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

D. D. Correa, M. Kryza-Lacombe, X. Zhou, R. E. Baser, B. J. Beattie, Z. Beiene, J. Humm, L. M. DeAngelis, I. Orlow, W. Weber, J. Osborne

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Brain tumor patients treated with radiotherapy (RT) often develop cognitive dysfunction, and recent studies suggest that the APOE ε-4 allele may influence cognitive outcome. The ε-4 allele is known to promote beta (β) amyloid deposition in the cortex, and preliminary evidence suggests that RT may be associated with this process. However, it is unknown whether β-amyloid accumulation contributes to treatment neurotoxicity. In this pilot study, we assessed neuropsychological functions and β-amyloid retention using 18 F-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 ε-4 carriers and 14 were non-ε-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 ε-4 carriers. There were no significant differences in any of the FBB PET analyses between APOE ε-4 carriers and non-ε-4 carriers. The findings suggest that glioma patients may experience worsening in attention and executive functions several years after treatment, and that the APOE ε-4 allele may modulate cognitive decline, but independent of increased β-amyloid deposition.

Original languageEnglish
Pages (from-to)613-622
Number of pages10
JournalJournal of Neuro-Oncology
Volume136
Issue number3
DOIs
StatePublished - 1 Feb 2018
Externally publishedYes

Keywords

  • APOE
  • Amyloid
  • Brain tumors
  • Cognitive

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