Mood, cognition and EEG changes during interferon alpha (alpha-IFN) treatment for chronic hepatitis C.
BACKGROUND
This study is aim to investigate concurrent long-term psychiatric, cognitive and neurophysiological measures of alpha-IFN neurotoxicity in the treatment of chronic viral hepatitis.


METHODS
Twenty patients with HCV hepatitis were enrolled while treated with alpha-IFN (3-6 MU t.i.w. for 6-12 months). Neurotoxicity was evaluated by psychiatric [Hamilton Depression Rating Scale (HAM-D), Hamilton Scale for Anxiety (HAM-A), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI-Y)], complete cognitive and neurophysiological assessments (EEG spectral analysis, P300). Patients were assessed at baseline (t0), 2 (t1) and 6 months (t2) since the beginning of therapy.


RESULTS
Depression scores significantly increased (HAM-D: t0=4.4+/-2.6; t1=8.9+/-3.9, p<0.001; and t2=7.7+/-3.8, p<0.001). A concurrent increase was shown also for anxiety (HAM-A: t0=6.0+/-3.2; t1=9.6+/-4.5, p<0.005; and t2=9.1+/-4.5, p<0.005). Significant neurophysiological effects were also detected: increase of alpha power (p<0.05) in frontal derivations, reduction of the mean dominant frequency (p<0.005) and increase of theta power (p<0.05) in parietal derivations. In contrast, no significant cognitive changes occurred.


CONCLUSIONS
The study was performed on a relative small sample of patients mainly with observational intentions. Biological data (e.g. blood cytokines samples) are not available: they could have given useful information about biological mechanisms related to the alterations observed.


CONCLUSIONS
Alpha-IFN treatment caused a time-dependent induction of symptoms of mild depression, concurrent anxiety and EEG changes. These psychiatric and neurophysiological changes can better explain the pharmacological profile of alpha-IFN and could help to address research on at risk population and, particularly, during pegylated-IFN therapy.
Amodio
Piero
P
Dipartimento di Medicina Clinica e Sperimentale, Clinica Medica 5, Policlinico Universitario, via Giustiniani, 2, 35128, Padova, Italy.
De Toni
Enrico N
EN
Cavalletto
Luisa
L
Mapelli
Daniela
D
Bernardinello
Elisabetta
E
Del Piccolo
Franco
F
Bergamelli
Cristina
C
Costanzo
Raffaella
R
Bergamaschi
Federica
F
Poma
Stefano Zanone
SZ
Chemello
Liliana
L
Gatta
Angelo
A
Perini
Giulia
G
D000293:Adolescent; D000328:Adult; D000339:Affect; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D003071:Cognition; D003072:Cognition Disorders / Q000139:chemically induced / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004569:Electroencephalography; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
D000998:Antiviral Agents; D016898:Interferon-alpha