Memory performance used to detect radiation effects on cognitive functioning

Although radiotherapy remains a necessary and frequently used treatmentfor brain tumors, uncertainty remains about the nature and severity of neurocognitive morbidity. We show that verbal-semantic memory (free recall of word list) is sensitive to damaging radiation effects in 20 patients with low-grade, supratentorial, primary brain tumors who received moderate doses of partial-brain irradiation. We previously reported that verbal-semantic memory is dissociated from visual memory (acquisition and recall) during the same phase ofradiation effects, indicating that memory is differentially affected by radiation. In this study, we provide evidence of the nature of the iatrogenic radiation effect on memory by testing collateral cognitive functions that might explain the specific memory impairment. We found that the verbal-semantic recall impairment was not associated with impairments in auditory attention, auditory processing speed, auditory-verbal working memory, or in the temporal coding or subjective organization of word-list recall. These findings focus damaging radiation effects on primary retrievalprocesses, rather than on earlier cognitive processes or executive processes affecting recall. Knowledge of the specific patterns of change in cognition would guide the differential diagnosis and rehabilitation of survivors of brain tumors whose conditions are complicated by tumors with multiple treatments.