A - 142 Exploratory Analysis of the Cognitive Outcomes of Cognitive Behavioral Therapy for Insomnia (CBT-I) in Patients with Primary Brain Tumor

Abstract Objective Patients with primary brain tumor (PBT) experience declines in cognitive functioning and frequently endorse sleep disturbance. Our single-arm proof-of-concept trial of Cognitive Behavioral Therapy for Insomnia (CBT-I) in patients with PBT demonstrated clinically significant improvements in self-reported insomnia symptoms. The present study explored changes in patients’ subjective and objective cognitive functioning following completion of the six-week CBT-I intervention. Methods Participants with PBT and clinical insomnia (N = 35; Mage = 51.6 ± 11 years; 54.03 female) enrolled in a 6-week group-based telehealth CBT-I intervention. Participants completed pre-post-intervention subjective and objective cognitive assessments (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30]; Hopkins Verbal Learning Test–Revised [HVLT-R], Oral Trail Making Test-B [OTMT-B], and Controlled Word Association Test [COWAT]). Within-group cognitive change was examined using established minimally important differences and reliable change indices. Results All participants demonstrated clinically stable subjective cognitive functioning from pre-to-post intervention. Individual analyses showed that 32 participants (91.4%) demonstrated clinically stable or improved verbal memory, 30 participants (85.7%) demonstrated clinically stable or improved divided attention, and all participants (100%) demonstrated clinically stable or improved phonemic fluency. Few participants demonstrated clinically significant decline in verbal memory (n = 2, 5.7%) or divided attention (n = 5, 14.3%). Conclusions Changes in both subjective and objective cognitive functioning were predominantly positive following a behavioral intervention for insomnia (CBT-I) among patients with PBT; however, these results should be viewed as preliminary. We will more thoroughly examine cognitive outcomes with a longer follow-up period in an upcoming randomized pilot trial of CBT-I in PBT.