Depressive symptoms and executive function in relation to survival in patients with glioblastoma

Abstract

Introduction: Depression and neurocognitive function, particularly executive functioning (EF), have been associated with overall survival (OS) in patients with glioblastoma (GBM). However, the combined effect of depressive symptoms and impaired EF upon OS has not been reported. Methods: Patients with GBM (N = 102) completed neuropsychological assessment postoperatively, including the Beck Depression Inventory-Second Edition (BDI-II) and the Trail Making Test Part B (TMTB). Median splits were used to determine cut-points denoting elevated depressive symptoms on the BDI-II and impaired EF on TMTB. Patients were stratified into four groups: low depressive symptoms/low EF impairment (− Dep/− Imp; N = 23), high depressive symptoms/low EF impairment (+ Dep/− Imp; N = 28), low depressive symptoms/high EF impairment (− Dep/+Imp; N = 28), and high depressive symptoms/high EF impairment (+ Dep/+Imp; N = 23). The Kaplan–Meier method, log-rank test, and Cox regression were used to examine differences in survival between groups. Results: Relative to − Dep/− Imp patients (median OS = 22.8 months), median OS in all other patient groups was shorter (+ Dep/− Imp OS = 16.6; − Dep/+Imp OS = 14.8; +Dep/+Imp OS = 10.8; all p