Post-WBRT cognitive impairment and hippocampal neuronal depletion measured by in vivo metabolic MR spectroscopy: Results of prospective investigational study
Jazyk angličtina Země Irsko Médium print-electronic
Typ dokumentu časopisecké články
PubMed
28063694
DOI
10.1016/j.radonc.2016.12.013
PII: S0167-8140(16)34445-0
Knihovny.cz E-zdroje
- Klíčová slova
- Hippocampus, Magnetic resonance spectroscopy, Neurocognitive function, Radiation injury,
- MeSH
- biologické markery metabolismus MeSH
- degenerace nervu etiologie metabolismus MeSH
- hipokampus diagnostické zobrazování metabolismus účinky záření MeSH
- kognitivní dysfunkce etiologie metabolismus MeSH
- kraniální ozáření škodlivé účinky MeSH
- kvalita života MeSH
- kyselina asparagová analogy a deriváty metabolismus MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční spektroskopie metody MeSH
- nádory mozku radioterapie sekundární MeSH
- následné studie MeSH
- neuropsychologické testy MeSH
- paměť účinky záření MeSH
- prospektivní studie MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- biologické markery MeSH
- kyselina asparagová MeSH
- N-acetylaspartate MeSH Prohlížeč
BACKGROUND AND PURPOSE: The aim of this prospective study is to evaluate post-whole brain radiotherapy (WBRT) changes in hippocampal concentration of N-acetylaspartate (h-tNAA) as a marker of neuronal loss and to correlate those changes to neurocognitive function. MATERIAL AND METHODS: Thirty-five patients with brain metastases underwent baseline single slice multi-voxel MR spectroscopy (MRS) examination for measurement of hippocampal h-tNAA together with baseline battery of neurocognitive tests focused on memory (Auditory Verbal Learning Test and Brief Visuospatial Memory Test - Revised) as well as quality of life questionnaires (EORTC QLQ-C30 a EORTC QLQ-BN20). Eighteen patients completed follow-up evaluation four months after standard WBRT (2 laterolateral fields, 10×3.0Gy, 6MV photons) and were included in this analysis. MRS and cognitive examinations were repeated and compared to baseline measurements. RESULTS: Statistically significant decreases in h-tNAA were observed in the right (8.52-7.42mM; -12.9%, 95%CI: -7.6 to -16.4%) as well as in the left hippocampus (8.64-7.60mM; -12%, 95%CI: -7.9 to -16.2%). Statistically significant decline was observed in all AVLT and BVMT-R subtests with exception of AVLT_Recognition. Quality of life declined after WBRT (mean Δ -14.1±20.3 points in transformed 0-100 point scale; p=0.018) with no correlation to changes in hippocampal metabolite concentrations. Moderate positive correlation was observed between left h-tNAA concentration decrease and AVLT_TR decline (r=+0.32; p=0.24) as well as with AVLT_DR (r=+0.33; p=0.22) decline. Changes in right h-tNAA/Cr negatively correlated with AVLT_DR (r=-0.48; p=0.061). No correlation between right hippocampus h-tNAA and memory decline (AVLT) was observed. CONCLUSIONS: Our results suggest hippocampal NAA concentrations decline after WBRT and MRS may be a useful biomarker for monitoring neuronal loss after radiotherapy.
Department of Clinical Psychology St Anne's University Hospital Brno Czech Republic
Department of Diagnostic Imaging St Anne's University Hospital Brno Czech Republic
Department of Radiation Oncology Mayo Clinic Rochester United States
Citace poskytuje Crossref.org
Hippocampal subfield volumetric changes after radiotherapy for brain metastases
