Hostname: page-component-cc8bf7c57-xrnlw Total loading time: 0 Render date: 2024-12-09T20:07:32.237Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of Interferon-α on cognitive functioning in patients with chronic hepatitis C

Published online by Cambridge University Press:  28 January 2005

ROBIN C. HILSABECK ,
TAREK I. HASSANEIN ,
ELIZABETH A. ZIEGLER ,
MEGHAN D. CARLSON  and
WILLIAM PERRY
ROBIN C. HILSABECK
Affiliation:
Department of Neuropsychiatry & Behavioral Science, Texas Tech University Health Sciences Center, Lubbock, Texas Department of Medicine, Division of Hepatology, University of California San Diego Department of Psychiatry, University of California San Diego
TAREK I. HASSANEIN
Affiliation:
Department of Medicine, Division of Hepatology, University of California San Diego
ELIZABETH A. ZIEGLER
Affiliation:
Department of Medicine, Division of Hepatology, University of California San Diego
MEGHAN D. CARLSON
Affiliation:
Department of Medicine, Division of Hepatology, University of California San Diego
WILLIAM PERRY
Affiliation:
Department of Psychiatry, University of California San Diego
Get access Rights & Permissions [Opens in a new window]

Abstract

Treatment with interferon-alpha (IFN-α) has been shown to adversely affect cognitive functioning in patients with a variety of medical disorders, but information about the effects of IFN-α on cognitive functioning in patients with chronic hepatitis C (CHC) is limited. The purpose of this study was to examine the effects of IFN-α on neuropsychological test performance in CHC patients. Participants were 30 patients with CHC, 11 who underwent IFN-α therapy and 19 who did not. All participants were tested at baseline (i.e., pretreatment) and approximately 6 months later with the Symbol Digit Modalities Test and Trail Making Test. Results revealed that the treatment group performed significantly worse than untreated CHC patients on Part B of the Trail Making Test after approximately 6 months of treatment. No significant group differences were found on Part A of the Trail Making Test or Symbol Digit Modalities Test. Findings suggest that CHC patients undergoing treatment with IFN-α may experience reduced abilities to benefit from practice but suffer no decrements in performance after 6 months of treatment. Additional research is needed to replicate these findings and to explore risk factors for susceptibility to IFN-α-induced effects. (JINS, 2005, 11, 16–22.)

Keywords

Neuropsychological impairmentHCVChronic liver disease
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 1 , January 2005 , pp. 16 - 22
Copyright
© 2005 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adams, F., Fernandez, F., & Mavligit, G. (1988). Interferon-induced organic mental disorders associated with unsuspected pre-existing neurologic abnormalities. Journal of Neurooncology, 6, 355–359.Google Scholar
Adams, F., Quesada, J.R., & Gutterman, J.U. (1984). Neuropsychiatric manifestations of human leukocyte interferon therapy in patients with cancer. Journal of the American Medical Association, 252, 938–941.Google Scholar
Akwa, Y., Hassett, D.E., Eloranta, M.L., Sandberg, K., Masliah, E., Powell, H., Whitton, J.L., Bloom, F.E., & Campbell, I.L. (1998). Transgenic expression of IFN-α in the central nervous system of mice protects against lethal neurotropic viral infection but induces inflammation and neurodegeneration. Journal of Immunology, 161, 5016–5026.Google Scholar
Amato, R., Meyers, C.A., Ellerhorst, J., Finn, L., Kilbourn, R., Sella, A., & Logothetis, C. (1995). A phase I trial of intermittent high-dose alpha-interferon and dexamethasone in metastatic renal cell carcinoma. Annals of Oncology, 6, 911–914.Google Scholar
Basso, M.R., Bornstein, R.A., & Lang, J.M. (1999). Practice effects on commonly used measures of executive function across twelve months. Clinical Neuropsychologist, 13, 283–292.Google Scholar
Beck, A.T. & Steer, R.A. (1990). Beck Anxiety Inventory: Manual. San Antonio, TX: The Psychological Corporation.
Beck, A.T., Steer, R.A., & Brown, G.K. (1996). Beck Depression Inventory–Second Edition: Manual. San Antonio, TX: The Psychological Corporation.
