cognitive deficits memory and concentration problems
Conditions
Interventions
None listed
Sponsors
Antoni van Leeuwenhoek Ziekenhuis
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: All groups: - sufficient proficiency in the Dutch language - age under 70 years (to allow use of the same neuropsychological test battery) - eligibility to undergo the MRI scanning session;Cross sectional part, experimental group: - previous participation in our neuropsychological study - having been treated with standard-dose chemotherapy (FEC) ;Cross-sectional part, control group - previous participation in our neuropsychological study - No treatment with chemotherapy ;Control group: - Healthy subjects need to be matched for age
Exclusion criteria
Exclusion criteria: - metastatic disease or relapse since previous neuropsychological examination -history of neurological or psychiatric signs that can impact cognitive functioning - alcohol or drug abuse - conditions that preclude MRI examination
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| MRI scanning will be performed using a Philips Intera 3.0 Tesla scanner with an eight channel Sense head coil. MRI imaging parameters: 1. 3-dimensional T1-weigthed sequences followed by (automated) volumetric measurement, as a gross measure for tissue loss. 2. FLAIR sequence to determine presence and extent of demyelination. 3. MR spectroscopy allows the safe in vivo measurement of brain neurochemistry. Compounds that can be identified are N-acetylaspartaat (NAA), choline (Cho) en myo-inositol (MI). NAA is contained almost exclusively within neurons and is considered a neuronal marker for neuronal density and viability. Cho indicates integrity of neuronal structure. MI reflects glial content. 4. Diffusion Tensor Imaging (DTI) will be used to study the (density) of fibers subserving well-defined functional networks and as such provide an index of damage in the normal appearing white matter. The outcome measures will be used to study correlations with specific functional deficits. 5. Functional MRI: EPI sequence, 38 slices/2,5 mm, 0,5 mm slice gap, TR = 2.1 s, axial sequence acquisition. We will use the following, well-studied paradigms measuring executive functioning and memory to investigate changes in the blood oxygen level dependent (BOLD) response, reflecting neural activity. Tower of London task: a task widely used to investigate executive/planning processes and known to robustly activate the dorsolateral prefrontal cortex. Flanker task: previous studies by our group consistently show impaired performance on this task by patients treated with chemotherapy. It provides a means for examining interference control processes. Activation of the anterior cingulate cortex (a central component of the neural circuit for action monitoring) is reliably observed during this task. Paired associates task: a task concerning implicit memory. The medial temporal lobe (e.g. hippocampus) is reliably activated during encoding as well as retrieval of stimul | — |
Secondary
| Measure | Time frame |
|---|---|
| In addition to the tests that are administrated while MRI scans are being acquired, the patients will also be tested with a neuropsychological examination. The neuropsychological tests will take place before the MRI scanning session.The neuropsychological examination will consist of the following classical neuropsychological tests, which were also included in previous neuropsychological examinations conducted at the NKI-AvL: Hopkins Verbal Learning Test, Trail Making Test, Verbal Fluency Test, Digit Symbol Test, Wechsler Memory Scale, Fepsy Finger Tapping, Flanker task, Behavioural Assessment of the Dysexecutive Syndrome - zoo-map, Digit span, Visual Reaction time task. These tests are included to obtain information on the current cognitive status of the participants. The following data will be collected for all participants: Age, educational status, smoking habits, alcohol intake, body mass index, age at menopause (if applicable) and type of menopause (natural or artificial), previous use of hormone replacement therapy, psychological distress (Hopkins Symptom Checklist), current mood state (Profile Of Mood States), health related quality of life (EORTC QLQ-C30), self-reported cognitive problems (MOS questionnaire), self-reported stress (Perceived Stress Scale), presence of Post Traumatic Stress Disorder (PTSD) (Trauma Questionnaire), lifetime depression and PTSD (Compositie International Diagnostic Interview (CIDI)) , self-reported personality traits (TIPI), self-reported medical history and medication use. For the women and men that underwent chemotherapy the following additional information will be obtained through the medical records: kind of cytotoxic treatment, radiotherapy yes/no, endocrine therapy yes/no (if applicable). For the breast cancer and testicular cancer patients that did not undergo chemotherapy, the following information will be obtained through the medical records: radiotherapy yes/no, endocrine therapy yes/no (if appli | — |
Countries
Netherlands
Outcome results
None listed