title: Cognitive functions in low-grade gliomas: disease and treatment effects.
abstract: BACKGROUND
  The role of radiotherapy and chemotherapy in the treatment of low-grade gliomas (LGG) is controversial regarding their effect on survival and the development of neurotoxicity. The few published studies examining adverse treatment effects on cognition revealed conflicting results.
  
  
  OBJECTIVE
  To assess cognitive functioning in LGG patients who received conformal radiation therapy (RT), chemotherapy, or no treatment.
  
  
  METHODS
  40 LGG patients participated in the study; 16 patients had RT +/- chemotherapy, and 24 patients had no treatment. All patients underwent a neuropsychological evaluation. APOE genotype was obtained in 36 patients who were classified in two groups based on the presence or absence of at least one apolipoprotein E small je, Ukrainian-4 (APOE small je, Ukrainian-4) allele.
  
  
  RESULTS
  Treated LGG patients had lower scores than untreated patients on several cognitive domains; patients who completed treatment at intervals greater than 3 years and had long disease duration had significantly lower scores on the Non-Verbal Memory domain. Antiepileptic polytherapy, treatment history, and disease duration jointly contributed to low Psychomotor domain scores. 62% of treated patients showed white matter confluence on MRI, whereas only 9% of the untreated patients had such changes. Preliminary comparisons between APOE small je, Ukrainian-4 carriers (n = 9) and non-carriers (n = 27) on cognitive domain scores revealed no statistically significant differences, but APOE small je, Ukrainian-4 carriers had lower mean scores on the Verbal Memory domain than did non-small je, Ukrainian-4 carriers.
  
  
  CONCLUSIONS
  RT +/- chemotherapy, disease duration, and antiepileptic treatment contributed to mild cognitive difficulties in LGG patients.
authors.affiliation: Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. corread@mskcc.org
authors.forename: Denise D
authors.initials: DD
authors.lastname: Correa
authors.forename: Lisa M
authors.initials: LM
authors.lastname: DeAngelis
authors.forename: Weiji
authors.initials: W
authors.lastname: Shi
authors.forename: Howard T
authors.initials: HT
authors.lastname: Thaler
authors.forename: Michael
authors.initials: M
authors.lastname: Lin
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Abrey
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D053327:Apolipoprotein E4 / Q000235:genetics; D001932:Brain Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D003072:Cognition Disorders / Q000503:physiopathology*; D004827:Epilepsy / Q000209:etiology / Q000628:therapy; D005260:Female; D005910:Glioma / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests
chemical_list: D000970:Antineoplastic Agents; D053327:Apolipoprotein E4