title: Cognitive and neuropsychiatric impairment in cerebral radionecrosis patients after radiotherapy of nasopharyngeal carcinoma.
abstract: BACKGROUND
  We sought to characterize the cognitive function and neuropsychiatric symptoms in cerebral radionecrosis (CRN) patients who have received conformal radiation for nasopharyngeal carcinoma.
  
  
  METHODS
  A total of 40 patients treated with radiotherapy (RT) that developed CRN (RT + CRN), 40 patients treated with radiotherapy that did not have CRN (RT-No-CRN), and 36 newly diagnosed untreated nasopharyngeal carcinoma patients (No-RT) were recruited. The cognitive function and neuropsychiatric symptoms were evaluated with Montreal cognitive assessment (MoCA), the mini-mental state examination (MMSE), activity of daily living scale (ADL), neuropsychiatric inventory (NPI), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA).
  
  
  RESULTS
  The RT + CRN group had the lowest mean MMSE, MoCA and ADL scores, while highest mean NPI, HAMD and HAMA scores among the three patient groups (P < 0.05). Thirty (75%) of the RT + CRN patients were deemed cognitively impaired by the MoCA compared with 9 (22.5%) by the MMSE (χ(2) = 22.064; P < 0.001). Eighty-two percents of subject in RT + CRN group experienced neuropsychiatric symptoms within the past 4 weeks. Irritability, anxiety, depression and agitation in the RT + CRN group were of the most significantly frequent among the 3 groups.
  
  
  CONCLUSIONS
  The CRN patients generally have manifestations in cognitive and psychological impairment, which have their typical characteristics, and should be considered in CRN treatment and rehabilitation. The MoCA classifies more CRN patients as cognitively impaired than the MMSE, justifying further studies of the MoCA as an appropriate screen for CRN.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Wu
authors.forename: Mofa
authors.initials: M
authors.lastname: Gu
authors.forename: Guijuan
authors.initials: G
authors.lastname: Zhou
authors.forename: Xue
authors.initials: X
authors.lastname: Xu
authors.forename: Mengmeng
authors.initials: M
authors.lastname: Wu
authors.affiliation: Department of Neurology, First Affiliated Hospital of Sun Yat-Sen University, No, 58 Zhongshan Road 2, Guangzhou 510080, China. hhw2002@sohu.com.
authors.forename: Haiwei
authors.initials: H
authors.lastname: Huang
mesh_terms: D000328:Adult; D002277:Carcinoma; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000523:psychology* / Q000532:radiotherapy*; D009336:Necrosis / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*