Karin Gehring

Karin Gehring
Tilburg University | UVT · Department of Cognitive Neuropsychology

PhD

About

76
Publications
8,783
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1,428
Citations
Additional affiliations
January 2015 - present
Elisabeth-Tweesteden Hospital
Position
  • Researcher
January 2015 - present
Tilburg University
Position
  • Researcher

Publications

Publications (76)
Article
Background Manual segmentation of brain tumors requires expertise, is time-consuming, and is subject to inter-rater variability. Fully automatic brain tumor segmentation is possible for glioma and meningioma when volumetric T1, T1 contrast-enhanced (T1c), T2, and Fluid-attenuated inversion recovery (FLAIR) MRIs are available. In clinical care of me...
Article
Background Protocols for assessment of (neuro)psychological outcomes in lower-grade glioma patients vary between hospitals. This potentially complicates generalization of these outcomes. We compared standardized scores on tests of two frequently impaired cognitive domains (attention and executive functioning (EF)), and two relevant patient-reported...
Article
Background The aim of this study was to assess long-term multidimensional fatigue and (change in) fatigue as predictor for survival in patients with brain metastases (BM) up to 21 months after Gamma Knife radiosurgery (GKRS). Material and Methods Patients with 1 to 10 BM, expected survival >3 months, and Karnofsky Performance Status ≥70 were inclu...
Article
Background Both stereotactic radiosurgery (SRS) and whole brain radiation therapy (WBRT) have proven to be effective treatments for multiple brain metastases (BM) with similar overall survival. Cognition and Radiation (CAR) Study B is a randomized trial on the effect of Gamma Knife radiosurgery (GKRS) or WBRT on cognitive performance in patients wi...
Article
Background In order to assess whether the oncological benefits outweigh the functional risks of treatment for an individual patient, it is important that physicians involve patients in decision-making and personalize the process. This is especially important for brain tumor patients considering the limited treatment options available. The aim of th...
Article
Full-text available
Background: Cognitive training elicits mild-to-moderate improvements in cognitive functioning in people with multiple sclerosis (PwMS), although response heterogeneity limits overall effectiveness. Objective: To identify patient characteristics associated with response and non-response to cognitive training. Methods: Eighty-two PwMS were randomiz...
Article
Full-text available
Survival outcomes for patients with lower grade gliomas (LrGG) continue to improve. However, damage caused both by tumor growth and by the consequences of treatment often leads to significantly impaired cognitive function and quality of life (QoL). While neuropsychological testing is not routine, serial clinical MRIs are standard of care for patien...
Article
Full-text available
Background Evidence-based cognitive rehabilitation programs for brain tumor patients are not widely available, despite the high need. We aimed to evaluate the effects of a tablet-based cognitive rehabilitation program on cognitive performance, cognitive complaints, fatigue, and psychological distress in primary brain tumor patients following neuros...
Article
Full-text available
Purpose: Increasingly more patients with multiple (> 4) brain metastases (BM) are being treated with stereotactic radiosurgery (SRS). Preserving patients' health-related quality of life (HRQoL) is an important treatment goal. The aim of this study was to assess (individual) changes in HRQoL in patients with 1-10 BM over time. Methods: A total of...
Article
BACKGROUND Survival rates have improved in the past years for patients with brain metastases (BMs). OBJECTIVE To evaluate cognitive functioning and health-related quality of life (HRQoL) after Gamma Knife radiosurgery (GKRS) in a relatively large sample of long-term survivors. METHODS Data from 38 long-term survivors (assessments available ≥ 12 m...
Article
Full-text available
Aims Stereotactic radiosurgery is increasingly used to treat multiple (four or more) brain metastases. Preserving cognitive functions is a highly relevant treatment goal because cognitive deteriorations may negatively affect a patient's quality of life. The aim of this study was to assess cognitive change, at the group and individual level, in pati...
Article
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Background Recent studies suggest a relationship between the APOE ε4 allele and cognitive outcome in patients treated for malignant brain tumors. Still, longitudinal investigations that include a pre‐treatment cognitive assessment are lacking and APOE’s effects in patients with benign tumors are understudied. This study investigated pre‐surgical co...
Article
BACKGROUND Patients with lower grade (2 and 3) gliomas (LrGG) are living longer, but often with cognitive impairments from their tumor and treatments. However, cognitive assessments and access to cognitive rehabilitation are not a standard part of care. We present preliminary results of a pilot study investigating feasibility and efficacy of three...
