A prospective evaluation of changes in brain structure and cognitive functions in adult stem cell transplant recipients

被引:38
作者
Correa, D. D. [1 ,6 ]
Root, J. C. [2 ,7 ]
Baser, R. [3 ]
Moore, D. [6 ]
Peck, K. K. [4 ,8 ]
Lis, E. [4 ,8 ]
Shore, T. B. [9 ]
Thaler, H. T. [3 ]
Jakubowski, A. [5 ,9 ]
Relkin, N. [6 ]
机构
[1] Mem Sloan Kettering Canc Ctr, Dept Neurol, New York, NY 10065 USA
[2] Mem Sloan Kettering Canc Ctr, Dept Psychiat & Behav Sci, New York, NY 10065 USA
[3] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10065 USA
[4] Mem Sloan Kettering Canc Ctr, Dept Radiol, New York, NY 10065 USA
[5] Mem Sloan Kettering Canc Ctr, Dept Med, New York, NY 10065 USA
[6] Weill Cornell Med Coll, Dept Neurol & Neurosci, New York, NY USA
[7] Weill Cornell Med Coll, Dept Psychiat, New York, NY USA
[8] Weill Cornell Med Coll, Dept Radiol, New York, NY USA
[9] Weill Cornell Med Coll, Dept Med, New York, NY USA
关键词
Hematopoietic stem cell transplantation; Cognitive; Structural neuroimaging; Voxel-based morphometry; ACUTE MYELOGENOUS LEUKEMIA; TOTAL-BODY IRRADIATION; HIGH-DOSE CHEMOTHERAPY; BONE-MARROW; BREAST-CANCER; WHITE-MATTER; FOLLOW-UP; NEUROLOGICAL COMPLICATIONS; LONGITUDINAL ASSESSMENT; SURVIVORS;
D O I
10.1007/s11682-013-9221-8
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Hematopoietic stem cell transplantation (HSCT) is an efficacious treatment for many hematologic malignancies. However, the conditioning regimen of high-dose (HD) chemotherapy with or without total body irradiation (TBI) can be associated with neurotoxicity. In this prospective study, we used quantitative neuroimaging techniques to examine regional gray matter and ventricular volumes, and standardized neuropsychological tests to assess cognitive function before and 1 year after HSCT in 28 patients with hematologic malignancies and in ten healthy controls evaluated at similar intervals. Nineteen patients received conditioning treatment with HD chemotherapy alone and nine had both TBI and HD chemotherapy. There was a significant reduction in gray matter volume in the middle frontal gyrus bilaterally and in the left caudate nucleus in the patient group (all patients combined) but not among healthy controls over the 1-year follow-up period. There was a significant increase in left lateral ventricle volume and in total ventricle volume in the patient group, relative to healthy controls. Similar brain structural changes were seen for patients treated with HD chemotherapy alone. The neuropsychological results showed that 21 % of patients could be classified as impaired at baseline. The Reliable Change Index suggested no significantly different rates of cognitive decline between patients and healthy controls. The findings suggest that HSCT patients may be at an increased risk for developing regional brain volume loss, and that subgroups may experience cognitive dysfunction prior to and 1 year following the transplant.
引用
收藏
页码:478 / 490
页数:13
相关论文
共 65 条
[1]  
Accomazzi V, 2005, US Patent Application, Patent No. 20050031202
[2]   The relationship of APOE genotype to neuropsychological performance in long-term cancer survivors treated with standard dose chemotherapy [J].
Ahles, TA ;
Saykin, AJ ;
Noll, WW ;
Furstenberg, CT ;
Guerin, S ;
Cole, B ;
Mott, LA .
PSYCHO-ONCOLOGY, 2003, 12 (06) :612-619
[3]   Psychologic and neuropsychologic impact of autologous bone marrow transplantation [J].
Ahles, TA ;
Tope, DM ;
Furstenberg, C ;
Hann, D ;
Mills, L .
JOURNAL OF CLINICAL ONCOLOGY, 1996, 14 (05) :1457-1462
[4]   Cognitive function in breast cancer patients prior to adjuvant treatment [J].
Ahles, Tim A. ;
Saykin, Andrew J. ;
McDonald, Brenna C. ;
Furstenberg, Charlotte T. ;
Cole, Bernard F. ;
Hanscom, Brett S. ;
Mulrooney, Tamsin J. ;
Schwartz, Gary N. ;
Kaufman, Peter A. .
BREAST CANCER RESEARCH AND TREATMENT, 2008, 110 (01) :143-152
[5]   Candidate mechanisms for chemotherapy-induced cognitive changes [J].
Ahles, Tim A. ;
Saykin, Andrew J. .
NATURE REVIEWS CANCER, 2007, 7 (03) :192-201
[6]   Cancer- and Cancer Treatment-Associated Cognitive Change: An Update on the State of the Science [J].
Ahles, Tim A. ;
Root, James C. ;
Ryan, Elizabeth L. .
JOURNAL OF CLINICAL ONCOLOGY, 2012, 30 (30) :3675-3686
[7]   Longitudinal Assessment of Cognitive Changes Associated With Adjuvant Treatment for Breast Cancer: Impact of Age and Cognitive Reserve [J].
Ahles, Tim A. ;
Saykin, Andrew J. ;
McDonald, Brenna C. ;
Li, Yuelin ;
Furstenberg, Charlotte T. ;
Hanscom, Brett S. ;
Mulrooney, Tamsin J. ;
Schwartz, Gary N. ;
Kaufman, Peter A. .
JOURNAL OF CLINICAL ONCOLOGY, 2010, 28 (29) :4434-4440
[8]  
ANDRYKOWSKI MA, 1992, CANCER-AM CANCER SOC, V70, P2288, DOI 10.1002/1097-0142(19921101)70:9<2288::AID-CNCR2820700913>3.0.CO
[9]  
2-M
[10]  
[Anonymous], J BIOL