POSPÍŠIL, Petr, Tomáš KAZDA, Ludmila HYNKOVÁ, Martin BULIK, M. DOBIASKOVA, Petr BURKOŇ, N.N. LAACK, Pavel ŠLAMPA and Radim JANČÁLEK. Post-WBRT cognitive impairment and hippocampal neuronal depletion measured by in vivo metabolic MR spectroscopy: Results of prospective investigational study. Radiotherapy and Oncology, Journal of the European Society for Therapeutic Radiology and Oncology. Barcelona: Elsevier, vol. 122, No 3, p. 373-379. ISSN 0167-8140. doi:10.1016/j.radonc.2016.12.013. 2017.
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Basic information
Original name Post-WBRT cognitive impairment and hippocampal neuronal depletion measured by in vivo metabolic MR spectroscopy: Results of prospective investigational study
Authors POSPÍŠIL, Petr (203 Czech Republic, guarantor, belonging to the institution), Tomáš KAZDA (203 Czech Republic, belonging to the institution), Ludmila HYNKOVÁ (203 Czech Republic, belonging to the institution), Martin BULIK (203 Czech Republic), M. DOBIASKOVA (203 Czech Republic), Petr BURKOŇ (203 Czech Republic, belonging to the institution), N.N. LAACK (840 United States of America), Pavel ŠLAMPA (203 Czech Republic, belonging to the institution) and Radim JANČÁLEK (203 Czech Republic, belonging to the institution).
Edition Radiotherapy and Oncology, Journal of the European Society for Therapeutic Radiology and Oncology, Barcelona, Elsevier, 2017, 0167-8140.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30204 Oncology
Country of publisher Ireland
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 4.942
RIV identification code RIV/00216224:14110/17:00098708
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.radonc.2016.12.013
UT WoS 000397691500008
Keywords in English Hippocampus; Radiation injury; Neurocognitive function; Magnetic resonance spectroscopy
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 21/3/2018 18:07.
Abstract
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 multivoxel 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 x 3.0 Gy, 6 MV 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 (8.52-7.42 mM; -12.9%, 95%Cl: -7.6 to -16.4%) as well as in the left hippocampus (8.64-7.60 mM; -12%, 95%Cl: -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 Delta-14.1 +/- 20.3 points in transformed 0100 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 htNAA/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. 2016 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 122 (2017) 373-379
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