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- Title
Primary CNS lymphoma of the corpus callosum: presentation and neurocognitive outcomes.
- Authors
Nilles, Christelle; Delgadillo, Daniel; Sarazin, Marie; Nichelli, Lucia; Mokhtari, Karima; Mathon, Bertrand; Choquet, Sylvain; Feuvret, Loïc; Alentorn, Agusti; Ribeiro, Monica; Hoang-Xuan, Khê; Houillier, Caroline
- Abstract
Introduction: The corpus callosum (CC) is frequently involved in primary central nervous system lymphomas (PCNSLs). In this cohort study, we described the neurocognition of patients with PCNSL-CC and its posttherapeutic evolution. Methods: Immunocompetent patients with PCNSL-CC were identified retrospectively at the Pitié-Salpêtrière Hospital. We described their clinical presentation. Neuropsychological test scores (MMSE; digit spans; Free and Cued Selective Reminding Test; Image Oral Naming Test; Frontal Assessment Battery; Trail Making Test; Stroop and verbal fluency tests; Rey's Complex Figure test) and factors impacting them were analyzed. Results: Twenty-seven patients were included (median age: 67 years, median Karnofsky Performance Status: 70); cognitive impairment and balance disorders were present in 74% and 59%, respectively. At diagnosis, neuropsychological test results were abnormal for global cognitive efficiency (63% of patients), memory (33–80% depending on the test) and executive functions (44–100%). Results for visuospatial and language tests were normal. All patients received high-dose methotrexate-based polychemotherapy, followed in one patient by whole-brain radiotherapy; 67% of patients achieved complete response (CR). With a median follow-up of 48 months (range 6–156), patients in CR had persistent abnormal test results for global cognitive efficiency in 17%, executive function in 18–60%, depending on the test, and memory in 40–60%. Splenium location and age ≥ 60 years were significantly associated with worse episodic memory scores throughout the follow-up. Conclusions: PCNSL-CC is associated with frequent cognitive dysfunctions, especially memory impairment, which may recover only partially despite CR and warrant specific rehabilitation. Older age (≥ 60) and splenium location are associated with worse neurocognitive outcomes.
- Subjects
CORPUS callosum; TRAIL Making Test; EXECUTIVE function; VERBAL behavior testing; KARNOFSKY Performance Status; EPISODIC memory; BALANCE disorders
- Publication
Journal of Neuro-Oncology, 2022, Vol 158, Issue 1, p99
- ISSN
0167-594X
- Publication type
Article
- DOI
10.1007/s11060-022-04014-7