Cognitive sequelae of radiotherapy in primary brain tumors

Ramírez-Guerrero, Sofía; Vargas-Cuellar, María Paula; Charry-Sánchez, Jesús David; Talero-Gutiérrez, Claudia

doi:10.1016/j.inat.2021.101305

Cited by 8 publications

(7 citation statements)

References 65 publications

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“…Nonetheless, it is important to recognize that cognitive deficit is multifactorial, as deficit may be caused by the tumour itself, number of interventions, assessment time after treatment, functional deficit, preexisting cognitive abnormalities, and other adjuvant treatments [ 30 – 32 ]. Thus, it is not possible to precisely designate cognitive dysfunction to an isolated factor.…”

Section: Discussionmentioning

confidence: 99%

“…The study presented a moderate negative correlation between cognitive outcomes to QoL, which proposes that reducing the cancer burden or being cancer-free outweighs the effect of cognitive deficit. Nonetheless, it is important to recognize that cognitive deficit is multifactorial, as deficit may be caused by the tumour itself, number of interventions, assessment time after treatment, functional deficit, preexisting cognitive abnormalities, and other adjuvant treatments [30][31][32]. Thus, it is not possible to precisely designate cognitive dysfunction to an isolated factor.…”

Section: Discussionmentioning

confidence: 99%

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Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

2023

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Purpose Irradiation of the brain regions from nasopharyngeal carcinoma (NPC) radiotherapy (RT) is frequently unavoidable, which may result in radiation-induced cognitive deficit. Using deep learning (DL), the study aims to develop prediction models in predicting compromised cognition in patients following NPC RT using remote assessments and determine their relation to the quality of life (QoL) and MRI changes. Methods Seventy patients (20–76 aged) with MRI imaging (pre- and post-RT (6 months–1 year)) and complete cognitive assessments were recruited. Hippocampus, temporal lobes (TLs), and cerebellum were delineated and dosimetry parameters were extracted. Assessments were given post-RT via telephone (Telephone Interview Cognitive Status (TICS), Telephone Montreal Cognitive Assessment (T-MoCA), Telephone Mini Addenbrooke’s Cognitive Examination (Tele-MACE), and QLQ-H&N 43). Regression and deep neural network (DNN) models were used to predict post-RT cognition using anatomical and treatment dose features. Results Remote cognitive assessments were inter-correlated ( r > 0.9). TLs showed significance in pre- and post-RT volume differences and cognitive deficits, that are correlated with RT-associated volume atrophy and dose distribution. Good classification accuracy based on DNN area under receiver operating curve (AUROC) for cognitive prediction (T-MoCA AUROC = 0.878, TICS AUROC = 0.89, Tele-MACE AUROC = 0.919). Conclusion DL-based prediction models assessed using remote assessments can assist in predicting cognitive deficit following NPC RT. Comparable results of remote assessments in assessing cognition suggest its possibility in replacing standard assessments. Implications for Cancer Survivors Application of prediction models in individual patient enables tailored interventions to be provided in managing cognitive changes following NPC RT. Supplementary information The online version contains supplementary material available at 10.1007/s11764-023-01371-8.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

2023

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“…This highlights a need for close attention to long-term sequelae, even in those spared the neurotoxicity of intrathecal chemotherapy and cranial radiation. Although neurotoxic risk is often discussed in conjunction with adjuvant treatment approaches, particularly cranial radiation, 20,21 others have shown that treatment with surgery only conveys some risk of neurocognitive and behavioral late effects. 22,23 Although no significant group differences were found in parent-rated day-to-day executive skills on the Behavior Group differences in within-network connectivity followed a generally consistent pattern: pediatric brain tumor survivors demonstrated greater connectivity across ROIs in the default mode network, particularly the anterior portion of the default mode network.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pilot Study of Associations Among Functional Connectivity and Neurocognition in Survivors of Pediatric Brain Tumor and Healthy Peers

et al. 2022

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This pilot study examined the associations among functional connectivity in the salience, central executive, and default mode networks, and neurocognition in pediatric brain tumor survivors and healthy children. Thirteen pediatric brain tumor survivors (9 boys, M = 12.76 years) and 10 healthy children (6 boys, M = 12.70 years) completed magnetic resonance imaging (MRI) and assessment of processing speed and executive function. Pediatric brain tumor survivors performed more poorly than healthy children on measures of processing speed, divided attention, and working memory; parent ratings of day-to-day executive function did not differ significantly by group, though both pediatric brain tumor survivors who underwent only surgical resection and healthy children were rated by parents as having difficulties approaching a standard deviation above the normative mean. Connectivity was lower in the salience network and greater in the default mode network in pediatric brain tumor survivors. Cross-method correlations showed that increased salience network and default mode network connectivity were associated with better task performance and parent-rated executive skills and higher central executive network connectivity with poorer parent-rated executive skills. This perhaps reflects an adaptive pattern of hyperconnectivity in pediatric brain tumor survivors.

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“…ASL could be used to measure responses to treatment, as well as the neurocognitive deficits in executive functions, verbal processing, attention, and memory that are often observed in long-term survivors of pediatric brain tumors. It could even prevent or reduce neurocognitive dysfunction by quantifying perfusion according to variations in irradiation, one of the main contributors to neurocognitive sequelae [10,11].…”

Section: Introductionmentioning

confidence: 99%

Arterial Spin Labeling Perfusion in Pediatric Brain Tumors: A Review of Techniques, Quality Control, and Quantification

Troudi¹,

Tensaouti

Baudou

et al. 2022

Cancers

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Arterial spin labeling (ASL) is a magnetic resonance imaging (MRI) technique for measuring cerebral blood flow (CBF). This noninvasive technique has added a new dimension to the study of several pediatric tumors before, during, and after treatment, be it surgery, radiotherapy, or chemotherapy. However, ASL has three drawbacks, namely, a low signal-to-noise-ratio, a minimum acquisition time of 3 min, and limited spatial summarize current resolution. This technique requires quality control before ASL-CBF maps can be extracted and before any clinical investigations can be conducted. In this review, we describe ASL perfusion principles and techniques, summarize the most recent advances in CBF quantification, report technical advances in ASL (resting-state fMRI ASL, BOLD fMRI coupled with ASL), set out guidelines for ASL quality control, and describe studies related to ASL-CBF perfusion and qualitative and semi-quantitative ASL weighted-map quantification, in healthy children and those with pediatric brain tumors.

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Cognitive sequelae of radiotherapy in primary brain tumors

Cited by 8 publications

References 65 publications

Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

Remote assessment of cognition and quality of life following radiotherapy for nasopharyngeal carcinoma: deep-learning-based predictive models and MRI correlates

Pilot Study of Associations Among Functional Connectivity and Neurocognition in Survivors of Pediatric Brain Tumor and Healthy Peers

Arterial Spin Labeling Perfusion in Pediatric Brain Tumors: A Review of Techniques, Quality Control, and Quantification

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