The overall objective of this research is to investigate the clinical characteristics pre- and post-brain tumour resection with a focus on visual verticality disorder, and lateropulsion, including neuroimaging analysis, of a neurosurgical cohort of patients with brain tumours. This prospective observational cohort study will investigate clinical and neuroimaging characteristics and the relationship between lateropulsion and visual verticality disorder in patients pre- and post-brain tumour resection. Patients (aged 18-80 years, with a confirmed diagnosis of brain tumour and a neurosurgical pathway) will be enrolled from the state-wide Neurosurgery Service of Western Australia at Sir Charles Gairdner Hospital.
Patients of age 18 to 80 admitted to SCGH under the neurosurgery team with a confirmed diagnosis of a brain tumour.
Only patients who undergo partial or full brain tumour resection and are medically stable.
Able to provide written informed consent or consent provided by a Research Decision-Maker with the approval of an Independent Medical Practitioner (IMP) as per the Guardianship and Administration Act 1990 (GAA).
Patients with a support network that enables them to accommodate to travel commitments for assessments if travel to the hospital is required.
Patients who undergo only biopsy will not be included.
Unable to follow any instructions and complete assessments due to significant medical deterioration.
Patients who are pregnant.
Current diagnosis of COVID-19 or respiratory syncytial virus (RSV), or any type of influenza.
Patients admitted to the State-Wide Neurosurgical Service of Western Australia (WA) at Sir Charles Gairdner Hospital.
Cohort
Prospective
Not listed
Visual Verticality Perception (VV, visual graviceptive neglect)
Change in VV: assessment using the bucket test method.
Subjective Haptic Vertical (SHV) test
The SHV test, the participant is blindfolded and asked to align a movable rod or bar to what they perceive as vertical using only their sense of touch (haptic input). This is to isolate somatosensory and vestibular input from visual cues. This will be performed in an upright sitting position to explore graviceptive function and verticality perception.
The Four Point Pusher's Score (4PPS)
The 4PPS is a four-item scale that measures lateropulsion or pusher syndrome. The score for each component is rated on a scale from 0 to 3 (0 to 4 for standing) and the score is based on the severity of resistance or the tilt angle when the patient begins to resist the passive movement. The score for diagnosis of Pusher behaviour is \>2 points.
Scale for Contraversive Pushing
A 3-item scale that measures lateropulsion or pusher syndrome, by rating the action / reaction of patients required to keep or change position. Scores: 0= no contraversive pushing 1. minimum score for each item 2. maximum score Score on each component \>1 indicative of lateropulsion.
Retropulsion
Observed retropulsion of participants in sitting or standing will be documented as 'present' or 'not present'
MD Anderson Symptom Inventory - Brain Tumour (MDASI-BT)
The MDASI-BT is a health-related quality of life questionnaire to assess the severity of symptoms experienced by patients with brain tumours and the interference with daily living caused by these symptoms. The MDASI-BT assesses the severity of symptoms at their worst in the last 24 hours on a 1to 10 numerical scale, with 0 being "not present" and 10 being "as bad as you can imagine", therefore the higher the scores the worst the symptoms and interference. This questionnaire has a total of 28 questions; therefore minimum score is 0 and max 280.
Rehabilitation Complexity Scale - extended version (RCS-E v13)
Rehabilitation Complexity Scale - Extended (RCS-ev13) provides a simple overall measure of resource requirements for rehabilitation including basic care / risk, rehabilitation nursing, therapy (number of disciplines and intensity), medical acuity, equipment needs. The score subscale are divided as follows: Care or risk (0-4), Nursing (0-4), Medical (0-4), Therapy (0-8), Equipment (0-2). Total score is 22. The higher the score the higher the patient's rehabilitation needs and complexity.
Postural Assessment Scale for Stroke (PASS)
The PASS is an outcome measure specifically designed to assess and monitor postural control after stroke (but also suitable for patients with brain tumours since it is impairment based). It measures the ability of an individual to maintain stable postures and equilibrium during positional changes, using a 4-point scale with a total scoring range from 0 to 36. The PASS consists of 12 items that measure balance in lying, sitting, and standing. The higher the score the more impaired an individual is in regard to maintaining stable postures and equilibrium during positional changes.
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The University of Western Australia
Lead sponsor
Sir Charles Gairdner Hospital
Collaborator
University of Sao Paulo
Collaborator
