Cognitive impairment following radiation to hippocampus and other brain structures in adults with primary brain tumours.

Autor: Haldbo-Classen L; Department of Oncology, Aarhus University Hospital, Denmark., Amidi A; Department of Oncology, Aarhus University Hospital, Denmark; Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark., Lukacova S; Department of Oncology, Aarhus University Hospital, Denmark., Wu LM; Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark; Aarhus Institute of Advanced Studies, Aarhus University, Denmark., Oettingen GV; Department of Neurosurgery, Aarhus University Hospital, Denmark., Lassen-Ramshad Y; Danish Center for Particle Therapy, Aarhus University Hospital, Denmark., Zachariae R; Department of Oncology, Aarhus University Hospital, Denmark; Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark., Kallehauge JF; Danish Center for Particle Therapy, Aarhus University Hospital, Denmark., Høyer M; Danish Center for Particle Therapy, Aarhus University Hospital, Denmark.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2020 Jul; Vol. 148, pp. 1-7. Date of Electronic Publication: 2020 Mar 28.
DOI: 10.1016/j.radonc.2020.03.023
Abstrakt: Background: Radiation therapy (RT) to the brain may result in cognitive impairment. The primary objective of the present study was to examine the relationship between RT dose to the hippocampus and learning and memory functions. Secondary objective was to examine relationships between doses to other brain structures and specific cognitive functions.
Methods: A cross-sectional analysis was undertaken in 78 primary brain tumour patients after RT. Cognitive function was assessed by neuropsychological tests. Test scores were standardized using normative data adjusted for age and level of education. Test-specific cognitive impairment was determined as a z-score ≤-1.5. Radiation dose to brain structures and test-specific cognitive impairment outcomes were fitted to a logistic regression model.
Results: High RT dose to the left hippocampus was associated with impaired verbal learning and memory (p = 0.04). RT dose to the left hippocampus, left temporal lobe, left frontal lobe and total frontal lobe were associated with verbal fluency impairment (p < 0.05) and doses to the thalamus and the left frontal lobe with impaired executive functioning (p ≤ 0.03). Finally, RT dose to the brain and thalamus were associated with impaired processing speed (p ≤ 0.05).
Conclusion: The present study indicates that the hippocampus may be vulnerable to radiation and that high radiation doses to the left hippocampus may lead to significant verbal learning and memory impairment. High RT doses to the left hippocampus and other left side structures may result in impairments in verbal fluency, executive function, and processing speed. Validation of these findings are being undertaken in a prospective study.
(Copyright © 2020 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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