Mood, cognition and EEG changes during interferon α (alpha-IFN) treatment for chronic hepatitis C

Abstract 

Background

This study is aim to investigate concurrent long-term psychiatric, cognitive and neurophysiological measures of α-IFN neurotoxicity in the treatment of chronic viral hepatitis.

Methods

Twenty patients with HCV hepatitis were enrolled while treated with α-IFN (3–6 MU t.i.w. for 6–12 months). Neurotoxicity was evaluated by psychiatric [Hamilton Depression Rating Scale (HAM-D), Hamilton Scale for Anxiety (HAM-A), Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI-Y)], complete cognitive and neurophysiological assessments (EEG spectral analysis, P300). Patients were assessed at baseline (t₀), 2 (t₁) and 6 months (t₂) since the beginning of therapy.

Results

Depression scores significantly increased (HAM-D: t₀=4.4±2.6; t₁=8.9±3.9, p<0.001; and t₂=7.7±3.8, p<0.001). A concurrent increase was shown also for anxiety (HAM-A: t₀=6.0±3.2; t₁=9.6±4.5, p<0.005; and t₂=9.1±4.5, p<0.005). Significant neurophysiological effects were also detected: increase of α power (p<0.05) in frontal derivations, reduction of the mean dominant frequency (p<0.005) and increase of theta power (p<0.05) in parietal derivations. In contrast, no significant cognitive changes occurred.

Limitations

The study was performed on a relative small sample of patients mainly with observational intentions. Biological data (e.g. blood cytokines samples) are not available: they could have given useful information about biological mechanisms related to the alterations observed.

Conclusions

α-IFN treatment caused a time-dependent induction of symptoms of mild depression, concurrent anxiety and EEG changes. These psychiatric and neurophysiological changes can better explain the pharmacological profile of α-IFN and could help to address research on at risk population and, particularly, during pegylated-IFN therapy.

Keywords: α-interferon, Depression, EEG, Cognition, Chronic hepatitis C