Quantitative Imaging Biomarkers of Damage to Critical Memory Regions Are Associated With Post–Radiation Therapy Memory Performance in Brain Tumor Patients

Dose-dependent volume loss in subcortical deep grey matter structures after cranial radiotherapy

“…Finally, a link between post-RT hippocampal volume and neurocognitive outcomes was found in primary brain tumours by Tringale et al [9]. They found that, in addition to diffusion biomarkers, a smaller right hippocampal volume was associated with poorer visuospatial memory performance in the 12 months after RT.…”

“…Similarly, diffusion tensor imaging has shown that white matter shows dose-dependent changes in several metrics after RT [7] . Finally, two grey matter structures, the hippocampus [8] , [9] and the amygdala [10] , show susceptibility to radiation damage, again with higher volume changes with increasing dose. Furthermore, the dose to the hippocampus has been shown to negatively affect neurocognitive outcome after RT [11] .…”

Cognitive Decline After Cranial Irradiation: Hoping for a Systematic Application of the Reliable Change Index

“…The aim of this contribution was to unsystematically highlight some methodological issues observed within the literature about the cognitive consequences of cranial irradiation for oncological management (Gondi et al, 2010 , 2012 , 2014 ; Kim et al, 2018 ; Acharya et al, 2019 ; Tringale et al, 2019 ). We advocate that much of the debate and many of the controversial results found within and across these studies are mainly based on such issues; the patients with disease of different clinical stages, the timing of neuropsychological assessment, and the absence of guidelines about the neuropsychological battery to employ for assessing the outcomes make it difficult to compare studies.…”

“…In the cranial irradiation literature, even if the RCI is not the standard approach to assess whether patients have been diagnosed as cognitively worsened (or improved), some studies have employed this index (Chang et al, 2009 ; Gondi et al, 2014 ; Tringale et al, 2019 ). For example, Gondi et al ( 2014 ), on the basis of a version of RCI, adopted a drop of at least two, three, or five points from baseline on the Hopkins Verbal Learning Test—Revised (Benedict et al, 1998 ) for immediate recognition, delayed recall, and total recall, respectively.…”

“…Although the RCI is fairly widespread in neuropsychological literature (Chelune et al, 1993 ; Sawrie et al, 1996 ; Maassen, 2004 ; Hensel et al, 2007 ), in some subfields, this index is still employed in an unsystematic way. Here we will focus on the cognitive consequences of cranial irradiation for oncological management (Gondi et al, 2010 , 2012 , 2014 ; Kim et al, 2018 ; Acharya et al, 2019 ; Tringale et al, 2019 ). Converging literature indicates that the link between cranial irradiation and an increased risk of a posttreatment neurocognitive decline occurring months or years after radiation therapy can be taken for granted.…”