Social cognition in patients with intracranial tumors: do we forget something in the routine neuropsychological examination?

Purpose: Social cognitive functions are of high clinical relevance. To date, little is known about social cognition in neurooncological patients and this domain is usually not included in standardized neurocognitive test batteries. Aim of this study was thus to assess whether social cognition could pose a useful contribution to the neurocognitive assessment in patients with intracranial tumors.

Methods: We included 30 preoperative patients with a brain tumor. Patients completed a comprehensive test battery for assessment of social cognition. Thirty healthy participants matched for age, gender, and education, served as control group. Clinical relevance of social cognitive deficits was assessed via various self-report measures as well as a clinical rating scale assessing social and occupational functioning.

Results: Twenty-five patients (83%) were impaired in at least one measure of social cognition. Whereas patients with lesions to the temporal lobes were most severely impaired, deficits occurred in patients with tumors of a variety of localizations, sizes and malignancies. There was some evidence for missing patients' awareness as well as clinical significance of social cognitive deficits in terms of impaired interactional and occupational functioning. By combination of the Faux-Pas and the Eyes-Test, 77% of patients who were impaired in any social cognitive task were detected.

Conclusions: Deficits in social cognition are frequent and clinically relevant in patients with intracranial tumors. The inclusion of social cognitive measures in the routine neuropsychological examination for brain tumor patients might add valuable information about the patient whilst requiring reasonable additional resources.