiable factor influencing cognitive functioning. Pre- and postoperative cognitive status is an independent predictor of survival, and cognitive decline may serve as an early indicator of tumor progression. Medical decision-making capacity of glioblastoma patients primarily depends on the extent of cognitive impairment. The cognitive functioning and capacity of glioblastoma patients tends to be overestimated by clinicians. Therapeutic approaches for cognitive impairment depend on the underlying cause and include cognitive rehabilitation, which focuses on retraining or compensating for impaired functions and pharmacological interventions. Donepezil and memantine may provide benefits, although current evidence remains limited.</p>

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Kognitive Defizite bei Glioblastompatient:innen

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月28日

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  • Elias Konrath,
  • Stefan Oberndorfer

摘要

Over the course of the disease, patients with glioblastoma have a high risk of developing cognitive impairment, which significantly affects personal, social, and occupational domains and leads to a significant reduction in quality of life. Cognitive functioning may be impaired by direct tumor-related damage, disruption of neuronal networks, as well as by patient- and treatment-related factors, such as surgery, radiochemotherapy, age or level of education. Neuropsychological monitoring enables the assessment of changes in cognitive functioning over time, the identification of underlying causes, and the formulation of recommendations relevant to daily functioning. It also provides a basis for therapeutic decision-making, particularly in balancing treatment toxicity with the preservation of cognitive functioning. Neuropsychiatric comorbidities such as fatigue, sleep disturbances, depression, and anxiety should be specifically treated, as they can also affect cognitive functioning. In addition, concomitant medication represents a potentially modifiable factor influencing cognitive functioning. Pre- and postoperative cognitive status is an independent predictor of survival, and cognitive decline may serve as an early indicator of tumor progression. Medical decision-making capacity of glioblastoma patients primarily depends on the extent of cognitive impairment. The cognitive functioning and capacity of glioblastoma patients tends to be overestimated by clinicians. Therapeutic approaches for cognitive impairment depend on the underlying cause and include cognitive rehabilitation, which focuses on retraining or compensating for impaired functions and pharmacological interventions. Donepezil and memantine may provide benefits, although current evidence remains limited.