Neurocognitive decline (NCD) is a significant concern for patients with brain metastases, yet traditional paper-based assessments are often burdensome. This prospective cohort study evaluated the feasibility and outcomes of a tablet-based digital neurocognitive battery in patients with prior stereotactic radiosurgery (SRS). Data were analyzed from an institutional prospective registry (NCT05504681) including 41 adults with prior SRS. Patients were stratified into a high-risk group (undergoing repeat SRS for progression) and a low-risk group (surveillance only). Neurocognitive function was assessed using the “Cognition” tablet-based platform. NCD was defined as significant deterioration in at least 1 test at 3 months using the Reliable Change Index. The median age was 66 years, and 46% of assessments were conducted in Spanish. Learning and memory were the most frequently affected domains (32%). At 3 months, NCD rates were significantly higher in the high-risk cohort (76%) compared to the low-risk cohort (40%; p = 0.019). On multivariable analysis, risk group status was the only independent predictor of NCD (p = 0.030). Patient feedback indicated high satisfaction and usability. Digital neurocognitive assessment is a feasible and sensitive tool for monitoring patients with brain metastases. The platform effectively differentiated between patients undergoing repeat SRS and those under surveillance, underscoring the importance of routine cognitive monitoring.
Akdemir et al. (Tue,) studied this question.