Constructional Apraxia in Elderly Patients with Brain Tumors: Considerations with an Up To Date Review of the Literature.

Constructional Apraxia in Elderly Patients with Brain Tumors: Considerations with an Up To Date Review of the Literature.

World Neurosurg. 2018 Mar 30;:

Authors: Fornara GA, Di Cristofori A, Bertani GA, Carrabba G, Zarino B

Abstract
BACKGROUND: Constructional apraxia (CA) is a neuropsychological impairment of either basic perceptual and motor abilities, or executive functions, in absence of any kind of motor or perceptual deficit. Considering patients with focal brain tumors, CA is common in left or right parietal and parieto-occipital lesions. In neuropsychology, Rey-Osterrieth Complex Figure test (ROCF) (or parallel forms) is commonly used for the assessment of CA. This study stems from a clinical observation of a difficulty with CA tests for the majority of neurosurgical elderly patients without occipito-parietal lesions.
METHODS: Patients were tested at three different time-points (presurgically, 3 months after surgery, and 12 months after surgery). Thirty patients (15 meningiomas and 15 glioblastomas) were retrospectively studied.
RESULTS: results showed that elderly patients with focal brain lesions, regardless of the nature of the tumor, performed very poorly at CA tests: more than 50% of patients obtained pathological results at all the three time-points considered.
CONCLUSIONS: our findings suggest that CA abilities in neurosurgical elderly patients are fragile and eventually compromised already before surgery, and do not improve with time, no matter the nature of the lesion (malignant vs benign). We speculate that even focal brain tumor may cause a global cognitive deficit and that complex tests which involve multiple domains, such as the ROCF, may be influenced by this general impairment, without a specific correlation to the side and site of the lesion, resulting a too difficult task to cope with.

PMID: 29609083 [PubMed - as supplied by publisher]

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