Cognitive impairment following radiation to hippocampus and other brain structures in adults with primary brain tumours

• Published in: Radiotherapy and oncology 2020-07, Vol.148, p.1-7
• Main Authors: Haldbo-Classen, Lene, Amidi, Ali, Lukacova, Slavka, Wu, Lisa Maria, Oettingen, Gorm von, Lassen-Ramshad, Yasmin, Zachariae, Robert, Kallehauge, Jesper Folsted, Høyer, Morten
• Format: Article
• Language: English
• Subjects: Adult; Brain; Brain Neoplasms - radiotherapy; Brain tumour; Cognitive Dysfunction - etiology; Cognitive function; Cross-Sectional Studies; Hippocampus; Humans; Magnetic Resonance Imaging; Neuropsychological Tests; Prospective Studies; Radiation therapy
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2020.03.023

•Radiation therapy to the brain and substructures may result in cognitive impairment.•Hippocampal radiation may lead to learning and memory impairment.•Left sided brain structures may be more vulnerable to radiation. Radiation therapy (RT) to the brain may result in cognitive impairment. The primary objective of the present study was to examine the relationship between RT dose to the hippocampus and learning and memory functions. Secondary objective was to examine relationships between doses to other brain structures and specific cognitive functions. A cross-sectional analysis was undertaken in 78 primary brain tumour patients after RT. Cognitive function was assessed by neuropsychological tests. Test scores were standardized using normative data adjusted for age and level of education. Test-specific cognitive impairment was determined as a z-score ≤−1.5. Radiation dose to brain structures and test-specific cognitive impairment outcomes were fitted to a logistic regression model. High RT dose to the left hippocampus was associated with impaired verbal learning and memory (p = 0.04). RT dose to the left hippocampus, left temporal lobe, left frontal lobe and total frontal lobe were associated with verbal fluency impairment (p