6th Annual Brain Tumor Conference: Effects of Brain Tumors on Cognition, Mood and Behavior

The Effects of Brain Tumors on Cognition, Mood and Behavior
Dr. Thomas A. Kaleita, Neuropsychologist @ Dept. of Psychiatry UCLA

Symptoms
Fatigue and decreased stamina
Excessive sleepiness (often sleep 8+ hours)
Decreased alertness
Neurobehavioral dysfunction
- Attention
o Foundation for higher cortical functions
o Deficits appear as impaired ability regardless of intention
o Deficits can affect memory, language, executive functions, motor coordination and behavior
o Primary brain ability affected by malignant diseases and treatments
o Types of attention
* Focused
* Sustained (concentration over a period of time)
* Divided
* shifting
- memory
o differentiated theoretically from attention, but difficult at times to separate in observed behaviors
o capacity to retain info and utilize it for adaptive purposes
o verbal and nonverbal domains
o type and severity of deficits highly dependent on age
o memory abilities most often affect by tumor/treatment
* word finding/naming
* working memory (remembering phone numbers long enough to use it)
* retention of new info
* episodic memory (what happened earlier in the day, yesterday…)
- psychomotor speed (how fast brain processes information)
o often underlies attentional deficits
o may interact with physical impairments (i.e. visual perceptual difficulties)
o visual spatial and visual motor activities most commonly affected by deficits
o neurologic impairment differentiated from developmental or aging effects
o slowing a primary symptom of depression
* major depressive disorder
* 3% in US population
* 4-9% in studies of cancer patients
* 28% in brain tumor patients
* symptoms: major depression DSM IV
* sleep disorder
o difficulty falling asleep 52%
o continuity disturbance 41%
o early morning awakening 32%
o Modafinil (Provigil) - help alertness
* FDA-approved for narcolepsy, shift changes in employment and other sleep disorders
* Used to treat fatigue in multiple sclerosis
* Used to maintain performance by armed forces under sleep deprivation conditions
* Side effects: possible headache, nausea, dizziness, may have reaction with Dilantin
* concentration problem
* motor slowing
* weight change
* energy loss
* * sadness
* * diminished interest in activities
* guilt
* death ruminations
- other brain abilities - frontal, temporal, parietal, ,occipital, hypothalamic/pituitary regions