Open AccessLower cognitive performance and white matter changes in testicular cancer survivors 10 years after chemotherapy
Author(s) -
StoutenKemperman Myrle M.,
de Ruiter Michiel B.,
Caan Matthan W.A.,
Boogerd Willem,
Kerst Martijn J.,
Reneman Liesbeth,
Schagen Sanne B.
Publication year - 2015
Publication title -
human brain mapping
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.005
H-Index - 191
eISSN - 1097-0193
pISSN - 1065-9471
DOI - 10.1002/hbm.22942
Subject(s) - white matter , cognition , effects of sleep deprivation on cognitive performance , medicine , neurocognitive , diffusion mri , prospective cohort study , oncology , psychology , nuclear medicine , magnetic resonance imaging , radiology , psychiatry
Objective Chemotherapy (CT) is associated with adverse effects on cognition. Only few studies have investigated cognition in testicular cancer (TC) patients and studies on very late effects of CT on cognition are absent. Further, brain changes in relation to treatment have not been investigated in TC. The objective of the present study is to compare psychosocial functioning, cognitive performance and brain (micro)structure following surgery and CT for TC, against surgery (S)‐only. Methods Twenty‐eight CT (43.1 ± 7.5 y) and 23 S‐only (48.2 ± 9.5y) TC survivors on average 14 yr post‐treatment were examined using questionnaires, neurocognitive tests, and 3T‐MRI [Diffusion Kurtosis Imaging (DKI), T1‐weighted and Fluid Attenuated Inversion Recovery]. A multivariate cognitive performance score (Mahalanobis distance) was calculated to indicate the grade of cognitive performance. Kurtosis parameters, gray matter, and white matter (WM) volume were calculated from MRI data. Results Overall, the CT group showed lower cognitive performance (5.35 ± 1.7) compared with the S‐only group (4.4 ± 0.9; P =0.03; d = 0.70). Further, TC patients reported more memory problems after CT. DKI revealed a significantly higher radial kurtosis after CT in several anterior and posterior brain areas ( P < 0.05, corrected ) , but this was unrelated to cognitive performance. Conclusions This cross‐sectional study suggests that men receiving CT for TC are at risk for long‐term lower cognitive performance. Although CT affected WM microstructure, this was unrelated to cognitive performance. More extensive, preferably prospective studies are warranted to confirm these results and to provide more insight into the possible mechanisms behind the observed cognitive sequelae after treatment for TC. Hum Brain Mapp 36:4638–4647, 2015 . © 2015 Wiley Periodicals, Inc .