Cognitive and social functions of craniopharyngioma and germ cell tumor differ in patients with and without apathy

Abstract

Aim: Apathy, the quantitative reduction of self-generated voluntary and purposeful behaviors, can affect social functions in patients with acquired brain injury. However, how apathy impairs social life in patients with craniopharyngioma and germ cell tumor (diencephalon tumor) remains unclear. Therefore, this study investigated patients with diencephalon tumors to assess the impact of apathy on their neurocognitive, social cognitive, and social functions. Methods: Patients with diencephalon tumors treated at Kyoto University Hospital were enrolled in this observational study. Apathy was assessed using the Apathy Scale, while neurocognitive functions were evaluated using the Wechsler Adult Intelligence Scale-IV (WAIS-IV), Wechsler Memory Scale-Revised (WMS-R), and Behavioural Assessment of the Dysexecutive Syndrome. Social cognitive functions were evaluated by means of an emotion perception task and a theory of mind (ToM) task. Finally, social functions were evaluated using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, where a high score indicates greater functioning difficulties experienced. Results: Apathy was observed in 11 (45.8%) of 24 patients (15 males), with a mean (standard deviation) age of 35.83 (14.79) years. Patients with apathy scored significantly lower on the Verbal Comprehension Index (WAIS-IV), Working Memory Index (WAIS-IV), Attention (WMS-R), and ToM task than those without apathy (P = 0.03, 0.04, 0.01, and 0.046, respectively). Further, they scored significantly higher on the WHODAS 2.0 than patients without apathy. Conclusion: Apathy manifests as a neuropsychological complication and affects social functions in patients with diencephalon tumors. Effective interventions for apathy may ameliorate the social dysfunctions of patients with diencephalon tumors.