Christelle Nilles1, Daniel Delgadillo2, Marie Sarazin3,4,5, Lucia Nichelli6, Karima Mokhtari7, Bertrand Mathon8, Sylvain Choquet9, Loïc Feuvret10, Agusti Alentorn2, Monica Ribeiro2,11, Khê Hoang-Xuan2, Caroline Houillier2. 1. Neurologie 2, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, IHU, ICM, Paris, France. christelle.nilles@gmail.com. 2. Neurologie 2, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, IHU, ICM, Paris, France. 3. Department of Neurology of Memory and Language, GHU Paris Psychiatrie & Neurosciences, Hôpital Sainte Anne, 75014, Paris, France. 4. Université de Paris, 75006, Paris, France. 5. Université Paris-Saclay, BioMaps, Service Hospitalier Frédéric Joliot CEA, CNRS, Inserm, 91401, Orsay, France. 6. Service de Neuroradiologie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, Paris, France. 7. Neuropathologie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, Paris, France. 8. Service de Neurochirurgie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, Paris, France. 9. Service d'hématologie Clinique, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, Paris, France. 10. Service d'oncologie - radiothérapie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Sorbonne Université, Paris, France. 11. Centre Borelli, CNRS UMR 9010, Université de Paris, Paris, France.
Abstract
INTRODUCTION: The corpus callosum (CC) is frequently involved in primary central nervous system lymphomas (PCNSLs). In this cohort study, we described the neurocognition of patients with PCNSL-CC and its posttherapeutic evolution. METHODS: Immunocompetent patients with PCNSL-CC were identified retrospectively at the Pitié-Salpêtrière Hospital. We described their clinical presentation. Neuropsychological test scores (MMSE; digit spans; Free and Cued Selective Reminding Test; Image Oral Naming Test; Frontal Assessment Battery; Trail Making Test; Stroop and verbal fluency tests; Rey's Complex Figure test) and factors impacting them were analyzed. RESULTS: Twenty-seven patients were included (median age: 67 years, median Karnofsky Performance Status: 70); cognitive impairment and balance disorders were present in 74% and 59%, respectively. At diagnosis, neuropsychological test results were abnormal for global cognitive efficiency (63% of patients), memory (33-80% depending on the test) and executive functions (44-100%). Results for visuospatial and language tests were normal. All patients received high-dose methotrexate-based polychemotherapy, followed in one patient by whole-brain radiotherapy; 67% of patients achieved complete response (CR). With a median follow-up of 48 months (range 6-156), patients in CR had persistent abnormal test results for global cognitive efficiency in 17%, executive function in 18-60%, depending on the test, and memory in 40-60%. Splenium location and age ≥ 60 years were significantly associated with worse episodic memory scores throughout the follow-up. CONCLUSIONS: PCNSL-CC is associated with frequent cognitive dysfunctions, especially memory impairment, which may recover only partially despite CR and warrant specific rehabilitation. Older age (≥ 60) and splenium location are associated with worse neurocognitive outcomes.
INTRODUCTION: The corpus callosum (CC) is frequently involved in primary central nervous system lymphomas (PCNSLs). In this cohort study, we described the neurocognition of patients with PCNSL-CC and its posttherapeutic evolution. METHODS: Immunocompetent patients with PCNSL-CC were identified retrospectively at the Pitié-Salpêtrière Hospital. We described their clinical presentation. Neuropsychological test scores (MMSE; digit spans; Free and Cued Selective Reminding Test; Image Oral Naming Test; Frontal Assessment Battery; Trail Making Test; Stroop and verbal fluency tests; Rey's Complex Figure test) and factors impacting them were analyzed. RESULTS: Twenty-seven patients were included (median age: 67 years, median Karnofsky Performance Status: 70); cognitive impairment and balance disorders were present in 74% and 59%, respectively. At diagnosis, neuropsychological test results were abnormal for global cognitive efficiency (63% of patients), memory (33-80% depending on the test) and executive functions (44-100%). Results for visuospatial and language tests were normal. All patients received high-dose methotrexate-based polychemotherapy, followed in one patient by whole-brain radiotherapy; 67% of patients achieved complete response (CR). With a median follow-up of 48 months (range 6-156), patients in CR had persistent abnormal test results for global cognitive efficiency in 17%, executive function in 18-60%, depending on the test, and memory in 40-60%. Splenium location and age ≥ 60 years were significantly associated with worse episodic memory scores throughout the follow-up. CONCLUSIONS: PCNSL-CC is associated with frequent cognitive dysfunctions, especially memory impairment, which may recover only partially despite CR and warrant specific rehabilitation. Older age (≥ 60) and splenium location are associated with worse neurocognitive outcomes.
Authors: G Deloche; D Hannequin; M Dordain; M N Metz-Lutz; H Kremin; C Tessier; J Vendrell; D Cardebat; D Perrier; S Quint; B Pichard Journal: J Commun Disord Date: 1997 Jan-Feb Impact factor: 2.288
Authors: Wilhelm Küker; Thomas Nägele; Agnieska Korfel; Stefan Heckl; Eckhard Thiel; Michael Bamberg; Michael Weller; Ulrich Herrlinger Journal: J Neurooncol Date: 2005-04 Impact factor: 4.130