Belza, B.L. (1995). Comparison of self-reported fatigue in rheumatoid arthritis and controls. Journal of Rheumatology, 22, 639–643.Google Scholar
Belza, B.L., Henke, C.J., Yelin, E.H., Epstein, W.V., & Gilliss, C.L. (1993). Correlates of fatigue in older adults with rheumatoid arthritis. Nursing Research, 42, 93–99.Google Scholar
Bonkovsky, H.L., Woolley, J.M., & The Consensus Interferon Study Group. (1999). Reduction of health-related quality of life in chronic hepatitis C and improvement with interferon therapy. Hepatology, 29, 264–270.Google Scholar
Calvert, M. & Gresser, I. (1979). Interferon enhances the excitability of cultured neurons. Nature, 278, 558–560.Google Scholar
Caraceni, A., Gangeri, L., Martini, C., Belli, F., Brunelli, C., Baldini, M., Mascheroni, L., Lenisa, L., & Cascinelli, N. (1998). Neurotoxicity of interferon-α in melanoma therapy. Cancer, 83, 482–489.3.0.CO;2-S>CrossRefGoogle Scholar
Crow, Y.J., Black, D.N., Ali, M., Bond, J., Jackson, A.P., Lefson, M., Michaud, J., Roberts, E., Stephenson, J.B., Woods, C.G., & Lebon, P. (2003). Cree encephalitis is allelic with Aicardi-Goutières syndrome: implications for the pathogenesis of disorders of interferon alpha metabolism. Journal of Medical Genetics, 40, 183–187.Google Scholar
Daniels, H.M, Meager, A., Eddleston, A.L.W.F., Alexander, G.J.M., & Williams, R. (1990). Spontaneous production of tumor necrosis factor α and interleukin-1β during interferon-α treatment of chronic HBV infection. Lancet, 335, 875–877.Google Scholar
Davis, G.L., Esteban-Mur, R., Rustgi, V., Hoefs, J., Gordon, S.C., Trepo, C., Shiffman, M.L., Zeuzem, S., Craxi, A., Ling, M.H., Albrecht, J. (1998). Interferon alfa-2b alone or in combination with ribavirn for the treatment of relapse of chronic hepatitis C. New England Journal of Medicine, 339, 1493–1499.Google Scholar
de Boer, A.G. & Breimer, D.D. (1998). Cytokines and blood-brain barrier permeability. In H.S. Sharma & J. Westman (Eds.), Progress in brain research, volume 115 (pp. 425–451). New York: Elsevier Science.
Dikmen, S.S., Heaton, R.K., Grant, I., & Temkin, N.R. (1999). Test–retest reliability and practice effects of Expanded Halstead-Reitan Neuropsychological Test Battery. Journal of the International Neuropsychological Society, 5, 346–356.Google Scholar
Dwight, M.M., Kowdley, K.V., Russo, J.E., Ciechanowski, P.S., Larson, A.M., & Katon, W.J. (2000). Depression, fatigue, and functional disability in patients with chronic hepatitis C. Journal of Psychsomatic Research, 49, 311–317.CrossRefGoogle Scholar
Fontana, R.J. (2000). Neuropsychiatric toxicity of antiviral treatment in chronic hepatitis C. Digestive Diseases, 18, 107–116.CrossRefGoogle Scholar
Forton, D.M., Taylor-Robinson, S.D., & Thomas, H.C. (2002a). Reduced quality of life in hepatitis C—is it all in the head? Journal of Hepatology, 36, 435–438.Google Scholar
Forton, D.M., Thomas, H.C., Murphy, C.A., Allsop, J.M., Foster, G.R., Main, J., Wesnes, K.A., & Taylor-Robinson, S.D. (2002b). Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. Hepatology, 35, 433–439.Google Scholar
Foster, G.R., Goldin, R.D., & Thomas, H.C. (1998). Chronic hepatitis C virus infection causes a significant reduction in quality of life in the absence of cirrhosis. Hepatology, 27, 209–212.Google Scholar
Gisslinger, H., Svoboda, T., Clodi, M., Gilly, B., Ludwig, H., Havelec, L., & Luger, A. (1993). Interferon-alpha stimulates the hypothalamic-pituitary adrenal axis in vivo and in vitro. Neuroendocrinology, 57, 489–495.Google Scholar
Heaton, R.K., Grant, I., & Matthews, C.G. (1991). Comprehensive norms for an expanded Halstead-Reitan battery: Demographic corrections, research findings, and clinical applications. Odessa, FL: Psychological Assessment Resources, Inc.