Chapter
Many patients with cancer develop cognitive dysfunction due to their cancer and/or adverse effects of their cancer therapy. Cognitive dysfunction can adversely impact many aspects of patients’ lives including decreasing functional independence, reducing competitive employment, and contributing to role limitations within family and social communitie...
Article
Full-text available
PurposeCognitive functioning is increasingly investigated for its prognostic value in glioblastoma (GBM) patients, but the association of cognitive status during early adjuvant treatment with survival time is unclear. The aim of this study was to determine whether cognitive performance three months after surgical resection predicted survival time,...
Article
Full-text available
Background: Pre- and postoperative cognitive deficits have repeatedly been demonstrated in patients with glioblastoma (GBM). Objective: To identify presurgical risk factors that facilitate the identification of GBM patients at risk for postoperative cognitive impairment. Methods: Patients underwent neuropsychological assessment using Central N...
Article
Full-text available
Purpose A growing number of patients with brain metastases (BM) are being treated with stereotactic radiosurgery (SRS), and the importance of evaluating the impact of SRS on the health-related quality of life (HRQoL) in these patients has been increasingly acknowledged. This systematic review summarizes the current knowledge about the HRQoL of pati...
Article
Full-text available
Background: Patients with glioma often suffer from cognitive deficits. Physical exercise has been effective in ameliorating cognitive deficits in older adults and neurological patients. This pilot randomized controlled trial (RCT) explored the possible impact of an exercise intervention, designed to improve cognitive functioning in glioma patients...
Article
Objective: The authors evaluated the cognitive performance of patients with low-grade glioma (LGG) before and after surgery, and specifically investigated 1) the effects of hemispheric tumor location and 2) the type of surgery (either with or without intraoperative stimulation mapping [ISM]). Methods: Patients underwent neuropsychological assess...
Article
Full-text available
Objective This study aimed to examine: (1) patient–proxy agreement on executive functioning (EF) of patients with primary brain tumors, (2) the relationships between patient- and proxy-report with performance-based measures of EF, and (3) the potential influence of performance-based measures on the level of agreement. Methods Meningioma and low-gr...
Article
Full-text available
Purpose: Information on predictive factors of cognitive functioning in patients with (multiple) brain metastases (BM) selected for radiosurgery may allow for more individual care and may play a role in predicting cognitive outcome after radiosurgery. The aim of this study was to evaluate cognitive performance, and predictors thereof, in patients w...
Article
Full-text available
Purpose Progressive disease in patients with high-grade glioma may be reflected in cognitive decline. However, the cognitive functions most sensitive to progression may differ between patients. We investigated whether decline on a personalized selection of tests predicted progressive disease according to RANO criteria in high-grade glioma patients....
Article
Full-text available
Purpose Fatigue is a common and distressing symptom in cancer patients which negatively affects patients’ daily functioning and health-related quality of life. The aim of this study was to assess multidimensional fatigue in patients with brain metastases (BM) before, and after Gamma Knife radiosurgery (GKRS). Methods Patients with BM, an expected...
Article
Full-text available
Purpose of review: Increased life expectancy in brain tumour patients had led to the need for strategies that preserve and improve cognitive functioning, as many patients suffer from cognitive deficits. The tumour itself, as well as antitumor treatment including surgery, radiotherapy and chemotherapy, supportive treatment and individual patient fa...
Article
OBJECTIVE Patients with nonfunctioning pituitary adenomas (NFPAs) can suffer from cognitive dysfunction. However, the literature on longitudinal cognitive follow-up of patients undergoing endoscopic endonasal transsphenoidal surgery (EETS) is limited. This study was performed to investigate perioperative cognitive status and course in patients with...
Article
Full-text available
Purpose Information on health-related quality of life (HRQoL) of patients with brain metastases (BM) before stereotactic radiosurgery (SRS) is very relevant to improve communication between patients and clinicians and to be able to interpret changes in HRQoL after SRS. The aim of this study was to evaluate the prevalence and severity of complaints...
Article
Full-text available
Background Fatigue is a common symptom in patients with brain tumors, but comprehensive studies on fatigue in patients with meningioma specifically are lacking. This study examined the prevalence and correlates of fatigue in meningioma patients. Methods Patients with grade I meningioma completed the Multidimensional Fatigue Inventory (MFI-20) befo...
Article
Full-text available
Objective Although meningioma patients show deficits in objective cognitive functioning (OCF) measured with neuropsychological tests, subjective cognitive functioning (SCF) has received little attention. We investigate SCF from pre‐ to post‐surgery and its associations with OCF, psychological, sociodemographic, and clinical characteristics. Method...
