(1)H-Nuclear Magnetic Resonance Spectroscopic Imaging of the Brain in Patients Who Receive Neurotoxic Therapy
Condition: Brain Cancer; Brain Neoplasms
MeSH terms: Brain Neoplasms
Study type: Observational

Summary: 
      Central nervous system toxicity is a recognized side effect of certain therapies for cancers,
      particularly cranial irradiation, intrathecal therapy or systemic high-dose chemotherapy. The
      pathophysiologic mechanisms and clinical manifestations vary. Previous studies defining MRI
      changes and correlating these with neurocognitive deficiencies have been inconsistent. Recent
      advances in brain imaging may help to better define neurotoxic effects. (1)H-NMRS is a
      noninvasive method of obtaining in vivo biochemical information from the brain. It has been
      used to study patients with CNS disorders, including neuronal disorders. In this study,
      (1)H-NMRS will be used to objectively characterize CNS toxicities in patients with cancer who
      are receiving potentially neurotoxic therapies. In addition, we will retrospectively evaluate
      patients with known or suspected neurotoxicity associated with cancer therapy, to determine
      if changes in spectroscopic patterns are associated with CNS toxicity.
    

Detailed description: 
      Background:

        -  Central nervous system toxicity is a recognized side effect of certain cancer therapies,
           particularly cranial irradiation, intrathecal therapy and systemic high-dose
           chemotherapy.

        -  The pathophysiologic mechanisms are not well-defined and clinical manifestations vary.
           Previous studies defining MRI changes and correlating these with neurocognitive
           deficiencies have been inconsistent.

        -  Recent advances in brain imaging may help to better define neurotoxic effects. (1)H-NMRS
           is a noninvasive method of obtaining in vivo biochemical information from the brain. It
           has been used to study patients with CNS disorders, including neuronal disorders.

      Objective:

      -To identify specific patterns of brain metabolites that are associated with therapy-related
      neurotoxicity using (1)H-NMRS in cancer patients who are receiving or have received
      potentially neurotoxic therapy.

      Eligibility:

      -Patients with brain tumors or patients receiving high-dose systemic chemotherapy,
      intrathecal chemotherapy (lumbar puncture or intra-Ommaya), or cranial radiation therapy OR
      patients with documented or suspected clinical neurotoxicity presumed to be caused by
      treatment for cancer.

      Design:

        -  In order to identify metabolite profiles that may be associated with neurotoxicity, NMRS
           data will be collected in a cross-sectional manner from patients at various stages of
           treatment and longitudinally throughout the course of therapy.

        -  NMRS studies will be performed on patients entered on this study at any or all of the
           following times: prior to therapy, immediately after the first cycle of therapy, prior
           to subsequent cycles of therapy, or after completion of all therapy.

        -  Neurotoxicity will also be evaluated by neuropsychological testing.
    

Observational model: Cohort
Time perspective: Prospective
Keywords: CNS directed therapy; Neurotoxicity; H-NMRS; MRI