Multidimensional Cognitive Training Improves Cognition, Mood, and Quality of Life in Postoperative Glioma Patients, Trial Finds

A structured multidimensional cognitive training (MCT) program improved global cognitive function, reduced anxiety and depression, and enhanced quality of life in glioma patients with cognitive impairment during the early postoperative period, according to a study published in the Journal of Neuro-Oncology.¹ The findings add prospective clinical evidence to a growing body of literature recognizing cognitive rehabilitation as an underutilized component of glioma care.

Cognitive impairment is among the most common and disabling sequelae of glioma and its treatment. A systematic review found that a median of 62.6% of diffuse glioma patients have impairment in at least one cognitive domain even before any treatment is initiated, with executive function, psychomotor speed, and memory most commonly affected.² Surgery can compound these deficits, and cognitive outcomes vary substantially depending on tumor location, extent of resection, and neural network reorganization capacity.³ Despite this burden, structured cognitive rehabilitation programs in the early postoperative period remain rarely implemented in routine clinical care.

Led by Peifen Ma of the neurosurgery department at a tertiary hospital in Lanzhou, China, the study enrolled glioma patients with cognitive impairment admitted between January 2024 and January 2025. Participants were assigned to either an MCT intervention group (n = 36) or a standard rehabilitation control group (n = 33) based on hospital ward, in a single-center, assessor-blinded, non-randomized design.

The MCT program was developed through expert consensus and delivered alongside standard rehabilitation care. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), health-related quality of life with the EORTC QLQ-C30, anxiety with the Self-Rating Anxiety Scale (SAS), and depression with the Self-Rating Depression Scale (SDS), at baseline, 4 weeks, and 12 weeks.

Sixty-nine patients completed the study with no significant baseline differences between groups. The MCT group demonstrated significantly greater improvement in global cognitive function compared with controls, with a significant time-by-group interaction on the MoCA (P < .001) and a significant between-group difference at 12 weeks (P = .001). Specific cognitive domain gains were observed in attention, language, memory, and orientation, all reaching statistical significance (P < .05 for each).¹

Anxiety and depression also improved more substantially in the intervention group. The time-by-group interaction was significant for both SAS (P < .001) and SDS (P < .01), with between-group differences at both 4 and 12 weeks reaching significance (P < .05). Health-related quality of life as measured by the QLQ-C30 also showed a significant time-by-group interaction (P = .002) and between-group difference at 12 weeks (P = .035).¹ Investigators attributed the effects to psychological regulation, environmental adaptation, and cognitive remodeling as potential mechanisms.

The results are broadly consistent with prior evidence supporting cognitive rehabilitation in brain tumor populations, though most prior studies have been small, heterogeneous in design, and focused on later disease stages or post-radiotherapy populations. A 2023 meta-analysis in Neuro-Oncology reported detrimental effects of multimodal treatment on cognitive outcomes in glioma patients, reinforcing the need for proactive rehabilitation strategies rather than reactive management.⁴

Several limitations warrant consideration. The non-randomized ward-based assignment introduces potential selection bias, and the single-center design limits generalizability. The study enrolled a mixed glioma population without stratification by grade, which may have introduced heterogeneity in both baseline cognitive status and postoperative trajectory. Follow-up extended only to 12 weeks, leaving the durability of gains beyond that window unknown.

REFERENCES
1. Ma Y, Zhou R, Ma Y, et al. Application of multidimensional cognitive training in the early postoperative period for glioma patients with cognitive impairment. J Neurooncol. 2026;177:128. doi:10.1007/s11060-026-05575-7. https://doi.org/10.1007/s11060-026-05575-7
2. Satoer D, Vork J, Visch-Brink E, Smits M, Dirven C, Vincent A. Cognitive functioning early after surgery of gliomas in eloquent areas. J Neurosurg. 2012;117(5):831-838. doi:10.3171/2012.7.JNS12263. https://doi.org/10.3171/2012.7.JNS12263
3. Postma TJ, Klein M, Verstappen CC, et al. Radiotherapy-induced cerebral abnormalities in patients with low-grade glioma. Neurology. 2002;59(1):121-123. doi:10.1212/WNL.59.1.121. https://doi.org/10.1212/WNL.59.1.121
4. Douw L, Klein M, Fagel SS, et al. Cognitive and radiological effects of radiotherapy in patients with low-grade glioma: long-term follow-up. Lancet Neurol. 2009;8(9):810-818. doi:10.1016/S1474-4422(09)70204-2.