Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017638 (glioma)
 30,880 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a pilot study, two groups of patients with malignant glioma underwent sequential neuropsychological evaluations after successful tumor treatment. Group 1 included nine patients treated from 1981 to 1985; all patients received irradiation and eight underwent chemotherapy. The baseline neuropsychological assessment was performed 1 to 63 months after tumor diagnosis, with follow-up evaluations at irregular intervals over the next 3 to 7 years. Six patients in Group 1 exhibited impairment on most measures at baseline; subsequently, two patients developed profound cognitive impairment. Initially, three patients functioned in the average range on most tasks; thereafter, two deteriorated on one measure each. Group 2 was ascertained prospectively and included 16 patients treated from 1985 to 1987, all of whom received irradiation and chemotherapy. The first evaluation was performed 18 months after diagnosis, then every 6 months for 2 years, and then yearly. Compared to a control group, those in Group 2 had significant cognitive impairment at baseline. Cognitive performance did not change over the next 12 months in 10 patients who remained free of tumor, but within 2 years of baseline testing, deterioration on specific tasks was evident in two of seven disease-free survivors. When last tested, five of six disease-free survivors had deteriorated on one or more measures. Unlike Group 1, severe global cognitive impairment was not seen, perhaps because Group 2 was followed for a shorter time. Verbal and nonverbal composite scores derived from intelligence quotient (IQ) tests showed less impairment at baseline than did other measures and were more likely to remain stable subsequently. Verbal memory and sustained attention were the most impaired at baseline, and verbal learning and flexibility in thinking showed the greatest tendency to decline over time. Cognitive functioning in survivors of high-grade glioma is best measured and monitored by tests that probe a broader spectrum of abilities than IQ. Neuropsychological measures used in this analysis lacked sensitivity at the lower end of the impaired range. Future studies should use tests better able to discern cognitive differences at low performance levels. Based on this experience, the authors conclude that most long-term survivors of high-grade glioma will have significant cognitive difficulties, usually evident by the first assessment; some patients will develop profound impairment years later, and few are capable of fully independent living.
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PMID:Cognitive functioning in long-term survivors of high-grade glioma. 828 63

The frequency of mood disorder was studied in a cohort of patients with treated intracranial glioma or meningioma, where psychological morbidity was related to physical and neuropsychological functioning and to the patients' knowledge of their disease. Forty patients were assessed on a range of physical, psychological and neuropsychological measures, with additional interview of a relative to obtain supplementary information regarding each patients' knowledge of their disease. Two (5%) of the 40 patients had clinically significant levels of anxiety, six (15%) clinically significant levels of depression and 92% full or intermediate knowledge about their prognosis. Psychological morbidity was associated with high levels of physical disability and also with cognitive dysfunction, but was not related to the grade of the patient's tumour or the extent to which the patient was aware of the nature of his or her disease. A proportion of patients with intracranial tumours suffer levels of psychological distress sufficient to warrant psychological and/or pharmacological intervention.
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PMID:Mood disorders in patients after treatment for primary intracranial tumours. 1062 79

External radiation therapy of brain tumors may cause adverse effects on normal brain tissue, resulting in severe neuropsychological and cognitive impairment. We investigated the late delayed radiation effects in the white matter (WM) using (1)H magnetic resonance spectroscopic imaging ((1)HMRSI). Nine glioma patients with local radiation-induced signal abnormalities in the T(2)-weighted MR images were studied with nine age- and sex-matched controls. The metabolite ratios in the radiation-induced hyper intensity area (RIHA) and in the normal appearing white matter (NAWM) of the patients were compared with respective WM areas of the controls. In RIHA, choline/creatine (Cho/Cr) was 17% decreased (1.22 +/- 0.13 vs 1.47 +/- 0.16, p = 0.0027, significant (s), unpaired Student's t test with Bonferroni correction) in the patients compared to the controls, while there was no difference in N-acetyl aspartate/Cr (NAA/Cr) (2.49 +/- 0.57 vs 2.98 +/- 0.32, p = 0.039) or NAA/Cho (2. 03 +/- 0.40 vs 2.04 +/- 0.17, p = 0.95). In NAWM, Cho/Cr was 24% decreased (1.21 +/- 0.15 vs 1.59 +/- 0.13, p < 0.0001, s) and NAA/Cho was 20% increased (2.49 +/- 0.49 vs 1.98 +/- 0.15, p = 0. 0082, s) in the patients compared to the controls, while there was no difference in NAA/Cr (2.99 +/- 0.46 vs 3.16 +/- 0.32, p = 0.38). NAA(RIHA)/NAA(NAWM) was 25% decreased (0.75 +/- 0.20 vs 1.00 +/- 0. 12, p = 0.0043, s) and Cr(RIHA)/Cr(NAWM) was 16% decreased (0.89 +/- 0.15 vs 1.06 +/- 0.10, p = 0.013, s) in the patients compared to the controls, while there was no difference in Cho(RIHA)/Cho(NAWM) (0.92 +/- 0.23 vs 0.98 +/- 0.10, p = 0.47). (1)HMRSI reveals widespread chemical changes in the WM after radiation therapy. In RIHA, there is loss of NAA, Cho, and Cr implying axonal and membrane damage and in NAWM, there is loss of Cho, reflecting membrane damage.
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PMID:Spectroscopic imaging of radiation-induced effects in the white matter of glioma patients. 1102 79

