Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade glioma
BackgroundFor recurrent high-grade glioma, especially glioblastoma, no standard of care treatment exists. Due to the prolongation of progression-free survival and a cortiocosteroid-sparing effect, bevacizumab is often used in this condition. Despite initial clinical responses, there is growing evide...
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Frontiers Media S.A.
2023-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1191226/full |
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| author | Rebecca Kassubek Dorothée Lulé Albert C. Ludolph Albert C. Ludolph Jan Kassubek Jan Kassubek Hans-Peter Müller |
| author_facet | Rebecca Kassubek Dorothée Lulé Albert C. Ludolph Albert C. Ludolph Jan Kassubek Jan Kassubek Hans-Peter Müller |
| author_sort | Rebecca Kassubek |
| collection | DOAJ |
| description | BackgroundFor recurrent high-grade glioma, especially glioblastoma, no standard of care treatment exists. Due to the prolongation of progression-free survival and a cortiocosteroid-sparing effect, bevacizumab is often used in this condition. Despite initial clinical responses, there is growing evidence that bevacizumab may potentiate microstructural alterations which may cause cognitive decline, mostly affecting learning and memory.MethodsTo investigate bevacizumab-associated microstructural damage of defined regions of interest (ROIs) in the white matter, diffusion tensor imaging (DTI) was performed in 10 patients with a case history or third-party report for neurological dysfunction concerning cognitive performance. Serial DTI data before and under bevacizumab were collected and longitudinal changes of fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) were assessed in mesiotemporal (hippocampal), frontal, and occipital regions.ResultsThe longitudinal DTI data under bevacizumab compared to DTI prior to bevacizumab demonstrated a significant decrease in FA and increase in AD and RD both in mesiotemporal (hippocampal) regions and in frontal regions, whereas occipital regions showed no significant alterations in DTI metrics.ConclusionThe regionally impaired microstructure in mesiotemporal (hippocampal) regions and in frontal regions is in line with the fact that neurocognitive impairment in learning and memory is mostly related to hippocampal integrity and attentional control in frontal regions. Further studies could investigate the potential of DTI to assess bevacizumab-associated microstructural damages in vulnerable brain regions. |
| first_indexed | 2024-03-13T09:46:42Z |
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| id | doaj.art-95e4c515c5af41419f2decd3d39b0dd4 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-13T09:46:42Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-95e4c515c5af41419f2decd3d39b0dd42023-05-25T04:15:49ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-05-011410.3389/fneur.2023.11912261191226Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade gliomaRebecca Kassubek0Dorothée Lulé1Albert C. Ludolph2Albert C. Ludolph3Jan Kassubek4Jan Kassubek5Hans-Peter Müller6Department of Neurology, University of Ulm, Ulm, GermanyDepartment of Neurology, University of Ulm, Ulm, GermanyDepartment of Neurology, University of Ulm, Ulm, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Ulm, GermanyDepartment of Neurology, University of Ulm, Ulm, GermanyGerman Center for Neurodegenerative Diseases (DZNE), Ulm, GermanyDepartment of Neurology, University of Ulm, Ulm, GermanyBackgroundFor recurrent high-grade glioma, especially glioblastoma, no standard of care treatment exists. Due to the prolongation of progression-free survival and a cortiocosteroid-sparing effect, bevacizumab is often used in this condition. Despite initial clinical responses, there is growing evidence that bevacizumab may potentiate microstructural alterations which may cause cognitive decline, mostly affecting learning and memory.MethodsTo investigate bevacizumab-associated microstructural damage of defined regions of interest (ROIs) in the white matter, diffusion tensor imaging (DTI) was performed in 10 patients with a case history or third-party report for neurological dysfunction concerning cognitive performance. Serial DTI data before and under bevacizumab were collected and longitudinal changes of fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) were assessed in mesiotemporal (hippocampal), frontal, and occipital regions.ResultsThe longitudinal DTI data under bevacizumab compared to DTI prior to bevacizumab demonstrated a significant decrease in FA and increase in AD and RD both in mesiotemporal (hippocampal) regions and in frontal regions, whereas occipital regions showed no significant alterations in DTI metrics.ConclusionThe regionally impaired microstructure in mesiotemporal (hippocampal) regions and in frontal regions is in line with the fact that neurocognitive impairment in learning and memory is mostly related to hippocampal integrity and attentional control in frontal regions. Further studies could investigate the potential of DTI to assess bevacizumab-associated microstructural damages in vulnerable brain regions.https://www.frontiersin.org/articles/10.3389/fneur.2023.1191226/fullglioblastomabevacizumabmagnetic resonance imagingdiffusion tensor imagingmicrostructural damage |
| spellingShingle | Rebecca Kassubek Dorothée Lulé Albert C. Ludolph Albert C. Ludolph Jan Kassubek Jan Kassubek Hans-Peter Müller Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade glioma Frontiers in Neurology glioblastoma bevacizumab magnetic resonance imaging diffusion tensor imaging microstructural damage |
| title | Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade glioma |
| title_full | Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade glioma |
| title_fullStr | Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade glioma |
| title_full_unstemmed | Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade glioma |
| title_short | Bevacizumab is associated with cerebral microstructural alterations: a DTI study in high-grade glioma |
| title_sort | bevacizumab is associated with cerebral microstructural alterations a dti study in high grade glioma |
| topic | glioblastoma bevacizumab magnetic resonance imaging diffusion tensor imaging microstructural damage |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1191226/full |
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