AGR – 3 From Overstimulation to Optimization: Goal-Driven Outcomes in a Tailored Cognitive Rehabilitation and Mindfulness Case Study

Abstract Objective Cognitive and functional decline are common among patients with primary brain tumors. Existing cognitive rehabilitation programs lack individualization targeting patient-specific cognitive and daily living goals. This case presents a patient treated with C-SMART (Cognitive Strategies, Mindfulness, and Rehabilitation Therapy), an individualized intervention for patients with primary brain tumors and mild cognitive decline. Method A 60-year-old White female with a WHO Grade II left-frontotemporal oligodendroglioma and mild objective cognitive decline (≥1.5 SD below expectations in ≥1 domain) participated in eight weekly 1-hour sessions with her caregiver. C-SMART integrated neuropsychological/brain tumor education, strategies targeting observed deficits (attention, working memory, and visual encoding), daily living goals, and mindfulness. Data collection included medical record review, pre/post-intervention neurocognitive testing (expanded International Cognition and Cancer Task Force battery) and psychological measures, weekly goal attainment scaling (GAS; −2 to +2), and patient/caregiver semi-structured exit interviews. Results Neurocognitive performance was grossly stable, with improved visual encoding and reduced divided attention. Psychological symptoms remained stable. The patient demonstrated progress toward self-determined functional goals (managing “overstimulation”), with weekly GAS scores exceeding expectations (MGAS = 1.3). Exit interviews revealed increased cognitive strategy use and improved socioemotional functioning. Detailed results, neuroimaging, and pathology will be presented. Conclusion Despite stable subjective and objective neurocognitive functioning, the patient demonstrated successful goal attainment and reported improved daily and socioemotional functioning, driven by strategy use targeting “overstimulation.” Findings suggest standardized measures may not fully capture the benefits of individualized cognitive rehabilitation within neuro-oncology. Future research should explore alternative mechanisms of goal attainment and possible biomarkers of intervention efficacy, such as functional connectivity.