The alien hand syndrome is rare, occurring with lesions in the mesial frontal lobe area and corpus callosum. We report an unusual presentation of seizures in a 65-year-old woman with a presumed low-grade glioma involving the mesial frontal lobe region, with the "alien hand" seen only during a seizure. Neuropsychological evaluation revealed lateralized cognitive dysfunction consistent with the location of the lesion. There were no interictal indications of disconnection syndrome. The mechanism postulated is disruption of transcallosal motor connections due to the propagating seizure across nondominant motor regions.
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PMID:"Ictal" Alien Hand Syndrome. 1260 83

In this study, the presence of motor and cognitive disability is described in a cohort of patients with low-grade glioma recruited from a geographical area with a well-defined population located in the middle of Sweden. The study group consisted of 35 patients, of which 24 were evaluated by both a neurologist and a neuropsychologist, and 11 only by a neurologist. The test battery according to EFIT (Edinburgh Functional Impairment Test) was used by the neurologist to measure impairments of limb function, memory and speech. Patients were asked to self-evaluate their deficits in motor function and cognition by responding to a specific questionnaire. In addition, a neuropsychological test battery was used by an experienced neuropsychologist who had no previous contact with the patients. In general, motor impairment was mild and predominantly found in the upper limb. Neuropsychological assessment revealed moderate or severe cognitive impairment in more than half of the patients. This impairment was not detected by neurological examination, and only to some extent reported by the patients them selves. The results show statistical differences in cognitive function, memory and language as recorded by the three assessors. In conclusion, this study demonstrates the usefulness of neuropsychological assessment as a complement to neurological examination to detect cognitive dysfunction in patients with low-grade gliomas.
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PMID:Pitfalls in the assessment of disability in individuals with low-grade gliomas. 1468 35

The authors studied cognitive functioning as a potential predictor of survival in 68 newly diagnosed patients with high-grade glioma. In a combined Cox proportional hazards model, the influence of tumor, treatment, and patient characteristics, including cognitive functioning, was studied. Older age and higher tumor grade were associated with poorer survival. Although cognitive impairment was not found to be an independent prognostic factor for the entire sample, it was associated with significantly poorer survival among older patients with World Health Organization grade IV gliomas. Assessment of cognitive functioning in these patients may improve clinical decision making and thus quality of treatment.
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PMID:The prognostic value of cognitive functioning in the survival of patients with high-grade glioma. 1469 52

Distinction of gliomatosis cerebri (GC), a rare entity characterized by a widespread infiltration of the brain by tumor, from diffuse glioma is a difficult clinical problem. Most previously reported cases of GC have been autopsy cases because of the lack of objective and quantitative clinical diagnostic criteria. In order to better define this entity, we report the neuroradiological and pathological findings of three cases of GC. Three patients (one man and two women, aged 46-71 years) presented with symptoms of mild increased intracranial pressure, cognitive impairment, or seizure. Magnetic resonance imaging (MRI) was done with T1-weighted images after gadolinium injection, and with T2-weighted images and fluid attenuated inversion recovery (FLAIR) in all cases. Histological confirmation of glial proliferation was obtained in all cases by craniotomy. The topography of the tumoral infiltration was characteristic, involving mainly the white matter, basal ganglia, thalamus, and commissural fibers. More than two cerebral lobes were affected. Contrast enhancement was absent, and mass effects were minimal compared with the extent of tumoral infiltration, but one patient presented with a small frontal enhanced mass during the clinical course. The pathological analyses demonstrated infiltration of the brains by variably differentiated neoplastic glial cells with destruction of the myelin sheath, but the involved axis cylinder and neuronal cells were preserved. Diagnosis of GC should be faithful to the pathological diagnosis criteria of Scheinker and Evans, and therefore the precise assessment of MRI findings according to these criteria is required for clinical, antemortem diagnosis of GC.
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PMID:Clinical diagnosis of gliomatosis cerebri: report of three cases. 1570 Aug 39

