A pilot study of neuropsychological functions, APOE and amyloid imaging in patients with gliomas

作者：Correa D. D.; Kryza-Lacombe M.; Zhou X.; Baser R. E.; Beattie B. J.; Beiene Z.; Humm J.; DeAngelis L. M.; Orlow I.; Weber W.; O**orne J.

来源：Journal of Neuro-Oncology, 2018, 136(3): 613-622.

DOI：10.1007/s11060-017-2692-5

• Cognitive
• APOE
• Amyloid
• Brain tumors

Brain tumor patients treated with radiotherapy (RT) often develop cognitive dysfunction, and recent studies suggest that the APOE epsilon-4 allele may influence cognitive outcome. The epsilon-4 allele is known to promote beta (beta) amyloid deposition in the cortex, and preliminary evidence suggests that RT may be associated with this process. However, it is unknown whether beta-amyloid accumulation contributes to treatment neurotoxicity. In this pilot study, we assessed neuropsychological functions and beta-amyloid retention using F-18-florbetaben (FBB) PET in a subset of brain tumor patients who participated in our study of APOE polymorphisms and cognitive functions. Twenty glioma patients treated with conformal RT +/- chemotherapy participated in the study: 6 were APOE epsilon-4 carriers and 14 were non-epsilon-4 carriers. Patients completed a neuropsychological re-evaluation (mean time interval = 5 years, SD = 0.83) and brain MRI and FBB PET scans. Wilcoxon signed-rank test comparisons between prior and current neuropsychological assessments showed a significant decline in attention (Brief Test of Attention, p = 0.018), and a near significant decline in verbal learning (Hopkins Verbal learning Test-Learning, p = 0.07). Comparisons by APOE status showed significant differences over time in attention/working memory (WAIS-III digits forward, p = 0.028 and digits backward, p = 0.032), with a decline among APOE epsilon-4 carriers. There were no significant differences in any of the FBB PET analyses between APOE epsilon-4 carriers and non-epsilon-4 carriers. The findings suggest that glioma patients may experience worsening in attention and executive functions several years after treatment, and that the APOE epsilon-4 allele may modulate cognitive decline, but independent of increased beta-amyloid deposition.

• 出版日期2018-2