Article
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Introduction Many patients with brain cancer experience cognitive problems. In this narrative review, we comprehensively evaluated empirical studies on various intervention approaches for cognitive problems in these patients. Methods Intervention studies that reported effects on cognitive functioning (either objectively tested or subjectively repo...
Article
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Background Meningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients. Methods Patients underwent neuropsychological assessment (NP...
Article
Background: Meningioma patients are known to face cognitive deficits before and after surgery. We examined individual changes in cognitive performance over time and identified preoperative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients. Methods: Patients underwent neuropsychological assessmen...
Article
Objective: The majority of meningioma patients suffer from presurgical cognitive deficits. Since meningiomas do not directly damage the brain, this is presumably caused by a functional integrity reduction of the surrounding brain tissue through perilesional edema and/or mass effect of the tumor. Tumor location is a key feature in determining neuro...
Article
OBJECTIVE To assess feasibility and effect on cognitive function and Health-Related Quality of Life (HRQoL) of an iPad-based intervention in grade 2 and 3 glioma patients stable off treatment. Patients with lower grade glioma suffer significant cognitive dysfunctions that impact their HRQoL. Formal cognitive rehabilitation is a limited resource tha...
Article
Background Cognitive dysfunction in patients with non-functioning pituitary adenoma (NFPA) primarily pertains to memory and executive functioning. Current literature is comprised of studies employing dissimilar methodological approaches and there is little prospective research using standardized cognitive function measures before and after surgical...
Article
Background Meningioma patients are faced with deficits in several cognitive domains before and after surgery. We examined individual changes in cognitive performance over time and identified pre-operative predictors of cognitive functioning 12 months after surgery in a large sample of meningioma patients. Material and Methods Patients underwent ne...
Poster
BACKGROUND Monitoring of symptoms and quality of life in patients with primary brain tumors is increasingly being supported with information of informal caregivers, but research on patient-proxy agreement is limited. In this study, the level of agreement between patient-report and patient-by proxy-report of executive functioning was evaluated. MAT...
Article
Full-text available
Purpose Stereotactic radiation surgery (SRS) is increasingly applied in patients with brain metastases (BM) and is expected to have fewer adverse effects on cognitive functioning than whole brain radiation therapy (WBRT). Patients with BM are often confronted with a relatively short life expectancy, and the prevention or delay of cognitive decline...
Article
This study examined test-retest reliabilities and (predictors of) practice effects of the widely used computerized neuropsychological battery CNS Vital Signs. The sample consisted of 158 Dutch healthy adults. At 3 and 12 months follow-up, 131 and 77 participants were retested. Results revealed low to high test–retest reliability coefficients for CN...
Article
Full-text available
Background: Many patients with primary brain tumors suffer from cognitive deficits, which negatively impact their quality of life. However, cognitive rehabilitation programs for these patients are scarce. We developed an iPad-based cognitive rehabilitation program for brain tumor patients, which was based on our effective face-to-face cognitive re...
Article
Full-text available
Object: There is a growing interest to include evaluations of cognitive performance in the clinical management of patients with Glioblastoma (GBM). However, as changes in cognitive performance of a group may mask changes in individual patients, study results are often difficult to transfer into clinical practice. We focused on the comparison of gr...
Article
Full-text available
Many patients with primary brain tumors experience cognitive deficits. Cognitive rehabilitation programs focus on alleviating these deficits, but availability of such programs is limited. Our large randomized controlled trial (RCT) demonstrated positive effects of the cognitive rehabilitation program developed by our group. We converted the program...
Article
Full-text available
Background: Gamma Knife radiosurgery (GKRS) is increasingly applied in patients with multiple brain metastases and is expected to have less adverse effects in cognitive functioning than whole brain radiation therapy (WBRT). Effective treatment with the least negative cognitive side effects is increasingly becoming important, as more patients with...
Article
Full-text available
Introduction: Central Nervous System Vital Signs (CNS VS) is a computerized neuropsychological battery that is translated into many languages. However, published CNS VS' normative data were established over a decade ago, are solely age-corrected, and collected in an American population only. Method: Mean performance of healthy Dutch participants...
Article
Full-text available
Objective: In this pilot study, we investigated the feasibility of a home-based, remotely guided exercise intervention for patients with gliomas. Design: Pilot randomized controlled trial (RCT) with randomization (2:1) to exercise or control group. Subjects: Patients with stable grade II and III gliomas. Intervention: The six-month intervent...