Hilsabeck, R.C., Hassanein, T.I., Carlson, M.D., Ziegler, E.A., & Perry, W. (2003). Cognitive functioning and psychiatric symptomatology in patients with chronic hepatitis C. Journal of the International Neuropsychological Society, 9, 847–854.Google Scholar
Hilsabeck, R.C., Perry, W., & Hassassein, T.I. (2002). Neuropsychological impairment in patients with chronic hepatitis C. Hepatology, 35, 440–446.CrossRefGoogle Scholar
Juengling, F.D., Ebert, D., Gut, O., Engelbrecht, M.A., Rasenack, J., Nitzsche, E.U., Bauer, J., & Lieb, K. (2000). Prefrontal cortical hypmetabolism during low-dose interferon alpha treatment. Psychopharmacology, 152, 383–389.Google Scholar
Lezak, M.D. (1995). Neuropsychological Assessment (3rd ed.). New York: Oxford University Press.
Licinio, J., Kling, M.A., & Hauser, P. (1998). Cytokines and brain function: Relevance to interferon-α-induced mood and cognitive changes. Seminars in Oncology, 25, S30–S38.Google Scholar
Lineweaver, T.T. & Chelune, G.J. (2003). Use of the WAIS–III and WMS–III in the context of serial assessments: Interpreting reliable and meaningful change. In D.S. Tulsky, M.F. Ledbetter, G.J. Chelune, R.K. Heaton, R.A. Bornstein, R. Ivnik, & A. Prifitera (Eds.), Clinical Interpretation of the WAIS–III and WMS–III (pp. 303–337). New York: Academic Press.
Mapou, R.L., Law, W.A., Wagner, K., Malone, J.L., & Skillman, D.R. (1996). Neuropsychological effects of interferon alfa-n3 treatment in asymptomatic immunodeficiency virus-1-infected individuals. Journal of Neuropsychiatry, 8, 74–81.Google Scholar
Mattson, K., Niiranen, A., Laaksonen, R., & Cantell, K. (1984). Psychometric monitoring of interferon neurotoxicity. Lancet, 1, 275–276.Google Scholar
Mayr, N., Zeitlhofer, J., Deecke, L., Fritz, E., Ludwig, H., & Gisslinger, H. (1999). Neurological function during long-term therapy with recombinant interferon alpha. Journal of Neuropsychiatry and Clinical Neurosciences, 11, 343–348.CrossRefGoogle Scholar
McHorney, C.A., Ware, J.E., Lu, J.F.R., & Sherbourne, C.D. (1994). The MOS 36-item Short-form Health Survey (SF–36): III. Tests of data quality, scaling assumptions and reliability across diverse patient groups. Medical Care, 32, 40–66.Google Scholar
McHorney, C.A., Ware, J.E., & Raczek, A.E. (1993). The MOS 36-item short-form health status survey (SF–36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 31, 247–263.Google Scholar
McHutchison, J.G., Gordon, S.C., Schiff, E.R., Shiffman, M.L., Lee, W.M., Rustgi, V.K., Goodman, Z.D., Ling, M.H., Cort, S., & Albrecht J.K. (1998). Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. New England Journal of Medicine, 339, 1485–1492.CrossRefGoogle Scholar
Meyers, C.A. (1999). Mood and cognitive disorders in cancer patients receiving cytokine therapy. Advances in Experimental Medicine and Biology, 461, 75–81.Google Scholar
Meyers, C.A., Obbens, E.A.M.T., Scheibel, R.S., & Moser, R.P. (1991a). Neurotoxicity of intraventricularly administered alpha-interferon for leptomeningeal disease. Cancer, 68, 88–91.Google Scholar
Meyers, C.A., Scheibel, R.S., & Forman, A.D. (1991b). Persistent neurotoxicity of systemically administered interferon-alpha. Neurology, 41, 672–676.Google Scholar
Niiranen, A., Laaksonen, R., Iivanainen, M., Mattson, K., Farkkila, M., & Cantell, K. (1988). Behavioral assessment of patients treated with alpha-interferon. Acta Psychiatrica Scandinavica, 78, 622–626.CrossRefGoogle Scholar
Panitch, H.S., Gomez-Plascencia, J., Norris, F.H., Cantell, H., & Smith, R.A. (1986). Subacute sclerosing panecephalitis: remission after treatment with intraventricular interferon. Neurology, 36, 562–566.CrossRefGoogle Scholar
Pavol, M.A., Meyers, C.A., Rexer, J.L., Valentine, A.D., Mattis, P.J., & Talpaz, M. (1995). Pattern of neurobehavioral deficits associated with interferon alpha therapy for leukemia. Neurology, 45, 947–950.Google Scholar
Reitan, R.M. & Wolfson, D. (1993). The Halstead-Reitan Neuropsychological Test Battery: theory and clinical interpretation. Tucson, AZ: Neuropsychology Press.
