Aim: A growing number of neuropsychological studies reported that chemotherapy may impair brain functions, inducing persistent cognitive changes in a subset of cancer survivors. The aim of this paper was to investigate the neural basis of the chemotherapy induced neurobehavioral changes by means of metabolic imaging and neuropsychological testing. Methods.:We studied the resting brain [18F]FDG-PET/CT images of 50 adult cancer patients with diagnosis of lymphoma: 18 patients were studied prior and 32 after to chemotherapy. All patients underwent to a neuropsychological examination assessing cognitive impairment (tests for shifting attention, verbal memory, phonemic fluency), depression, anxiety and distress. Results: Compared to no chemotherapy patients, the treated group showed significant bilateral lower rate of glucose metabolism in prefrontal cortices, cerebellum, medial cortices and limbic brain areas. The metabolism of these regions negatively correlated with number of cycles and positively with post-chemotherapy time. The treated group showed a poorer performance in many frontal functions, but similar level of depression, anxiety and distress. Conclusions:Chemotherapy induced significant long-term changes in metabolism of multiple regions with a prevailing involvement of the prefrontal cortex. The observed cognitive dysfunctions could be explained by these changes. The recovery from chemotherapy is probably affected by treatment duration and by the time elapsed after its end. We speculated that the mechanism could be an accelerating ageing / oxidative stress that, in some patients at risk, could result in an early and persistent cognitive impairment.

The chemotherapy long-term effect on cognitive functions and brain metabolism in lymphoma patients

D'AGATA, Federico;CAUDA, Simona;MANFREDI, Matteo;CASTELLI, Lorys;MORTARA, Paolo;CAUDA, Franco;SACCO, Katiuscia;ARDITO, Rita Debora Bianca;PINESSI, Lorenzo;GEMINIANI, Giuliano Carlo;TORTA, Riccardo;BISI, Gianni
2012-01-01

Abstract

Aim: A growing number of neuropsychological studies reported that chemotherapy may impair brain functions, inducing persistent cognitive changes in a subset of cancer survivors. The aim of this paper was to investigate the neural basis of the chemotherapy induced neurobehavioral changes by means of metabolic imaging and neuropsychological testing. Methods.:We studied the resting brain [18F]FDG-PET/CT images of 50 adult cancer patients with diagnosis of lymphoma: 18 patients were studied prior and 32 after to chemotherapy. All patients underwent to a neuropsychological examination assessing cognitive impairment (tests for shifting attention, verbal memory, phonemic fluency), depression, anxiety and distress. Results: Compared to no chemotherapy patients, the treated group showed significant bilateral lower rate of glucose metabolism in prefrontal cortices, cerebellum, medial cortices and limbic brain areas. The metabolism of these regions negatively correlated with number of cycles and positively with post-chemotherapy time. The treated group showed a poorer performance in many frontal functions, but similar level of depression, anxiety and distress. Conclusions:Chemotherapy induced significant long-term changes in metabolism of multiple regions with a prevailing involvement of the prefrontal cortex. The observed cognitive dysfunctions could be explained by these changes. The recovery from chemotherapy is probably affected by treatment duration and by the time elapsed after its end. We speculated that the mechanism could be an accelerating ageing / oxidative stress that, in some patients at risk, could result in an early and persistent cognitive impairment.
56
6
559
568
Neoplasms; Neuropsychology; Rest
Bruno Baudino; Federico D’Agata; Paola Caroppo; Giancarlo Castellano; Simona Cauda; Matteo Manfredi; Elisabetta Geda; Lorys Castelli; Paolo Mortara; Laura Orsi; Franco Cauda; Katiuscia Sacco; Rita Ardito; Lorenzo Pinessi; Giuliano Geminiani; Riccardo Torta; Gianni Bisi
File in questo prodotto:
File Dimensione Formato  
The_chemotherapy_long-term_effect_on_cog.pdf

Accesso riservato

Tipo di file: PDF EDITORIALE
Dimensione 534.93 kB
Formato Adobe PDF
534.93 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Chemotherapy_postprint_4aperto.pdf

Accesso aperto

Descrizione: Articolo principale
Tipo di file: POSTPRINT (VERSIONE FINALE DELL’AUTORE)
Dimensione 1.08 MB
Formato Adobe PDF
1.08 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/128274
Citazioni
  • ???jsp.display-item.citation.pmc??? 15
  • Scopus 49
  • ???jsp.display-item.citation.isi??? 46
social impact