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De Roeck L, Spiessens P, Vermeulen H, Clement P, Daisne J, De Vleeschouwer S, Sleurs C, Lambrecht M. P01.09.A Prevalence and predictors of cognitive impairment in adult glioma survivors after multimodal therapy. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Long-term survival can be achieved in an increasing number of glioma patients after treatment. Therefore, safeguarding these survivors’ quality of life (QoL) is essential. Neurocognitive decline arises in many young patients, placing a heavy burden on the social and economic aspects of the patients’ lives. A lot of debate is currently ongoing regarding the prevalence of neurocognitive impairment and individual predictors of whom is susceptible for such side effect.
Material and Methods
In this cross-sectional study, 37 WHO grade 2-3 adult glioma survivors, at least one year after multimodal therapy, were tested using a comprehensive neurocognitive test battery covering multiple cognitive domains. Neurocognitive test scores were converted into z-scores using country-specific normative data. Cognitive impairment was defined as a z-score lower or equal to -1.50 for each subtest. Age, time since multimodal therapy, radiotherapy treatment and tumour location were included as predictors in a linear regression model per outcome (n=12).
Results
In this cohort, 29 patients (78%) showed a test score below the predefined cutoff on at least one cognitive test. The percentage of patients who showed test-specific cognitive impairment ranged from 8.1% to 56.76% per test. Fine motor skills, verbal memory, processing speed and executive functioning were the most commonly affected cognitive domains. In this study, the variability in processing speed performance was associated with age (TMT A, p=0.03), time since therapy (WAIS-IV coding, p=0.02) and tumour location. In these measures, poorer outcomes were observed with increasing age, longer time since therapy and in patients with gliomas located in the left frontal lobe. Moreover, age showed to be a significant predictor of verbal memory, with poorer outcomes on the HVLT-R delayed recall task with increasing age (p=0.04). Tumour location predicted working memory performance, as patients with right parietal tumours (p=0.03) showed significantly worse on the WAIS-IV digit span task.
Conclusion
These preliminary data underline the various alterations of neurocognitive functioning in glioma survivors after multimodal therapy. Therefore, future research needs to shift towards a patient-tailored approach. The next step in this study will be to link these neurocognitive data to advanced neuroimaging data to explore the potential predictive value of imaging markers for neural damage and cognitive outcomes, paving the path to innovative treatment planning techniques.
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Affiliation(s)
- L De Roeck
- Department of Radiation Oncology, University Hospitals Leuven , Leuven , Belgium
- Laboratory of Experimental Radiotherapy, KU Leuven , Leuven , Belgium
| | - P Spiessens
- Department of Psychology, KU Leuven , Leuven , Belgium
| | - H Vermeulen
- Department of Psychology, KU Leuven , Leuven , Belgium
| | - P Clement
- Department of Oncology, University Hospitals Leuven , Leuven , Belgium
- Department of Oncology, KU Leuven , Leuven , Belgium
| | - J Daisne
- Department of Radiation Oncology, University Hospitals Leuven , Leuven , Belgium
- Laboratory of Experimental Radiotherapy, KU Leuven , Leuven , Belgium
| | - S De Vleeschouwer
- Department of Neurosurgery, University Hospitals Leuven , Leuven , Belgium
- Leuven Brain Institute, KU Leuven , Leuven , Belgium
| | - C Sleurs
- Department of Oncology, KU Leuven , Leuven , Belgium
- Leuven Brain Institute, KU Leuven , Leuven , Belgium
| | - M Lambrecht
- Department of Radiation Oncology, University Hospitals Leuven , Leuven , Belgium
- Laboratory of Experimental Radiotherapy, KU Leuven , Leuven , Belgium
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De Roeck L, Blommaert J, Defraene G, Sleurs C, Vandenbussche L, Lambrecht M. PO-1133 Comparative planning study (IMPT vs VMAT) on sparing OARs important for neurocognition in gliomas. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De Roeck J, Van Houcke J, Almeida D, Galibarov P, De Roeck L, Audenaert EA. Statistical Modeling of Lower Limb Kinetics During Deep Squat and Forward Lunge. Front Bioeng Biotechnol 2020; 8:233. [PMID: 32300586 PMCID: PMC7142215 DOI: 10.3389/fbioe.2020.00233] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/06/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Modern statistics and higher computational power have opened novel possibilities to complex data analysis. While gait has been the utmost described motion in quantitative human motion analysis, descriptions of more challenging movements like the squat or lunge are currently lacking in the literature. The hip and knee joints are exposed to high forces and cause high morbidity and costs. Pre-surgical kinetic data acquisition on a patient-specific anatomy is also scarce in the literature. Studying the normal inter-patient kinetic variability may lead to other comparable studies to initiate more personalized therapies within the orthopedics. Methods Trials are performed by 50 healthy young males who were not overweight and approximately of the same age and activity level. Spatial marker trajectories and ground reaction force registrations are imported into the Anybody Modeling System based on subject-specific geometry and the state-of-the-art TLEM 2.0 dataset. Hip and knee joint reaction forces were obtained by a simulation with an inverse dynamics approach. With these forces, a statistical model that accounts for inter-subject variability was created. For this, we applied a principal component analysis in order to enable variance decomposition. This way, noise can be rejected and we still contemplate all waveform data, instead of using deduced spatiotemporal parameters like peak flexion or stride length as done in many gait analyses. In addition, this current paper is, to the authors’ knowledge, the first to investigate the generalization of a kinetic model data toward the population. Results Average knee reaction forces range up to 7.16 times body weight for the forwarded leg during lunge. Conversely, during squat, the load is evenly distributed. For both motions, a reliable and compact statistical model was created. In the lunge model, the first 12 modes accounts for 95.26% of inter-individual population variance. For the maximal-depth squat, this was 95.69% for the first 14 modes. Model accuracies will increase when including more principal components. Conclusion Our model design was proved to be compact, accurate, and reliable. For models aimed at populations covering descriptive studies, the sample size must be at least 50.
