Carla Perna has been working as Locum consultant in Clinical Oncology at Royal County Surrey Hospital, Guildford, Surrey. She is also a Clinical Research Fellow at University College of London Hospital in Clinical Oncology. Besides she is a Clinical Oncologist in training at “Villa Santa Teresa diagnostica per immagini”, Bagheria (Palermo,IT) (University of Palermo, IT)
High-grade glioma is characterizes by increasing intracranial pressure and consequent neurological deficit related to the tumour site. Radiotherapy with concomitant chemotherapy may themselves complicate these issues, involving also metabolic, hematologic and electrolytic imbalances. On the other hand, a diagnosis of brain tumour with his poor prognosis, is classically accompanied by sentiment of suffer, loss of dignity, disability, thoughts of death. This can make diagnostic and therapeutic management more complex for patient and relatives. Aim of the study was to investigate the possible relation between cognitive impairment and radiotherapy treatment. Also we wanted to determinate quality of life of patients analysed before and after treatment.
47 patients underwent psychological testing before and after chemo-radiotherapy, between December 2011 and July 2013, but only 30 truly analysed (13 females and 17 males). Tests used were MMSE (Mini Mental State Examination ); Clock design; Phonemic Verbal Fluency Test and semantics; Tokens Test; AAChener Aphasia Test; Span Verbal Words; Rey’s Words; Prose Memory; Figure of Rey-B; Trial Making Test; Raven's Progressive Matrices (C.P.M.); EORTC QLQ C30; EORTC QLQ -BN20; HAD (Hospital Anxiety and Depression Scale).
In our finding radiotherapy does not cause in itself cognitive deficits. Unexpectedly, the analysis showed that the neuropsychological assessment and counselling have helped to increase the compliance of the patients. In particular they improved their mood, their coping strategies and also their personal assessment about their mental and physical health.
Not evidence in our finding that radiotherapy causes cognitive deficits. Neuropsychological assessment and counselling improved patients mood and coping with a benefit in term of quality of life.
Prof. Magda Ahmed Eldomiaty has completed his PhD at the age of 37 years from Tanta University and postdoctoral studies from Tanta University College of Medicine Egypt. She is prof. Of Anatomy and embryology in Taibah University Saudi Arabia, Tanta University Egypt. She is international reviewer in many international journals. She has published more than 25 papers in reputed journals and has been serving as an editorial board member of Edorium Journal of Anatomy and Embryology.
The study demonstrated the expression of muscle-derived myokines in the dentate gyrus (DG), medial frontal cortex (mFC) and cerebellum during depression and after voluntary exercise. Depression was developed by forced swimming (15 minutes/day) for 2 weeks and evaluated by automatic monitoring of the locomotor activity. Voluntary exercise was performed through accessing voluntary rat wheel for 3 weeks. Brain sections were processed and immunostained with antibodies against BDNF, MIF, VEGF and IL6. Light microscopic study and measuring the integrated optic density (IOD) of the photographs using ImajeJ software were performed to evaluate the myokines’ expression. Microscopically; BDNF was expressed in the cytoplasm and nuclei of nearly all neurons of DG, mFC and in granular and Purkinje cells of the cerebellum. MIF expression was mainly cytoplasmic in neurons of subgranular zone of DG, neurones of mFC and in Pukinje cells of cerebellum. VEGF showed cytoplasmic expression in many neurons of DG, mFC and in purkinje cells. IL6 was also cytoplasmic but expressed more in the glial cells, endothelial cells and purkinje cells. After voluntary running protocol; the IOD of BDNF increased significantly in upper and lower limbs of DG (P= 0.005 and p<0.001 respectively), mFC (P=0.001) and cerebellum (P=0.001). IOP of MIF significantly increased in both limbs of DG (p<0.001), mFC (p=0.001) but not in the cerebellum (P=0.052). IOP of VEGF and IL6 showed significant increase of in both limbs of DG (p<0.001), mFC (p<0.001) and cerebellum (p=0.001). The study could re-define the muscle derived myokines that might help in managing depression.