Guastadisegni, P., Neuwelt, E.A. and Varallyay, P., Oregon Health Sciences University, USA
This study examined neuropsychological functioning in a group of primary central nervous system lymphoma patients. To assess the impact of enhanced chemotherapy treatment with blood brain barrier disruption on cognitive functioning, all patients underwent a neuropsychological assessment prior to treatment, at the conclusion of treatment, and annually thereafter. Each patient received routine MRI studies assessing the disease and treatment process. 16 patients where available after 1 year from initial diagnosis (n=16), and 9 (n=9) patients were available for comparison at least 2 years from diagnosis. The neuropsychological assessment included measures of IQ, memory, attention, visual-spatial, motor, and verbal abilities. Scores were converted to Z scores, and a summary Z score was generated. MRI data was calculated by measuring T-2 signal abnormality surrounding the tumor at baseline and residual T-2 at end of treatment. A summary T-2 abnormality score was also calculated. Paired samples T-test found that the neuropsychological data and T-2 signal significantly improved from baseline to end of treatment (t=-3.3, P< 005; t= 2.0, P< 009). Long term survivors had a non-significant improvement in cognitive functioning, and new MRI changes were not associated with cognitive decline. PCNSL brain tumor patients can be treated without associated cognitive decline related to enhanced chemotherapy delivery, and cognitive functioning is preserved over time. This study demonstrates the important role and use of neuropsychological assessment with MRI studies in the treatment of brain tumor patients.