Abstract | UNLABELLED: METHODS: 31 patients aged 42 to 73 years underwent the following procedures before and after chemotherapy: clinical examination; MRI of the brain (Elscint Prestige 2T), MRS (PRESS sequence, TR 1500 ms, TE 80 ms) with volumes of interest (VOI) of 8 ml localized in the semi-oval center and a cerebellar hemisphere. The analysis of each patient's NAA/Cr and Cho/Cr ratios was carried out separately for the semi-oval center and cerebellum measurements. RESULTS: None of the patients demonstrated any clinical manifestations of the CNS neuropathy. MRI of the brain did not reveal any abnormalities caused by chemotherapy. Pre-treatment NAA/Cr and Cho/Cr ratios in the semi-oval center did not differ significantly from these measured after chemotherapy. However, the analysis of the cerebellar spectra showed a significant decrease in the NAA/Cr ratio (p < 0.05) and a time-related decrease in the Cho/Cr ratio (p < 0.05) after chemotherapy. An analysis of Pearson's correlations showed a very strong linear relationship between NAA/Cr and Cho/Cr ratios (p < 0.001), both in the semi-oval center and cerebellum. CONCLUSION: The decreased NAA/Cr ratio can indicate some neuronal loss caused by chemotherapy. The decrease in the Cho/Cr ratio could be associated with some myelin damage. The MRS results suggest the presence of a sub-clinical selective cerebellar neuropathy caused by chemotherapy. The MRS revealed that reaction to chemotherapy was different at the semi-oval center than that in the cerebellum. The results allow theorizing about an alternative or two-stage brain response to the neurotoxic factor found both in the cerebrum (the semi-oval center) and cerebellum. These initial results indicate that proton MR spectroscopy is a potentially useful modality for detecting an early stage of the CNS pathology caused by neurotoxicity of chemotherapy.
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Authors | Beata Ciszkowska-Łysoń, Leszek Królicki, Anna Teska, Anna Janowicz-Zebrowska, Maciej Krzakowski, Małgorzata Tacikowska |
Journal | Neurologia i neurochirurgia polska
(Neurol Neurochir Pol)
Vol. 37
Issue 4
Pg. 783-98
( 2003)
ISSN: 0028-3843 [Print] Poland |
Vernacular Title | Zaburzenia metabolizmu mózgowia po chemioterapii w badaniu spektroskopii protonowej rezonansu magnetycznego. |
PMID | 14746239
(Publication Type: English Abstract, Journal Article)
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Chemical References |
- Aspartic Acid
- N-acetylaspartate
- Creatine
- Choline
|
Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects)
- Aspartic Acid
(analogs & derivatives, metabolism)
- Brain
(metabolism, pathology)
- Brain Diseases, Metabolic
(chemically induced, diagnosis)
- Choline
(metabolism)
- Creatine
(metabolism)
- Female
- Humans
- Lung Neoplasms
(drug therapy)
- Magnetic Resonance Spectroscopy
- Male
- Middle Aged
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