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Hardy SJ, Finkelstein A, Milano MT, Schifitto G, Sun H, Holley K, Usuki K, Weber MT, Zheng D, Seplaki CL, Janelsins M. Association of Radiation Dose to the Amygdala-Orbitofrontal Network with Emotion Recognition Task Performance in Patients with Low-Grade and Benign Brain Tumors. Cancers (Basel) 2023; 15:5544. [PMID: 38067248 PMCID: PMC10705220 DOI: 10.3390/cancers15235544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Although data are limited, difficulty in social cognition occurs in up to 83% of patients with brain tumors. It is unknown whether cranial radiation therapy (RT) dose to the amygdala-orbitofrontal network can impact social cognition. METHODS We prospectively enrolled 51 patients with low-grade and benign brain tumors planned for cranial RT. We assessed longitudinal changes on an emotion recognition task (ERT) that measures the ability to recognize emotional states by displaying faces expressing six basic emotions and their association with the RT dose to the amygdala-orbitofrontal network. ERT outcomes included the median time to choose a response (ERTOMDRT) or correct response (ERTOMDCRT) and total correct responses (ERTHH). RESULTS The RT dose to the amygdala-orbitofrontal network was significantly associated with longer median response times on the ERT. Increases in median response times occurred at lower doses than decreases in total correct responses. The medial orbitofrontal cortex was the most important variable on regression trees predicting change in the ERTOMDCRT. DISCUSSION This is, to our knowledge, the first study to show that off-target RT dose to the amygdala-orbitofrontal network is associated with performance on a social cognition task, a facet of cognition that has previously not been mechanistically studied after cranial RT.
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Affiliation(s)
- Sara J. Hardy
- Department of Radiation Oncology, University of Rochester, Rochester, NY 14620, USA; (M.T.M.); (D.Z.); (M.J.)
- Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Alan Finkelstein
- Department of Biomedical Engineering, University of Rochester, Rochester, NY 14627, USA;
- Center for Advanced Brain Imaging and Neurophysiology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Michael T. Milano
- Department of Radiation Oncology, University of Rochester, Rochester, NY 14620, USA; (M.T.M.); (D.Z.); (M.J.)
| | - Giovanni Schifitto
- Department of Neurology, University of Rochester Medical Center, Rochester, NY 14642, USA;
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Hongying Sun
- Department of Surgery, Supportive Care in Cancer, University of Rochester Medical Center, Rochester, NY 14642, USA; (H.S.); (M.T.W.)
| | - Koren Holley
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA;
| | - Kenneth Usuki
- Department of Radiation Oncology, University of Rochester, Rochester, NY 14620, USA; (M.T.M.); (D.Z.); (M.J.)
| | - Miriam T. Weber
- Department of Surgery, Supportive Care in Cancer, University of Rochester Medical Center, Rochester, NY 14642, USA; (H.S.); (M.T.W.)
- Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Dandan Zheng
- Department of Radiation Oncology, University of Rochester, Rochester, NY 14620, USA; (M.T.M.); (D.Z.); (M.J.)
| | - Christopher L. Seplaki
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY 14642, USA;
- Office for Aging Research and Health Services, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Michelle Janelsins
- Department of Radiation Oncology, University of Rochester, Rochester, NY 14620, USA; (M.T.M.); (D.Z.); (M.J.)
- Department of Surgery, Supportive Care in Cancer, University of Rochester Medical Center, Rochester, NY 14642, USA; (H.S.); (M.T.W.)
