Dan Fayette

Background/Objectives: Cancer- or chemotherapy-related cognitive deficit is a common side effect occurring in patients with Hodgkin lymphoma. No previous study compared the influence of different types of treatment on the onset and development of chemotherapy cognitive impairment in longitudinal design. The aim of this study was to assess whether a more intensive form of chemotherapy causes greater cognitive impairment. Methods: Forty-four patients at three different stages of the disease and with three different treatments (ABVD + 30 Gy, BEACOPPesc, or ABVD + 30 Gy plus BEACOPPesc) completed the neuropsychological battery and psychological measures of affective distress and quality of life. We compared their cognitive performance before, immediately after, and 6 months after the treatment. Results: Whether or not we divided the total number of people with Hodgkin lymphoma into two groups (mild and moderate disease versus severe disease) or three groups (mild, moderate, and advanced disease), we found no statistically significant difference between the groups in cognitive performance or other psychological factors or experienced quality of life. Conclusions: Our results did not show that disease stage or treatment protocol had an effect on the depth of cognitive impairment in cancer or chemotherapy. We hypothesize that, in terms of brain health, intensive forms of chemotherapy (6 × BEA-COPPesc) do not pose a greater risk than milder forms (4 × ABVD + 30 Gy IF RT and 2 × BEACOPPesc + 4 × ABVD + 30 Gy IF RT) of cancer treatment for Hodgkin lymphoma. However, a limitation of our study is the small number of participants in the study, so it would be advisable to repeat the study on a larger sample of patients. Confirmation of our results could be beneficial in that neither patients nor physicians need to worry that intensive chemotherapy will worsen cognitive deficits.

Background: Cancer-related cognitive impairment (CRCI) is one of the most serious side effects of cancer that negatively impacts the quality of life of cancer patients and survivors. There is evidence of CRCI in Hodgkin lymphoma patients (HL); however, there is a lack of studies examining the presence of cognitive deficits before starting any treatment in HL patients. Methods: Forty adult patients (N = 40) newly diagnosed with HL (with no previous cancer diagnoses) and 40 healthy controls (N = 40) matched for age, sex, education, and premorbid intellect completed the neuropsychological battery and subjective and objective measures of affective distress and quality of life. Results: The results showed impairment in three out of six cognitive domains: verbal memory and learning, speed of processing/psychomotor speed, and abstraction/executive functions in the HL patients before the initiation of any treatment. The speed of processing/psychomotor speed domain is negatively correlated with depression. Conclusion: Cognitive deterioration in verbal memory and learning and abstraction/executive functions domains in HL patients seems to occur before the initiation of treatment independently of anxiety, depression, or physical symptoms. This suggests that HL itself may cause cognitive deficits in these cognitive domains. However, the underlying causes of CRCI still remain unclear.

Background: Cancer-related cognitive impairment (CRCI) is one of the most serious side effects of cancer that negatively impact the quality of life of cancer patients and survivors. There is evidence of CRCI in Hodgkin lymphoma patients (HL); however, there is a lack of studies examining the presence of cognitive deficits before starting any treatment in HL patients. Methods: Forty patients (N=40) newly diagnosed with HL (with no previous cancer diagnoses) and 40 healthy controls (N=40) matched for age, sex, education, and premorbid intellect completed the neuropsychological battery and subjective and objective measures of affective distress and quality of life. Results: The results showed impairment in three out of six cognitive domains: verbal memory and learning, speed of processing/ psychomotor speed, and abstraction/executive functions in the HL patients before the initiation of any treatment. Speed of processing/psychomotor speed domain negatively correlated with depression. Conclusion: Impairment in verbal memory and learning and abstraction/executive functions domains in HL patients seems to occur before the initiation of treatment independently of anxiety, depression, or physical symptoms. This suggests that HL itself may cause cognitive deficits in these cognitive domains. However, the underlying causes of CRCI still remain unclear.

Background: The Czech version of the Montreal Cognitive Assessment (MoCA-CZ) and delayed recall of 5 words have not been validated in patients with mild cognitive impairment (MCI) due to Alzheimer disease (AD) and compared to norms of a large population. Method: The MoCA-CZ was administered to 1,600 elderly individuals in 2 groups consisting of 48 patients with MCI due to AD (AD-MCI) and 1,552 normal elderly adults. Results: MoCA-CZ scores were significantly lower in the AD-MCI patients than in the normal elderly (21 ± 4 vs. 26 ± 3 points; p = 0.03). Under the recommended cutoff score of ≤25, the MoCA-CZ demonstrated an excellent sensitivity of 94% but a low specificity of 62%. When the score was reduced to ≤24, the MoCA-CZ showed an optimal sensitivity of 87% for AD-MCI and a specificity of 72%. Normal elderly persons should recall at least 2 words after delay (sensitivity 80%, specificity 74%). Several cutoff points were derived from normative data stratified by age and education. Conclusions: The cutoff for AD-MCI and stratified norms are available for the MoCA total score and delayed recall of the Czech version. The cut-off scores of the MoCA-CZ, sensitivity, and specificity are lower than in the original study.

Background: Cognitive impairment (impairment of memory, attention, or concentration) is documented in 17–75% of patients with various malignancies treated with chemotherapeutic agents that worsen quality of life. CRCI affects patients of all ages. The impairment of cognitive function in connection with chemotherapy is usually mild, but an event. relationship with dementia remains to be...