What Is on Your Mind? Impaired Social Cognition in Primary Central Nervous System Lymphoma Patients Despite Ongoing Complete Remission

Abstract

Within the past decades, long-term survival was achieved in a substantial fraction of primary central nervous system lymphoma (PCNSL) patients, expanding the focus of research to their quality of life (QoL). Social relationships crucially contribute to well-being in the context of adversity. Therefore, abilities that facilitate social interactions essentially determine QoL. The present study specifically targeted those sociocognitive abilities. Forty-three PCNSL patients with ongoing complete remission to therapy for at least one year and 43 healthy controls matched for age, gender and education were examined with standardized self-report and behavioral measures of social cognition. An impaired ability to comprehend others´ feelings was found in patients for both positive and negative mental states. Patients had difficulties in identifying the awkward element in challenging social situations, whereas the degree of discomfort experienced in those situations was comparable between groups. Both the production of optimal solutions for social situations and the mere recognition of these among less optimal strategies were impaired in patients. Clinicians should be aware of possible sociocognitive impairment and ought to address this in additional supportive interventions. Impaired sociocognitive abilities may entail social conflicts at a time when patients rely on social support. This, in turn, could detrimentally affect QoL.

The impact of breast cancer on social cognition in female Colombian patients

“…Previous studies have shown that patients with brain tumor and patients in remission from primary CNS lymphoma had impairments in some social cognition measures [ 36 , 94 ]. However, it is interesting that cancer outside the CNS can also lead to social cognition alterations.…”

“…However, other domains could also be affected because there is an overlap in the neuroanatomical substrate of several social cognition tasks [ 35 ]. In other types of cancer, like primary CNS lymphoma, patients experienced social cognition deficits even though they were in remission [ 36 ]. Thus, there is promising evidence that social cognition may be altered in cancer patients, which would subsequently impact their life and social functioning.…”

Targeted Therapies and Immune Checkpoint Inhibitors in Primary CNS Lymphoma

“…Although comprehensive studies are lacking, these new treatment options may also have a more favorable toxicity profile, including less detrimental effects on cognitive function. The impact of novel drugs on neurocognition requires thorough analyses of large patient cohorts with adequate follow-up [ 78 ]. In summary, data from larger and ideally randomized trials are needed to determine if targeted agents (summarized in Table 1 ) or immune checkpoint inhibitors become available for clinical routine in the management of PCNSL patients.…”

Sociocognitive Functioning and Psychosocial Burden in Patients with Brain Tumors

“…Studies targeting PCNSL reported some conflicting results. While in an early study the self-reported sociocognitive abilities and stress coping abilities were comparable between PCNSL and the normal population [96] a recent study demonstrated impairments in cognitive empathy and social problem solving abilities in PCNSL patients [118]. These contradictory results may be due to an inappropriate targeting of sociocognitive impairment by self-report measures, also affected by potentially reduced metacognitive abilities of the patients (i.e., insight).…”

“…By contrast, other studies pointed to significantly impaired sociocognitive functioning even before any treatment has started in brain tumor patients [88,94]. Likewise, some posttreatment studies reported relevant impairments [87,118,122,130], some regionspecific [80,95,101] (e.g., mainly frontal and insular regions). By contrast, other investigations reported no clinically relevant or only minor impairment of sociocognitive functioning in brain tumor patients even after treatment [81,96,98,111,120,127].…”