Neuro-Oncology Cognition Measurement and Treatment
Cognitive skills can be measured using special tests to determine if someone has problems with thinking, emotions or behavior. The test results can help identify appropriate treatments to optimize the person’s cognitive functions. During an initial (baseline) evaluation, tests can be done to measure:
- Mental processing speed (quickness in thinking)
- Language skills
- Executive functions (problem-solving, planning and organization skills)
- Visual/spatial functions
- Motor skills (the movement of muscles in the body such as moving the arms, hands, legs or feet)
- Emotional functioning
- Overall quality of life
Testing is also done to assess emotional problems a person may be experiencing, as well as his or her overall quality of life. The total evaluation lasts about one and a half hours, followed by an interview of the patient and family.
The same tests are conducted at follow-up visits at three, six, nine and 12 months. The tests are very sensitive, allowing David Sabsevitz, PhD to detect any changes that may have occurred between visits.
Testing will indicate if a person is experiencing cognitive/behavioral/emotional changes, the types of changes and the severity.
Treatment for Cognitive Issues
Depending on the type of cognitive change a person experiences and the cause, different treatments are available. Medication, modifications in behavior, and lifestyle adjustments may be recommended to help with these issues.
Treatments may include:
- Medication — various drugs may be prescribed to treat problems with attention, fatigue, memory and mood/anxiety.
- Cognitive rehabilitation — a comprehensive approach to restoring cognitive skills by “retraining the brain.” Cognitive rehabilitation consists of exercises designed to help people relearn specific mental skills, replace lost cognitive functions with new skills and optimize control over emotions. Patients learn strategies to minimize or work around their cognitive problem. Treatment is individualized for each person, and family members are part of the rehabilitation program. A cognitive rehabilitation therapist provides cognitive therapy, and a speech therapist helps patients who have language problems.
- Cognitive training, part of a cognitive rehabilitation program, is therapy aimed at improving or restoring a person's cognitive skills, such as remembering, paying attention, reasoning/understanding, organizing, problem-solving and decision-making. Patients learn ways to minimize or compensate for cognitive changes they have experienced.
- Psychotherapy and/or supportive counseling — professional therapy and supportive counseling can help cancer patients cope with a variety of emotional issues. Family therapy is also available.
- Patient and family education — Medical College of Wisconsin neuropsychologist David Sabsevitz, PhD, spends time educating patients about their specific cognitive problems and treatment options. Patients often feel “validated” when they learn there’s a medical reason for their cognitive problems and their concerns are not imagined. He also educates family members about the cognitive changes their loved one is facing and ways they can help to minimize problems.
Treatment recommendations are made based on each person’s specific needs, and treatment options are discussed with each patient’s referring physician and Medical College of Wisconsin team members involved in the patient’s care.