Post-WBRT cognitive impairment and hippocampal neuronal depletion measured by in vivo metabolic MR spectroscopy: Results of prospective investigational study
Language English Country Ireland Media print-electronic
Document type Journal Article
PubMed
28063694
DOI
10.1016/j.radonc.2016.12.013
PII: S0167-8140(16)34445-0
Knihovny.cz E-resources
- Keywords
- Hippocampus, Magnetic resonance spectroscopy, Neurocognitive function, Radiation injury,
- MeSH
- Biomarkers metabolism MeSH
- Nerve Degeneration etiology metabolism MeSH
- Hippocampus diagnostic imaging metabolism radiation effects MeSH
- Cognitive Dysfunction etiology metabolism MeSH
- Cranial Irradiation adverse effects MeSH
- Quality of Life MeSH
- Aspartic Acid analogs & derivatives metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Spectroscopy methods MeSH
- Brain Neoplasms radiotherapy secondary MeSH
- Follow-Up Studies MeSH
- Neuropsychological Tests MeSH
- Memory radiation effects MeSH
- Prospective Studies MeSH
- Surveys and Questionnaires MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Biomarkers MeSH
- Aspartic Acid MeSH
- N-acetylaspartate MeSH Browser
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
References provided by Crossref.org
Hippocampal subfield volumetric changes after radiotherapy for brain metastases
