The Assessments Of Preoperative Cognitive Function In Patients With Glioma By Loewenstein Occupational Therapy Cognitive Assessment-Second Edition

Objective:To assess the preoperative cognitive function in patients with glioma by Loewenstein Occupational Therapy Cognitive Assessment-Second Edition. And analyze the factors of the preoperative cognitive function in patients with glioma.Methods:A completely randomized controlled trial. Based on the inclusion and exclusion criteria, select 36 patients with glioma before surgury in the First Affiliated Hospital of Kunming Medical University Neurosurgery in the period of May 2015 to March 2016 as the case group,and were select 42 healthy people matched age, gender, education level with the case group from the patients’ families, care workers, medical staffs as healthy controls group. The LOTCA-Ⅱ English version will be translated into Chinese,and used to evaluating cognitive function of glioma case group and healthy controls group, then calculates the total score of each subject, each sub-project and secondary component score. Analysis whether glioma cases group and healthy controls group is different. Then the case group according to pathological levels, different parts of the lesions, the left and right side of the lesion, lesion size packet, to explore whether there are differences in cognitive function in patients with glioma.Finally, analyze the impact factors on cognitive function in patients with glioma such as age, gender, education, epilepsy and antiepileptics, etc.Results:1,The glioma case group scored lower than the heaithy controls group in the total score of LOTCA-Ⅱ, subprojects including orientation, motor praxis, visuomotro organization, thinking operations, attention and concentration and the secondary components including orientation for time, copy geometric forms, colored block-design,plain biock-design, reproduction of a puzzle, drawing a clock, categorization, Riska objection classification structured, pictorial sequence B,geometrical sequence, logical questions (P<0.05).2, The frontal glioma case group scored lower than the heaithy controls group in LOTCA-Ⅱ scores, subprojects including visuomotro organization, thinking operations, attention and concentration,the temporal lobe glioma case group scored lower than the heaithy controls group in LOTCA-Ⅱ scores, subprojects including orientation, thinking operations, attention and concentration. The statistically difference is not significant in the total score of LOTCA-Ⅱ and each subproject between the left sides glioma case group and the right sides glioma case group. The high-grade glioma case group scored lower than the low-grade glioma case group in the total score of LOTCA-Ⅱ, subprojects including orientation, visual perception, spatial perception, visuomotro organization, attention and concentration.The large lesion glioma case group scored lower than the heaithy controls group in LOTCA-Ⅱ scores, subprojects including orientation, motor praxis, visuomotro organization, thinking operations, attention and concentration, the small lesion glioma case group scored lower than the heaithy controls group in LOTCA-Ⅱ scores, thinking operations, the large lesion glioma case group scored lower than the small lesion glioma case group in orientation, attention and concentration.3, The Spearman correlation analysis showed that preoperative cognitive function in patients with glioma is related to age, education level (P<0.05), irrelevant to gender, epilepsy, antiepileptic drugs (P> 0.05).Conclusions:1.The patients with glioma have cognitive impairment before surgery, including orientation, motor praxis, visuomotro organization, thinking operations, attention and concentration.2. Different parts of glioma patients have their own characteristics in cognitive impairment before surgery.3. The statistically difference is not significant in cognitive impairment between the patients with left sides glioma or right sides glioma.4.Cognitive impairment in the patient with a high-grade glioma is broader, more seriously than the patient with a low-grade glioma.5. Cognitive impairment in the patient with a large lesion glioma is more obvious than a small lesion glioma.6. The preoperative cognitive function in patients with glioma is relevant to age, education level and irrelevant to gender, epilepsy.