Filling the Gap: brief neuropsychological assessment protocol in glioma patients undergoing awake surgeries

Purpose: To evaluate the feasibility of applying a concise cognitive assessment protocol - Ohy-Maldaun Fast Track Cognitive Test (OMFTCT) and to compare it with the Boston Naming Test (BNT). This study aims to address the demand for a streamlined neurocognitive assessment in clinical practice. Methods: This is a prospective longitudinal observational clinical study conducted on a cohort of 50 glioma patients eligible for awake craniotomies. The proposed protocol assesses multiple cognitive domains, including language, short-term verbal and visual memories, working memory, praxis, executive functions, and calculation ability. The protocol comprises ten different subtests, with a maximum score of 50 points and was applied at three time points: preoperative, immediate postoperative period and 30 days after surgery. Results: Among the initial 50 patients enrolled, 36 underwent assessment at all three designated time points. The mean age of patients was 45.3 years, with an average of 15 years of education. Predominant tumor types included Glioblastoma, IDH-wt (44.1%), and diffuse astrocytoma, IDH-mutant (41.2%). Tumors were mainly located in the left temporal lobe (27.8%), followed by the left frontal lobe (25%). The full test had an average completion time of 23 minutes. Findings revealed a moderate correlation (r=0.6) and statistical significance (p=0.02) between the OMFTCT protocol and the BNT short version, with the proposed protocol also detecting additional deficits in visual memory. Conclusion: OMFTCT provided preoperative and postoperative assessment of different cognitive domains, enabling precise planning of intraoperative cognitive testing. Additionally, immediate diagnosis of neurocognitive deficits played a crucial role in optimizing patient care.