Molecular determinants of neurocognitive deficits in glioma: based on 2021 WHO classification

Abstract Purpose Cognitive impairment is a common feature among patients with diffuse glioma. This study aimed to investigate the relationship between cognitive function and clinical and molecular factors under the new 2021 WHO classification of tumors of the central nervous system (CNS 5). Methods A total of 110 patients with diffuse glioma were enrolled and underwent preoperative cognitive assessments using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Clinical information was collected from medical records, and gene sequencing was performed to analyze 18 most influenced gene alterations. The differences in cognitive function between patients with and without glioblastoma were compared under both CNS 4 and CNS 5 to assess the effect of differentiation on cognition. Results The study found that age, tumor location, and glioblastoma had significant differences on cognitive function. Several genetic alterations were significantly correlated with cognition. For most focused genes, patients with a low number of genetic alterations tended to have better cognitive function. Conclusion Our study suggested that, in addition to general clinical characteristics such as age, histological type and tumor location, the molecular characteristics of glioma play a crucial role in cognitive function. Further research into the mechanisms by which tumors affect brain function is expected to enhance the quality of life for glioma patients. The findings of this study highlight the importance of considering both clinical and molecular factors in the management of glioma patients to improve cognitive outcomes.