A randomized controlled trial of a telehealth group cognitive intervention (LaTCH-BRAINS) to improve cognition after primary brain tumor diagnosis.

BACKGROUND

Cognitive changes are common following primary brain tumor (PBT), impacting employment, independence, relationships, and quality of life (QoL). Despite this, tailored cognitive interventions are unavailable within Australia. The La Trobe and Caulfield Hospital (LaTCH) group cognitive rehabilitation program has demonstrated efficacy for older adults without PBT. Efficacy for people with PBT was examined using a telehealth adaption of LaTCH.

METHODS

A Type 1 hybrid-implementation design randomized controlled trial (RCT) with waitlist control (WLC) was used. Adults > 3-months post-PBT diagnosis, and > 1-month post-radiation were randomized to (1) Intervention [6-week group sessions; 2 hours/week], delivered over Zoom (n = 3-7/group) or (2) WLC (intervention offered at 16 weeks). Primary outcomes were self-perceived memory (ability, strategy knowledge and use, satisfaction) and general cognitive function; secondary outcomes included QoL, fatigue, mood, and objective cognition (attention, working memory, processing speed, memory, executive function). Linear mixed models analyzed between-group differences post-intervention and 6 weeks later (maintenance).

RESULTS

Sixty participants (M(SD) age = 49.0 (10.4) years, 57% female, 55% high-grade glioma) were randomized (29 intervention, 31 WLC). The intervention group reported significantly improved perceived memory ability, satisfaction, strategy use, and strategy knowledge. Effect sizes were moderate-large (ηp2 0.06-0.21), and maintained for memory ability (t = 4.26, P < .001, ηp2 = 0.18), satisfaction (t = 2.23, P = .028, ηp2 = 0.18), and strategy knowledge (t = 2.92, P = .004, ηp2 = 0.09). Secondary outcomes exhibited no intervention effect.

CONCLUSIONS

Telehealth-delivered LaTCH-BRAINS improved subjective memory-related outcomes for people with PBT, demonstrating promise as a cognitive rehabilitation approach for people with PBT reporting memory decline.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN 12622000189729p), registered on 03/02/2022 (Appendix A).