The Influences of Whole Brain Radiotherapy on Social Cognition and Association with Hippocampal and Frontal Dosimetry

Abstract

The influence of brain radiotherapy on neurocognition is a major concern. Social cognition is a mental process in the meaning of social interaction and the recognition of facial emotion is a domain of social cognition. Thus, we aimed to investigate the early effect of whole brain radiotherapy on facial emotion recognition ability. Thirteen patients with various brain tumors in the study. Beck depression and anxiety inventory and the facial emotion recognition test by using a set of photographs were performed at the beginning and post radiotherapy. The severity of depression (16.40 ± 12.16 vs 04.00 ± 02.38 points) and anxiety (14.47 ± 11.96 vs 04.54 ± 03.30 points) were significantly higher in patients. The only significance according to facial emotion recognition rate between initial phase of patients and healthy controls was identifying neutral facial em otion (p = 0.002). The patients after brain radiotherapy had significantly better rate of recognizing fear facial emotions (p = 0.039). This study is the first that investigated the effects of cranial irradiation on facial emotion recognition ability and compares this ability with healthy controls. Interestingly, in the early phase the patients seem to be improved in fear facial emotion after brain radiotherapy without sparing cognition specific regions as hippocampus and frontal regions.

Sociocognitive Functioning and Psychosocial Burden in Patients with Brain Tumors

“…Concerning studies with more than one assessment, to the best of our knowledge only one study assessed influences of an oncological treatment other than surgery. This study reported changes in emotion recognition after radiation [130]. Studies using two time points before and after surgery reported on a performance decrease in emotion recognition in glioblastoma patients [122] as well as region specific impairments of sociocognitive functioning [84] in a heterogeneous group of brain tumor patients.…”

“…By contrast, other studies pointed to significantly impaired sociocognitive functioning even before any treatment has started in brain tumor patients [88,94]. Likewise, some posttreatment studies reported relevant impairments [87,118,122,130], some regionspecific [80,95,101] (e.g., mainly frontal and insular regions). By contrast, other investigations reported no clinically relevant or only minor impairment of sociocognitive functioning in brain tumor patients even after treatment [81,96,98,111,120,127].…”

“…Fourthly, there is only a limited number of studies specifically targeting the influence of oncological treatments other than surgery. Although there are posttreatment studies most of them did not assess treatment related factors, with the exception of one study, explicitly gauging the influence of radiation [130]. These aspects require incorporation into future studies to fully understand the impact of each treatment phase and the impact of radio-and chemotherapy on social cognition and psychosocial burden.…”

Association of Radiation Dose to the Amygdala–Orbitofrontal Network with Emotion Recognition Task Performance in Patients with Low-Grade and Benign Brain Tumors

“…Data on social cognition in patients with brain tumors, particularly whether there are changes after treatment, are limited [8]. One prior small study evaluated changes in emotion recognition after whole brain RT [56], and studies have shown performance decreases in patients with glioblastoma [57] and varied brain tumors [58] after surgery. There is a critical need to mechanistically study the impact of cranial RT on social cognition.…”

Longitudinal Study of Irradiation-Induced Brain Microstructural Alterations With S-Index, a Diffusion MRI Biomarker, and MR Spectroscopy

“…Cognitive deficits have been reported in adult brain tumor survivors (who survived >6 months) with an incidence rate of 50% to 90% after partial-or whole-brain irradiation (1)(2)(3). The cognitive impairments induced by RT are marked by reduced verbal memory, spatial memory, attention, and novel problem-solving abilities (4)(5)(6). Clinically, irradiationinduced brain injury is classified as acute (days to weeks), early delayed (1-6 months), and late delayed (>6 months) (7).…”