Self- and informant-reported cognitive concerns associated with primary brain tumour: systematic review

People with primary brain tumour (PBT) experience objective cognitive impairment, but subjective cognitive concerns have received less attention. This review sought to determine the type of self- and informant-reported cognitive concerns following PBT and to ascertain if they vary according to patient, tumour and/or treatment characteristics. Further objectives were to determine whether subjective reports aligned with objective findings or informant reports.

Literature searches were conducted using PsycINFO and Medline, limited to English-language and full-text format. Studies focusing on non-PBTs, objective cognition without subjective reports, or paediatric PBT were excluded.

Eleven studies were included, representing the cognitive concerns of 957 PBT participants, with varying tumour types/treatment, and ranging from pre-surgery to an average of 5 years post-diagnosis. Subjective concerns regarding global perceived cognitive impairment, language, memory, executive function, and attention were common, but change in processing speed, visual function, and reading/spelling were also reported. Few studies investigated factors impacting subjective cognition, but there was some suggestion that left-lateralised and larger tumours resulted in more subjective concerns. The alignment between objective and subjective cognition varied, ranging from strong to weak, whereas the overlap between patient and informant reports was robust.

Identifying the alignment between patient and informant reports is of significant benefit when considering treatment interventions and outcomes for people with PBT, particularly in instances where they may not be able to report their cognitive concerns. Overall, the importance of the patient perspective was highlighted, which can often be replaced by objective measures in clinical research.