A substantial number of neural stem cells (NSCs) continue to proliferate and generate neurons in the central nervous system throughout life. Ionizing radiation, an important adjuvant therapy for glioma patients, may damage NSCs and cause neuronal deficits, such as cognitive dysfunction and memory impairment. However, the precise mechanism of radiation effects on death and differentiation of NSCs remains largely unknown. Here, we found that radiation induced apoptosis in NSCs via the mitochondrial pathway, upregulating the ratio of Bax to Bcl-2 and releasing cytochrome c into the cytoplasm. Radiation also inhibited neuronal differentiation of NSCs by 50%. Of the three stress-associated mitogen-activated protein kinases (MAPKs), only c-Jun NH(2)-terminal kinase (JNK) was activated in NSCs after radiation. Interestingly, JNK inhibition by the specific inhibitor SP600125 rescued NSCs from apoptosis and improved neuronal differentiation. Furthermore, we examined whether radiation directly inhibits neuronal differentiation or not. Radiation did not affect the promoter activity of NeuroD, a basic helix-loop-helix transcription factor that regulates the expression of neuronal differentiation markers. Radiation induced more apoptosis in NeuroD-positive cells than NeuroD-negative cells. We concluded that radiation activates JNK and induces apoptosis, especially in neural progenitor cells, resulting in the inhibition of neurogenesis. Our findings raise the possibility that JNK inhibition has therapeutic potential in protecting NSCs from the adverse effects of radiation.
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PMID:Ionizing radiation induces apoptosis and inhibits neuronal differentiation in rat neural stem cells via the c-Jun NH2-terminal kinase (JNK) pathway. 1649 Nov 25

Human immunodeficiency virus type 1 (HIV-1) tropism plays an important role in HIV-associated dementia. In this study, aimed at determining if the tropism and coreceptor usage of circulating viruses correlates with cognitive function, the authors isolated and characterized HIV from the peripheral blood of 21 Hispanic women using antiretroviral therapy. Macrophage tropism was determined by inoculation of HIV isolates onto monocyte-derived macrophages and lymphocyte cultures. To define coreceptor usage, the HIV isolates were inoculated onto the U87.CD4 glioma cell lines with specific CCR5 and CXCR4 coreceptors. HIV isolates from cognitively impaired patients showed higher levels of replication in mitogen-stimulated peripheral blood mononuclear cells than did isolates from patients with normal cognition (P < .05). The viral growth of HIV primary isolates in macrophages and lymphocytes did not differ between patients with and those without cognitive impairment. However, isolates from the cognitively impaired women preferentially used the X4 coreceptor (P < .05). These phenotypic studies suggest that cognitively impaired HIV-infected women receiving treatment may have a more highly replicating and more pathogenic X4 virus in the circulation that could contribute to their neuropathogenesis.
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PMID:Characterization of peripheral blood human immunodeficiency virus isolates from Hispanic women with cognitive impairment. 1784 15

Background In patients with low-grade glioma (LGG), the tumor and its treatment with conformal radiation therapy (RT) and chemotherapy can disrupt cognitive function. However, the contribution of disease and treatment to long-term cognitive outcome remains to be elucidated. In this study, we performed longitudinal cognitive follow-up in a subgroup of patients who received RT, chemotherapy, or no treatment. Methods Twenty-five LGG patients underwent neuropsychological evaluations at study entry, and 6 and 12 months subsequently; 9 patients had RT +/- chemotherapy prior to enrollment and 16 had no treatment. Results At the initial evaluation, treated patients had impaired performance on motor speed only, but scored 1 standard deviation below normative values on tests of executive functions; untreated patients had no cognitive impairment. Repeated measures analyses of variance showed a significant variation over time (P = 0.03) in nonverbal memory (delayed recall); treated patients' performance improved at the 6-month follow-up to a level comparable to untreated patients, but both groups declined slightly by the 12-month evaluation. In a subset of patients (N = 16) available for an additional cognitive evaluation, significant changes between the 12-month and the long-term follow-up were seen in phonemic verbal fluency, mood and quality of life; untreated patients seen at short intervals improved slightly while treated patients seen at longer intervals declined. Conclusions Longitudinal follow-up showed that both disease duration and treatment with RT +/- chemotherapy contributed to a mild decrement in nonverbal recall and in some aspects of executive functions and quality of life in this group of LGG patients.
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PMID:Longitudinal cognitive follow-up in low grade gliomas. 1792 7


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