Detection and characterization of neurotoxicity in cancer patients using proton MR spectroscopy

Abstract

Objective-The study objective was to detect abnormalities and identify relationships between brain metabolic ratios determined by proton magnetic resonance spectroscopic imaging ( 1 H-MRSI) and neuropsychological (NP) function in cancer patients at risk for neurotoxicity.Methods-Thirty-two patients received 1 H-MRSI using a multi-slice, multivoxel technique on a 1.5T magnet. Cho/NAA, NAA/Cr and Cho/Cr ratios were identified in 7 pre-determined sites without tumor involvement. A battery of age-appropriate NP tests was administered within 7 days of imaging. Relationships were examined between test scores and metabolite ratios.Results-1 H-MRSI data was considered acceptable in 31 patients. Significant associations were identified. Full Scale IQ (r = −0.62 p = 0.011), Verbal IQ (r = −0.61, p = 0.014), Performance IQ (r = −0.57, p = 0.024), and arithmetic scores (r = −0.51, p = 0.50) correlated with Cho/Cr in the globus pallidus. Full Scale IQ (r = −0.48, p = 0.043) correlated with Cho/NAA in the putamen. Reading scores correlated with NAA/Cr in the putamen (r = 0.59, p = 0.034). Presence of a lipid peak (1.6 − 1.8 ppm) was associated with lower Full Scale IQ (p = .012) and Verbal IQ scores (p = .004).Conclusions-This study identifies relationships between brain metabolite ratios and cognitive functioning in cancer patients. 1 H-MRSI may be useful in early detection of neurotoxic effects, but prospective longitudinal studies in a homogeneous population are recommended to determine the prognostic value.

Brain damage from anticancer treatments in adults

“…A reduced activation in midfrontal areas was noted with functional MRI. A recent proton magnetic resonance spectroscopy study indicated that poorer neuropsychological performances were correlated with choline/N-acetylaspartic acid and N-acetylaspartic acid/creatinine ratios in the putamen [26 ]. This study corroborated previous reports underlining the role Brain damage from anticancer treatments in adults Ricard et al 563 of basal ganglia in chemo-induced cognitive impairment.…”

Functional Impairments and Caregiver Depressive Symptoms in the Context of Brain Tumour and Other Cancers: A Mediating Effect of Strain

“…. Nonetheless, neurotoxic effects of treatment for other cancers have been demonstrated in neuropsychological and neuroimaging studies (e.g., Jansen, Miaskowski, Dodd, Dowling, & Kramer, 2005;Steffen-Smith, Wolters, Albert, Baker, Shimoda et al, 2008). The significance of functional impairments in cancer is being increasing recognised for neuropsychological assessment and rehabilitation practices (Cole, Scialla, & Bednarz, 2000;Jansen et al, 2005;Marciniak, Sliwa, Heinemann, & Semik, 2001).…”