Profil Gangguan Kognitif pada Tumor Intrakranial Primer dan Metastasis

Gangguan kognitif sering menyertai pasien tumor intrakranial dan menjadi penyebab utama disabilitas. Perbedaan patofisiologi tumor intrakranial primer (TIP) dan metastasis (TM) menyebabkan perbedaan gambaran klinis dan derajat  gangguan kognitif. Tujuan penelitian ini untuk mengetahui prevalensi dan profil gangguan kognitif pasien TIP dan TM. Disain penelitian potong-lintang retrospektif menggunakan data sekunder dari Poliklinik Saraf RSCM pada bulan Januari 2011-Desember 2013. Subjek berusia 18-65 tahun yang didiagnosis TIP dan TM berdasarkan anamnesis, pemeriksaan fisik, CT scan atau MRI kepala, dan atau histopatologi. Terdapat 121 subjek, 79 TIP dan 27 TM; usia rerata TIP 43,7 tahun dan TM 50,9 tahun. Pada kelompok TM mayoritas (40,7%) memiliki lesi di kedua hemisfer sedangkan TIP hanya di satu hemisfer. Lokasi tumor pada TM lebih dari 1 lobus (51,9%). Gangguan kognitif lebih banyak pada TM (81,5%) dibandingkan TIK (52,5%) dengan domain tersering gangguan visuospasial. Subjek TM mengalami gangguan kognitif lebih berat dibandingkan TIP (rerata MMSE 20,96 dan 22,61). Gangguan kognitif lebih banyak pada kelompok TM dibandingkan TIP dengan gangguan kognitif lebih berat karena mayoritas lesi tumor mengenai lebih dari 1 lobus. Kata kunci: gangguan kognitif, tumor intrakranial, neuro-onkologi.   Cognitve Impairment in Primary and Metastatic Brain Tumors Abstract Brain tumor patients are often accompanied by a wide range of cognitive impairment as a major cause of disablility. The different pathophysiology of primary and metastatic brain tumor influences patients’ clinical signs and symptoms, and also the severity of cognitive impairment. To determine the prevalence and profile of cognitive impairment in patients with primary and metastatic brain tumors, this cross-sectional study was done on subjects of 18 to 65 years old with the diagnosis of primary and metastatic brain tumors based on anamnesis, physical examination, imaging modalities, and/or histopathology results. Subjects underwent cognitive and neuropsychology assessment in Neurology Outpatient Clinics, Cipto Mangunkusumo Hospital, from January 2011 to December 2013. From 121 subjects, 79 were primary and 27 were metastatic brain tumor patients. The metastatic tumor group mean of age were older than the primary tumor group (50,9 and 43,7 years respectively). In metastatic group, majority of subjects had bilateral lesion (40,7%) and localized in more than 1 lobe (51,9%), compared to primary tumor who had single lobe and one hemispheric lesion. Cognitive impairment was mostly found in metastatic brain tumor group (81,5%) rather than primary (52,5%) and also more severe in metastatic group (MMSE mean 20,96 and 22,61 respectively) with visuospatial impairment as the most common disorder. Cognitive impairment was much higher in metastatic brain tumor compared to primary brain tumor, with more severe degree of cognitive impairment because majority of lesion affected more than 1 lobe. Keywords: cognitive impairment, brain tumors, neuro-oncolog