Memantine +/- Raloxifene for Cognitive Preservation After Radiation Therapy to the Brain

MRIs will be used to capture any changes in hippocampal volume

A 0-5 scale to assess a cancer patient's functional ability showing how their daily life is impacted by the disease. A score of 0 means fully active, while a higher score indicates increasing disability with 5 indicating death.

HVLT-R scoring involves summing words recalled in learning trials for Total Recall, calculating Percentage Retention (Delayed Recall / Higher of Trials 2/3), and determining the Recognition Discrimination Index (True Positives - False Positives). These raw scores are then converted to age-adjusted T-scores, which are compared to normative data (16-92 years old) to assess verbal learning and memory in brain-disordered populations, with higher scores generally indicating better performance.

A neuropsychological number test measuring psychomotor speed and visual attention by connecting numbers (1-25) in sequence. Higher scores (more time) indicate greater impairment, with averages around 29 seconds, while scores over 30-40 seconds often suggest potential cognitive issues, though norms vary by age and education.

A neuropsychological number and letter test measuring psychomotor speed and visual attention by connecting numbers (1-25) in sequence. Higher scores (more time) indicate greater impairment, with averages around 75 seconds, while scores over 273 second often suggest potential cognitive issues, though norms vary by age and education.

A neuropsychological test assessing verbal fluency and executive functions like self-initiation, requiring a person to name as many words as possible starting with a specific letter (like F, A, S, or C, F, L) within 60 seconds, for three trials, while avoiding repetitions, proper nouns, or variations of the same word root to gauge cognitive health, especially after brain injury or with conditions like dementia. The score includes the total number of unique, correct words across the trials. A higher score indicated better cognitive function.

A 20 item questionnaire with each item scored from 0-4 with a total possible score of 0-80. A higher score indicates a worse quality of life.

Involves rating 23 symptoms and 6 interference items on a 0-10 scale (0=not present/did not interfere, 10=as bad as you can imagine/interfered completely) for the last 24 hours, calculating mean scores for overall symptoms, symptom factors (like neurological, cognitive, GI), and interference (activity/mood), with scores of 5 or greater indicating moderate-to-severe symptoms. Scores are averaged for summary measures, providing a picture of symptom burden and its impact on daily life for brain tumor patients. A mean of the total score is calculated with a higher score indicating worse symptoms.

A total of 50 items are included that cover the following domains of Quality of life (QOL): physical well-being, social/family well-being, emotional well-being, functional well-being, and disease specific concerns. Patients are asked to indicate the presence/severity of certain issues/symptoms on a scale of 0 - 4 (a 5-point Likert Scale).The range of scores is 0-148 with a higher indicating a better quality of life.

The Medical Outcomes Study Cognitive Functioning Scale is a patient-reported measure of perceived cognitive functioning consisting of six items that assess the frequency of problems with concentration, reasoning, confusion, forgetfulness, and mental clarity during the previous four weeks. Each item is scored on a 6-point Likert scale ranging from 1 ("all of the time") to 6 ("none of the time"), where higher values indicate fewer cognitive difficulties. Item scores are summed to generate a raw total score ranging from 6 to 36, with higher scores reflecting better cognitive functioning and fewer reported cognitive problems, and lower scores indicating greater perceived impairment. In some studies the raw score is also linearly transformed to a 0-100 scale, where 0 represents the worst cognitive functioning and 100 represents the best cognitive functioning.

The PROMIS-CF score is derived from two items: (1) My memory has been as good as usual and (2) I have been able to focus my attention, which ask patients to self-report on their cognitive abilities with the following response scale: 1 = Not at all, 2 = A little bit, 3 = Somewhat; 4 = Quite a bit, and 5 = Very much. Total scores are from 1-10 with a higher score indicating better cognitive function.

Hopkins Verbal Learning Test-Revised Delayed Recall is a neuropsychological test assessing verbal memory by having individuals recall a list of 12 words after a delay (around 20-25 minutes). Scoring is from 0-12 with a higher score indicating better recall.

The Hopkins Verbal Learning Test-Revised recognition discrimination index is a component of the HVLT-R that evaluates verbal recognition memory following presentation of a 12-word learning list. After the delayed recall phase, participants complete a recognition trial consisting of 24 items (the 12 original target words mixed with 12 distractor words). For each item, the respondent indicates whether the word was part of the original list (yes/no). Scoring is based on the Recognition Discrimination Index (RDI), calculated as the number of correct recognitions (hits) minus the number of incorrect endorsements of distractors (false positives). The resulting score ranges from -12 to +12, with higher scores indicating better recognition memory and greater ability to discriminate target words from distractors, while lower scores reflect poorer recognition performance and greater memory impairment.