Conference Paper
Full-text available
INTRODUCTION: Fatigue is a common symptom in patients with primary brain tumors and may have major impact on quality of life. However, little research has been done on fatigue in patients with a meningioma. The primary aim of this study was to examine the prevalence and severity of fatigue among patients with a meningioma one year after neurosurger...
Article
Full-text available
This systematic review evaluates relevant findings and methodologic aspects of studies on cognitive functioning in meningioma patients prior to and/or following surgery with or without adjuvant radiotherapy. PubMed and Web of Science electronic databases were searched until December 2015. From 1012 initially identified articles, 11 met the inclusio...
Article
Full-text available
BACKGROUND: Physical exercise (PE) has proven effective in ameliorating cognitive deficits in older adults and select neurological patient populations. This pilot RCT investigates a PE program for improving cognitive deficits in glioma patients. METHODS: Patients with stable grades II/III glioma were randomized 2:1 to a home-based PE group or a con...
Article
Studies in cancer and noncancer populations demonstrate lower than expected correlations between subjective cognitive symptoms and cognitive functioning as determined by standardized neuropsychological tests. This paper systematically examines the association between subjective and objective cognitive functioning in patients with low-grade glioma a...
Article
Cognitive deficits are common in people who have received cranial irradiation and have a serious impact on daily functioning and quality of life. The benefit of pharmacological and non-pharmacological treatment of cognitive deficits in this population is unclear. To assess the effectiveness of interventions for preventing or ameliorating cognitive...
Article
Cognitive dysfunction is common in patients with primary brain tumors, and may have a major impact on activities of daily living and on quality of life. This is the first prospective study that investigated the incidence and severity of cognitive dysfunction in meningioma patients before and after surgery, and the change in dysfunction over time, b...
Article
Cognitive dysfunction is common in patients with primary brain tumors, and may have a major impact on activities of daily living and on quality of life. This is the first prospective study that investigated the incidence and severity of cognitive dysfunction in meningioma patients before and after surgery, and the change in dysfunction over time, b...
Article
Full-text available
Many patients with gliomas suffer from cognitive deficits. Recent findings indicate that physical exercise is effective in ameliorating cognitive decline, in particular in older adults and select neurological patient populations. Studies of exercise interventions in patients with cancer demonstrated to have beneficial effects on various measures of...
Article
This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness of interventions for preventing or ameliorating cognitive deficits in adult patients previously treated with cranial irradiation, or during treatment with cranial irradiation.
Poster
Full-text available
A significant proportion of brain tumour patients has cognitive impairments. Most studies have focussed on patients with glioma. Meningioma patients have been infrequently studied; we found only seven studies in the literature. Most of these studies lack preoperative measurements, a priori limiting conclusions on the impact of surgery on cognition....
Article
Previous studies showed that advanced neuroimaging measures (functional MRI, diffusion tensor imaging) could distinguish multiple sclerosis (MS) patients with and without cognitive impairment. Are these measures indeed better indicators for cognitive impairment or subjective cognitive complaints than conventional MRI? Fifty MS patients and 29 contr...
Article
Full-text available
Research has demonstrated that patients with cancer experience cognitive deficits, often due to aggressive anticancer treatments. In this article, we critically review the interventional studies that have been conducted to investigate beneficial effects on cognitive function in cancer patients. Pharmacological agents that have been studied include...
Conference Paper
Full-text available
OBJECTIVE: Our objective was to show the neuropsychological findings in patients with NSMD before and after neurosurgical treatment at INCan during 2009-2010. MATERIAL AND METHODS: Eleven patients with NSMD underwent neurosurgical metastasectomy. Preoperative and postoperative neuropsychological assessments were performed. Also, RTOG prognostic fac...
Article
Limited research is available regarding the efficacy of psychostimulants in treating cognitive function in primary brain tumor patients. An open-label, randomized, pilot trial examined both the general and differential efficacy of 4 weeks of methylphenidate (MPH) and modafinil (MOD) in 24 brain tumor patients. Participants completed cognitive tests...
Article
Full-text available
Unlabelled: This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is cognitive rehabilitation. Background: There is a paucity of literature on the...
Article
Predictors of Neuropsychological Improvement Following Cognitive Rehabilitation in Patients with Gliomas—Erratum - Volume 17 Issue 2 - Karin Gehring, Neil K. Aaronson, Chad M. Gundy, Martin J.B. Taphoorn, Margriet M. Sitskoorn