Joyce Wilbers1, Arnoud C Kappelle1, Laura Versteeg1, Anil M Tuladhar1, Stefan C A Steens1, Frederick J A Meijer1, Willem Boogerd1, Lucille D Dorresteijn1, Johannes H Kaanders1, Roy P C Kessels1, Ewoud J van Dijk1. 1. Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen PO Box 9101, 6500 HB Nijmegen, the Netherlands (J.W., A.C.K., A.M.T., E.J.v.D.); Department of Medical Psychology, Radboud University Medical Center and Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, 6500 HE, the Netherlands (L.V., R.P.C.K.); Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands (S.C.A.S., F.J.A.M.); Department of Neurology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, the Netherlands (W.B.); Department of Neurology, Medisch Spectrum Twente, PO Box 50000, 7500 KA Enschede, the Netherlands (L.D.D.); Department of Radiation Oncology, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands (J.H.K.).
Abstract
BACKGROUND: Long-term cancer treatment complications become more prevalent as survival improves. Little is known about the psychological complications in long-term survivors of head and neck cancer (HNC). We investigated cognitive functioning and its relation with depression, fatigue, cognitive complaints, and brain lesions on MRI. METHODS: This study is part of a multicentre, prospective cohort study of 65 patients treated for HNC. A comprehensive neuropsychological assessment was combined with validated questionnaires on subjective memory complaints, depression, and fatigue after a median of 7 years follow-up. Results were compared with age- and education-adjusted normative data. Further, we evaluated cerebral white matter hyperintensities (WMH), brain volume, and infarctions on MRI. RESULTS: HNC patients had worse cognitive performance in two of the five assessed cognitive domains: episodic memory (z = -0.48, P = .003) and speed of information processing (z = -0.47, P < 0.001). Patients with fatigue performed worse than patients without fatigue on verbal fluency (mean difference in z-score 0.52, P = .02) and speed of information processing (0.49, P = .04). Patients with subjective memory complaints had a worse episodic memory performance (mean difference in z-score -0.96; P = .02). Patients with cerebral infarction(s) on MRI performed worse on fluency (mean difference in z-score 0.74, P = .005). A lower cognitive performance was not associated with depression, WMH or brain volume. CONCLUSION: Long-term HNC survivors showed worse cognitive functioning 7 years after treatment. Cognitive function was associated with subjective complaints and fatigue, but not with depressive symptoms. Cerebral infarctions on MRI were correlated with cognitive function, whereas WMH, and brain volume were not.
BACKGROUND: Long-term cancer treatment complications become more prevalent as survival improves. Little is known about the psychological complications in long-term survivors of head and neck cancer (HNC). We investigated cognitive functioning and its relation with depression, fatigue, cognitive complaints, and brain lesions on MRI. METHODS: This study is part of a multicentre, prospective cohort study of 65 patients treated for HNC. A comprehensive neuropsychological assessment was combined with validated questionnaires on subjective memory complaints, depression, and fatigue after a median of 7 years follow-up. Results were compared with age- and education-adjusted normative data. Further, we evaluated cerebral white matter hyperintensities (WMH), brain volume, and infarctions on MRI. RESULTS: HNC patients had worse cognitive performance in two of the five assessed cognitive domains: episodic memory (z = -0.48, P = .003) and speed of information processing (z = -0.47, P < 0.001). Patients with fatigue performed worse than patients without fatigue on verbal fluency (mean difference in z-score 0.52, P = .02) and speed of information processing (0.49, P = .04). Patients with subjective memory complaints had a worse episodic memory performance (mean difference in z-score -0.96; P = .02). Patients with cerebral infarction(s) on MRI performed worse on fluency (mean difference in z-score 0.74, P = .005). A lower cognitive performance was not associated with depression, WMH or brain volume. CONCLUSION: Long-term HNC survivors showed worse cognitive functioning 7 years after treatment. Cognitive function was associated with subjective complaints and fatigue, but not with depressive symptoms. Cerebral infarctions on MRI were correlated with cognitive function, whereas WMH, and brain volume were not.
Entities:
Keywords:
cognition; depression; fatigue; head and neck cancer; white matter hyperintensities
Authors: Lucille D A Dorresteijn; Arnoud C Kappelle; Natasja M J Scholz; Marten Munneke; José T Scholma; Alfons J M Balm; Harry Bartelink; Willem Boogerd Journal: Eur J Cancer Date: 2005-05 Impact factor: 9.162
Authors: G A Curt; W Breitbart; D Cella; J E Groopman; S J Horning; L M Itri; D H Johnson; C Miaskowski; S L Scherr; R K Portenoy; N J Vogelzang Journal: Oncologist Date: 2000
Authors: Sarah E Vermeer; Niels D Prins; Tom den Heijer; Albert Hofman; Peter J Koudstaal; Monique M B Breteler Journal: N Engl J Med Date: 2003-03-27 Impact factor: 91.245
Authors: Lucille D A Dorresteijn; Arnoud C Kappelle; Willem Boogerd; Willem J Klokman; Alfons J M Balm; Ronald B Keus; Flora E van Leeuwen; Harry Bartelink Journal: J Clin Oncol Date: 2002-01-01 Impact factor: 44.544
Authors: Niels D Prins; Ewoud J van Dijk; Tom den Heijer; Sarah E Vermeer; Peter J Koudstaal; Matthijs Oudkerk; Albert Hofman; Monique M B Breteler Journal: Arch Neurol Date: 2004-10
Authors: Judith T Pruijssen; Ashwin Wenmakers; Roy P C Kessels; Vitoria Piai; Frederick J A Meijer; Sjoert A H Pegge; Jacqueline J Loonen; Anil M Tuladhar; Hendrik H G Hansen; Johannes H A M Kaanders; Joyce Wilbers Journal: BMC Cancer Date: 2022-03-05 Impact factor: 4.430