Renault, P.F., Hoofnagle, J.H., Park, Y., Mullen, K.D., Peters, M., Jones, D.B., Rustgi, V., & Jones, E.A. (1987). Psychiatric complications of long-term interferon alfa therapy. Archives of Internal Medicine, 147, 1577–1580.CrossRefGoogle Scholar
Rohatiner, A.Z.S., Prior, P.F., Burton, A.C., Smith, A.T., Balkwill, F.R., & Lister, T.A. (1983). Central nervous systemic toxicity of interferon. British Journal of Cancer, 47, 419–422.Google Scholar
Shibata, M. & Blatteis, C.M. (1991). Human recombinant tumor necrosis factor and interferon affect the activity of neuron in the organum vasculosum laminea terminalis. Brain Research, 562, 323–326.Google Scholar
Shuto, H., Kataoka, Y., Horikawa, T., Fujihara, N., & Oishi, R. (1997). Repeated interferon-alpha administration inhibits dopaminergic neural activity in the mouse brain. Brain Research, 747, 348–351.Google Scholar
Smedley, H., Katrak, M., Sikora, K., & Wheeler, T. (1983). Neurological effects of recombinant human interferon. British Medical Journal, 286, 262–264.Google Scholar
Smith, A. (1982). Symbol Digit Modalities Test (SDMT) manual (revised). Los Angeles, CA: Western Psychological Services.
Smith, R.A., Norris, F., Palmer, D., Bernhardt, L., & Wills, R.J. (1985). Distribution of alpha interferon in serum and cerebrospinal fluid after systemic administration. Clinical Pharmacology and Therapeutics, 37, 85–88.CrossRefGoogle Scholar
Suter, C.C., Westmoreland, B.F., Sharbrough, F.W., & Hermann Jr., R.C. (1984). Electroencephalographic abnormalities in interferon encephalopathy: A preliminary report. Mayo Clinic Proceedings, 59, 847–850.Google Scholar
Taylor, M.J. & Heaton, R.K. (2001). Sensitivity and specificity of WAIS–III/WMS–III demographically corrected factor scores in neuropsychological assessment. Journal of the International Neuropsychological Society, 7, 867–874.Google Scholar
Valentine, A.D., Meyers, C.A., Kling, M.A., Richelson, E., & Hauser, P. (1998). Mood and cognitive side effects of interferon-α therapy. Seminars in Oncology, 25, S39–S47.Google Scholar
Ware, J.E. & Sherbourne, C.D. (1992). The MOS 36-item short-form health survey (SF–36): I. Conceptual framework and item selection. Medical Care, 30, 473–483.Google Scholar
Yamada, T. & Yamnaka, I. (1995). Microglial localization of α-interferon receptor in human brain tissues. Neuroscience Letters, 189, 73–76.Google Scholar
Zachary, R.A. (1986). Shipley Institute of Living Scale Revised manual. Los Angeles, CA: Western Psychological Services.