| Objective: To assess cognitive function in patients with multiple myeloma(MM),and to investigate the effect of bortezomib chemotherapy on cognitive function in MM patients.Serum brain-derived neurotrophic factor(BDNF)levels were measured in MM patients,and the correlation between cognitive function and serum BDNF levels in MM patients was further investigated.Methods: 90 patients with multiple myeloma admitted to The First Affiliated Hospital of Anhui Medical University and Chaohu Hospital Affiliated to Anhui Medical University from August 2021 to August 2022 were included as the observation group,and 30 healthy physical examiners were selected as the healthy control group during the same period.According to whether bortezomib chemotherapy was used and the course of chemotherapy,the subjects in the observation group were divided into the primary MM group(30 cases),the bortezomib chemotherapy course≤4 group(30 cases),and the bortezomib chemotherapy course>4group(30 cases).The Montreal Cognitive Assessment(MoCA)scale was used to assess the cognitive function of all study subjects,and the serum BDNF level of the observation group was tested by ELISA.Data analysis was performed using SPSS 23.0 statistical software.The baseline data,MoCA scores of the four groups were compared.The serum BDNF levels of the patients in the observation group were compared,and the correlation between MoCA scores and serum BDNF levels of the patients in the observation group was analyzed.Results:(1)There was no statistical difference between the baseline information of the four groups,including age(F=0.795,P=0.499),gender(χ~2=1.972,P=0.578),education(χ~2=0.676,P=0.879),ISS stage(χ~2=1.731,P=0.421)and immunophenotyping(χ~2=5.714,P=0.456).(2)There was significant difference in MoCA score among the four groups(F=73.525,P<0.001).Further multiple comparison showed that the MoCA score in the primary MM group was lower than that in the healthy control group,with a statistically significant difference(P<0.05).The MoCA scores in the bortezomib chemotherapy MM group(including the chemotherapy course≤4group and the chemotherapy course>4 group)were lower than those in the primary MM group,with a statistically significant difference(P<0.05),and patients in the bortezomib chemotherapy course>4 group had further lower MoCA scores than those in the chemotherapy course≤4 group,with a statistically significant difference(P<0.05).(3)The difference in serum BDNF levels between the observation groups was statistically significant(F=35.128,P<0.001).Further multiple comparisons revealed that the serum BDNF levels in the bortezomib chemotherapy MM group(including the chemotherapy course≤4 group and the chemotherapy course>4 group)were lower than those in the primary MM group,and the differences were statistically significant(P<0.05),and the serum BDNF levels in the chemotherapy course>4 group were further reduced compared with those in the chemotherapy course≤4 group,and the differences were statistically significant(P<0.05).(4)Partial correlation analysis showed that the MoCA score of the observation group was positively correlated with the serum BDNF level(r=0.539,P<0.001),when controlling for the influence of age and education on the MoCA score.Conclusion: MM patients have some degree of cognitive impairment prior to chemotherapy.The cognitive impairment of patients can be further aggravated by bortezomib chemotherapy as well as by the prolongation of chemotherapy duration.Bortezomib chemotherapy caused a decrease in serum BDNF levels in MM patients,and the cognitive function of MM patients had a positive correlation with serum BDNF levels.Therefore,it is hypothesized that there is a correlation between the aggravation of cognitive impairment in MM patients by bortezomib chemotherapy and the decrease in serum BDNF levels. |
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