QOL-02. Tele-Cognitive rehabilitation for adult lower grade glioma: A prospective feasibility study

Abstract BACKGROUND Cognitive impairments are common in lower-grade gliomas (LrGG, grades 1-3), yet with limited evidence-based interventions. Tele-health cognitive rehabilitation offers a potential solution. We conducted a pilot study investigating tele-cognitive rehabilitation adherence, satisfaction, and preliminary efficacy for adult LrGG. METHODS Enrolled stable adult LrGG (≥ 6-months post-treatment) reporting subjective and objective cognitive impairments (>1 SD below average in ≥2 domains). Participants received three-months of individual Goal Management Training (GMT) telehealth cognitive rehabilitation; a manualized behavioral treatment. Collected baseline (T1), post-intervention (T2), and 9-months post-baseline (T3) cognitive assessments and patient-reported outcomes (PROs). Adherence required ≥80% of sample complete ≥80% of sessions. Satisfaction defined as ≥6/7 on post-T2 survey. Preliminary within-group efficacy assessed by repeated measures t-tests, effect sizes, and reliable change indices (T1-T2, T1-T3). RESULTS Thirty-two patients (median age 48-years; median 61-months post-diagnosis; 46% astrocytoma, 46% oligodendroglioma; 82% IDH mutant; 39% grade 2, 61% grade 3; 64% prior radiotherapy) prospectively enrolled between May 2019 and September 2023. GMT adherence: 88%. Significant improvements in WAIS-IV Working Memory Index T1 (mean z=-0.12, SD 1.13) to T2 (mean z=0.06, SD 1.09; p=0.03, eta²=0.18); 25% demonstrated reliable improvement. Improved PROs: Fatigue Symptom Inventory-Interference decreased significantly T1 (mean=3.37, SD 2.48) to T3 (mean=2.55, SD 2.42; p=0.04, eta²=0.18). Clinically evident fatigue (FSI >3) decreased 50% at T1 to 25% at T3. Brief Symptom Inventory (BSI)-Somatization improved significantly T1 (mean=0.06, SD 0.84) to T2 (mean=-0.38, SD 0.60; p=0.001, eta²=0.33) and T1-T3 (mean=-0.34, SD 0.76; p=0.01, eta²=0.28). Overall GMT satisfaction was excellent (mean=6.87/7, SD 0.35). CONCLUSION GMT tele-cognitive rehabilitation is feasible for stable adult LrGG, demonstrating good adherence and high patient satisfaction. Preliminary results show improvements in working memory, fatigue, and somatic distress, with some effects sustained 6-months post-intervention. Further research is warranted to confirm efficacy and explore mechanisms of action.