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Affiliation(s)
- Joris De Roeck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - J Van Houcke
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - D Almeida
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | | | - L De Roeck
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Emmanuel A Audenaert
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium.,Department of Orthopaedic Surgery and Traumatology, Ghent University Hospital, Ghent, Belgium.,Department of Trauma and Orthopaedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.,Department of Electromechanics, Op3Mech Research Group, University of Antwerp, Antwerp, Belgium
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De Roeck L, Michaux L, Debackere K, Lierman E, Vandenberghe P, Devos T. Coexisting driver mutations in MPN: clinical and molecular characteristics of a series of 11 patients. ACTA ACUST UNITED AC 2018; 23:785-792. [PMID: 29993347 DOI: 10.1080/10245332.2018.1498182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES CML, PV, ET and PMF are so called classical MPN with distinct clinical phenotypes. The discovery of the BCR-ABL1 translocation and mutations in driver genes JAK2, MPL and CALR has provided novel insights in their pathogenesis. While these mutations are thought to be mutually exclusive, rare cases of MPN with coexisting driver mutations have been reported. However, little is known about the clinical, biological and molecular characteristics of these patients and the interaction of the neoplastic clones. METHODS We retrospectively studied 11 MPN patients with coexisting driver mutations (JAK2 V617F + BCR-ABL1: n = 8; CALR type 2 + BCR-ABL1: n = 1; JAK2 V617F + MPL W515: n = 1; JAK2 V617F + CALR type 1: n = 1). To assess possible associated molecular aberrations, we analysed DNA of six patients using NGS. RESULTS In four CML patients, decreasing BCR-ABL1 transcript levels with increasing JAK2 V617F allele burden under TKI were observed. This strongly suggests that the coexistence of driver mutations originates from two different clones growing independently. Additional somatic mutations were detected in 5 out of 6 (83%) patients affecting 4 different genes, confirming the heterogeneity of this study cohort. Suboptimal response to TKI was observed with a higher frequency (4/8 patients) than reported in conventional series of CML and the overall tolerance of treatment with hydroxyurea and/or imatinib in our series was poor. CONCLUSION Given the emergence of NGS in clinical practice, more similar cases will be identified in the coming years. The optimal treatment strategy for this rare group of patients is uncertain and toxicity of combination treatment may have to be considered.
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Affiliation(s)
- L De Roeck
- a Department of Radiotherapy-Oncology , University Hospitals Leuven , Leuven , Belgium
| | - L Michaux
- b Center for Human Genetics , University Hospitals Leuven , Leuven , Belgium
| | - K Debackere
- c Department of Internal Medicine , University Hospitals Leuven , Leuven , Belgium
| | - E Lierman
- b Center for Human Genetics , University Hospitals Leuven , Leuven , Belgium
| | - P Vandenberghe
- b Center for Human Genetics , University Hospitals Leuven , Leuven , Belgium.,d Department of Hematology , University Hospitals Leuven , Leuven , Belgium
| | - T Devos
- d Department of Hematology , University Hospitals Leuven , Leuven , Belgium.,e Laboratory of Experimental Transplantation, Department of Microbiology and Immunology, KU Leuven , University Hospitals Leuven , Leuven , Belgium
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De Roeck L, Riahi L, Wijchers S, Stockman D, De Greef Y, Schwagten B. Retrograde access of the left atrium for pulmonary vein isolation using magnetic navigation after closure of an atrial septum defect. Neth Heart J 2015; 23:368-9. [PMID: 26017889 PMCID: PMC4497995 DOI: 10.1007/s12471-015-0701-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Transseptal puncture is the most commonly used technique to perform electrophysiological procedures in the left atrium. This case report describes a pulmonary vein isolation in a patient with a paroxysmal atrial fibrillation, complicated by the presence of an oversized Amplatzer device (AGA Medical Corp., Golden Valley, MN). A retrograde approach using the magnetic navigation system (Niobe, Stereotaxis Inc., St Louis, USA) was performed, and showed to provide a feasible, safe and successful alternative for catheter ablation of cardiac arrhythmias in patients in whom the classic transseptal approach is impossible.
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Affiliation(s)
- L De Roeck
- University of Antwerp, Campus Drie Eiken, Universiteitsplein 1, 2610, Antwerp (Wilrijk), Belgium
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