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Cognitive deficits in adult patients with high-grade glioma: A systematic review. Clin Neurol Neurosurg 2022; 219:107296. [DOI: 10.1016/j.clineuro.2022.107296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 04/04/2022] [Accepted: 05/13/2022] [Indexed: 11/15/2022]
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Pertz M, Schlegel U, Thoma P. Sociocognitive Functioning and Psychosocial Burden in Patients with Brain Tumors. Cancers (Basel) 2022; 14:cancers14030767. [PMID: 35159034 PMCID: PMC8833643 DOI: 10.3390/cancers14030767] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/24/2022] [Accepted: 01/31/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary After years of gauging the efficacy of tumor-directed therapies primarily by means of survival, a broader perspective on therapeutic outcome also focusses on patients’ everyday functional abilities. Besides neurocognition, a matter of high clinical relevance, “social cognition” may also affect well-being and quality of life (QoL) in brain tumor patients. Abilities that enable individuals to establish and maintain social relationships are summarized under the umbrella term “sociocognitive functioning”. These abilities encompass the understanding and sharing of emotional and mental states of other individuals as well as skills to detect and resolve interpersonal problems. These sociocognitive abilities may be challenged in highly demanding life situations such as brain tumor diagnosis and treatment. Therefore, we summarize the literature on psychosocial burden and sociocognitive functioning in adult brain tumor patients. Abstract Brain tumors may represent devastating diseases and neuro-oncological research in the past solely focused on development of better treatments to achieve disease control. The efficacy of tumor-directed treatment was evaluated by progression-free and overall survival. However, as neuro-oncological treatment became more effective, preservation and improvement of quality of life (QoL) was noticed to represent an important additional outcome measure. The need to balance between aggressive tumor-directed treatment and preservation of QoL was increasingly acknowledged in brain tumor patients. QoL is comprised by many determinants; one of those may have been rather neglected so far: social cognition. Since diagnosis and treatment of brain tumors represent demanding life situations, patients may experience increased psychosocial burden and the negative consequences of illness on well-being may be buffered by intact social relationships. These skills to build and maintain supportive social relationships essentially depend on the ability to empathize with others and to recognize and appropriately address social conflicts, i.e., “sociocognitive functioning”. Therefore, sociocognitive functions may influence QoL and treatment outcome. In this article, we review the literature on psychosocial burden and sociocognitive functioning in adult brain tumor patients.
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Affiliation(s)
- Milena Pertz
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, In der Schornau 23–25, D-44892 Bochum, Germany;
- Correspondence:
| | - Uwe Schlegel
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, In der Schornau 23–25, D-44892 Bochum, Germany;
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC), Faculty of Psychology, Ruhr University Bochum, Universitätsstraße 150, D-44780 Bochum, Germany;
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Kramkowski J, Hebert C. Neuropsychiatric sequelae of brain radiation therapy: A review of modality, symptomatology, and treatment options. Gen Hosp Psychiatry 2022; 74:51-57. [PMID: 34911026 DOI: 10.1016/j.genhosppsych.2021.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Consultation-liaison psychiatrists frequently evaluate cancer patients with brain involvement, and brain irradiation is often a mainstay of treatment for this population. A comprehensive review of the neuropsychiatric effects of brain radiotherapy is lacking in the psychiatric literature. This review aims to provide an in depth discussion of existing literature with guidance about treatments for radiation-induced neurocognitive decline. METHODS Narrative synthesis of available published literature retrieved from PubMed and MEDLINE databases. Particular focus was given to neuropsychiatric manifestations after radiotherapy, dose-response relationships, differential effects of whole versus stereotactic regimens, and studies investigating possible pharmacological treatments. RESULTS Brain irradiation induces cognitive, mood, and other symptoms that evolve in a time-dependent manner and adversely affect quality of life. Available data implicates loss of hippocampal neurogenesis and repair in post-radiotherapy changes. Clinical factors affecting incidence of neuropsychiatric compromise include total radiation dose, whole brain radiation, among others. Efficacy of pharmacological interventions is mixed for certain agents (ie, methylphenidate) but promising for others (ie, memantine). CONCLUSIONS Neuropsychiatric consequences of brain irradiation are common. Although our understanding of clinical manifestations and pathogenesis has advanced considerably, treatment options are poorly researched and use of any psychopharmacological intervention should therefore be tailored to individual patient needs.
