A prospective evaluation of changes in brain structure and cognitive functions in adult stem cell transplant recipients Journal Article
| Authors: | Correa, D. D.; Root, J. C.; Baser, R.; Moore, D.; Peck, K. K. ; Lis, E.; Shore, T. B.; Thaler, H. T.; Jakubowski, A.; Relkin, N. |
| Article Title: | A prospective evaluation of changes in brain structure and cognitive functions in adult stem cell transplant recipients |
| Abstract: | 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. © Springer Science+Business Media New York 2012. |
| Keywords: | adult; cancer chemotherapy; clinical article; controlled study; aged; busulfan; fludarabine; cytarabine; methotrexate; rituximab; neuroimaging; neurotoxicity; nuclear magnetic resonance imaging; follow up; prospective study; etoposide; clinical assessment; cyclophosphamide; melphalan; hematopoietic stem cell transplantation; carmustine; thiotepa; high risk patient; prednisolone; acute graft versus host disease; chronic graft versus host disease; hematologic malignancy; whole body radiation; brain ventricle; quantitative analysis; neuropsychological test; cognition; cognitive defect; cognitive; tacrolimus; graft recipient; clinical assessment tool; brain size; voxel based morphometry; gray matter; neuroanatomy; voxel-based morphometry; brain lateral ventricle; caudate nucleus; human; male; female; priority journal; article; structural neuroimaging; middle frontal gyrus; reliable change index |
| Journal Title: | Brain Imaging and Behavior |
| Volume: | 7 |
| Issue: | 4 |
| ISSN: | 1931-7557 |
| Publisher: | Springer |
| Date Published: | 2013-12-01 |
| Start Page: | 478 |
| End Page: | 490 |
| Language: | English |
| DOI: | 10.1007/s11682-013-9221-8 |
| PROVIDER: | scopus |
| PUBMED: | 23329358 |
| PMCID: | PMC5536351 |
| DOI/URL: | |
| Notes: | Brain Imaging Behav. -- Cited By (since 1996):2 -- Export Date: 8 July 2014 -- Source: Scopus |
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