High-dose chemotherapy and whole brain radiotherapy (WBRT) can prolong survival in primary CNS lymphoma (PCNSL) patients, but is often associated with clinically significant cognitive decline. In this study we assessed neuropsychological functioning prospectively in newly diagnosed PCNSL patients treated with induction chemotherapy followed by reduced-dose WBRT. Twelve patients underwent neuropsychological evaluations at diagnosis, after induction chemotherapy, and 6 and 12 months after WBRT. Nine patients completed additional cognitive evaluations 18 and 24 months post-treatment. At diagnosis, patients had impairments in Executive Functions, Verbal Memory, and Motor Speed. There was a significant improvement in Executive Functions (P< 0.01) and Verbal Memory (P < 0.05) following induction chemotherapy, and scores remained relatively stable up to 12 months post-treatment. Among the nine patients who completed a 2-year follow-up, there was a significant improvement in the Executive domain (P < 0.05) and a trend toward a decline in the Verbal Memory domain. Executive and Verbal Memory functions improved following induction chemotherapy, likely due to decreased tumor burden and discontinuation of corticosteroid and anticonvulsant medications. There was no significant cognitive decline up to 24 months post-chemotherapy and reduced-dose WBRT in this group of PCNSL patients, however, difficulties in Verbal Memory and Motor speed persisted over the follow-up period.

The reciprocal connections between primary motor (M1) and primary somatosensory cortices (S1) are hypothesized to play a crucial role in the ability to update motor plans in response to changes in the sensory periphery. These interactions provide M1 with information about the sensory environment that in turn signals S1 with anticipatory knowledge of ongoing motor plans. In order to examine the synaptic basis of sensorimotor feedforward (S1-M1) and feedback (M1-S1) connections directly, we utilized whole-cell recordings in slices that preserve these reciprocal sensorimotor connections. Our findings indicate that these regions are connected via direct monosynaptic connections in both directions. Larger magnitude responses were observed in the feedforward direction (S1-M1), while the feedback (M1-S1) responses occurred at shorter latencies. The morphology as well as the intrinsic firing properties of the neurons in these pathways indicates that both excitatory and inhibitory neurons are targeted. Differences in synaptic physiology suggest that there exist specializations within the sensorimotor pathway that may allow for the rapid updating of sensory-motor processing within the cortex in response to changes in the sensory periphery.