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Affiliation(s)
- Joseph Kramkowski
- Pine Rest Christian Mental Health Services, 300 68(th) Street SE, Grand Rapids, MI 49548, USA.
| | - Charles Hebert
- Departments of Internal Medicine & Psychiatry and Behavioral Sciences, Rush University Medical Center, 1700 W Van Buren Street, Suite 490, Chicago, IL 60612, USA.
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Maggio MG, Maresca G, Stagnitti MC, Anchesi S, Casella C, Pajno V, De Luca R, Manuli A, Calabrò RS. Social cognition in patients with acquired brain lesions: An overview on an under-reported problem. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:419-431. [PMID: 32301351 DOI: 10.1080/23279095.2020.1753058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Social cognition (SC) consists of mental representations of interpersonal relationships, which are used flexibly by the individual to promote functional social behaviors and achieve the goals. SC is a multidimensional construct and is supported by the activity of distributed neural networks in which different cortical and subcortical regions of the brain are involved. The review aims to evaluate the current literature on SC taking into account how it is compromised in acquired brain injury. Studies performed between 2010 and 2019 and fulfilling the selected criteria were searched on PubMed, Scopus, Cochrane and Web of Sciences databases. Impairment of SC is a neglected but common consequence of ABI, often leading to disordered interpersonal functioning and poor regulation of personal behavior with impaired social adaptation and quality of life of both the patient and his/her family. This review supports the idea that SC could have an important role in the management of neurological patients by both clinicians and caregivers.
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Pertz M, Okoniewski A, Schlegel U, Thoma P. Impairment of sociocognitive functions in patients with brain tumours. Neurosci Biobehav Rev 2019; 108:370-392. [PMID: 31786319 DOI: 10.1016/j.neubiorev.2019.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/24/2019] [Accepted: 11/25/2019] [Indexed: 12/30/2022]
Abstract
The ability to decode mental states and to come up with effective solutions for interpersonal problems aids successful initiation and maintenance of social interactions and contributes to participation and mental health. Since these abilities of social cognition are challenged in highly demanding situations, such as diagnosis and treatment of a life-threatening illness, this article reviews the literature on emotion recognition, empathy, Theory of Mind and socially skilled behaviour in brain tumour patients. The data available suggest that patients are affected by a slight but consistent impairment of emotion recognition, empathy and Theory of Mind before and immediately after brain tumour treatment, with the degree of impairment being influenced by tumour histology and localization. Impairments mostly decrease a few months after surgery due to assumed neuroplasticity. Future research may address more complex sociocognitive functions, such as social problem solving, and may investigate to which degree sociocognitive difficulties act as risk factors for poor or failed reintegration into occupational and social life following successful brain tumour treatment.
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Affiliation(s)
- Milena Pertz
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, In der Schornau 23-25, D-44892 Bochum, Germany.
| | - Annalena Okoniewski
- Neuropsychological Treatment Centre (NTC)/ Clinical Neuropsychology, Faculty of Psychology, Ruhr-University Bochum, Universitätsstraße 150, D-44780 Bochum, Germany
| | - Uwe Schlegel
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, In der Schornau 23-25, D-44892 Bochum, Germany
| | - Patrizia Thoma
- Neuropsychological Treatment Centre (NTC)/ Clinical Neuropsychology, Faculty of Psychology, Ruhr-University Bochum, Universitätsstraße 150, D-44780 Bochum, Germany
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Pérès EA, Etienne O, Grigis A, Boumezbeur F, Boussin FD, Le Bihan D. Longitudinal Study of Irradiation-Induced Brain Microstructural Alterations With S-Index, a Diffusion MRI Biomarker, and MR Spectroscopy. Int J Radiat Oncol Biol Phys 2018; 102:1244-1254. [DOI: 10.1016/j.ijrobp.2018.01.070] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 12/19/2017] [Accepted: 01/22/2018] [Indexed: 01/19/2023]
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Neurocognitive impact of cranial radiation in adults with cancer: an update of recent findings. Curr Opin Support Palliat Care 2017; 11:32-37. [DOI: 10.1097/spc.0000000000000255] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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