Magnetic resonance spectroscopic imaging of brain injury after nasopharyngeal cancer radiation in early delayed reaction

Chen, W.-S.; Li, J.-J.; Zhang, J.-H.; Liang, Hong; Xing, Zhiheng; Wang, F.; Li, C.-Q.

doi:10.4238/2014.august.29.6

Cited by 11 publications

(10 citation statements)

References 15 publications

(17 reference statements)

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“…This is the first‐reported fMRI‐based RT‐injury study. Several pioneering studies using other functional modalities—for example, PET, perfusion MRI, single‐photon emission computed tomography (SPECT), and MRS—have been conducted mainly to investigate RT‐induced necrosis [Chan et al, ; Chen et al, ; Chong et al, ; Kim et al, ; Matulewicz et al, ; Schwartz et al, ; Sundgren, ; Tsui et al, ] or other MR‐invisible lesions [Wang et al, ; Xiong et al, ]. These results can support our findings, as fMRI is also related to cerebral vascular function and perfusion.…”

Section: Discussionsupporting

confidence: 84%

“…The above findings, however, were not consistent with those from the brain tumor studies, in which different white matter areas, such as the parahippocampal cingulum bundles [Chapman et al, ] and the genu and splenium of the corpus callosum [Nagesh et al, ] were assessed and revealed a gradual course towards abnormality, which again indicates progression of structural abnormalities. In addition to DTI, both our group [Wang et al, ; Xiong et al, ] and another group [Chen et al, ] have used magnetic resonance spectroscopy (MRS) to measure brain tissue metabolism and neuronal function in post‐RT, normal‐appearing nasopharyngeal carcinoma patients, but this modality is hampered by heavy noise and poor spatial resolution [Jansen et al, ], as well as the same ROI‐definition problem. More advanced brain functional study using functional magnetic resonance imaging (fMRI) has been largely neglected.…”

Section: Introductionmentioning

confidence: 99%

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Radiation‐induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction

Ding

Zhang

et al. 2017

Human Brain Mapping

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Radiation therapy, a major method of treatment for brain cancer, may cause severe brain injuries after many years. We used a rare and unique cohort of nasopharyngeal carcinoma patients with normal-appearing brains to study possible early irradiation injury in its presymptomatic phase before severe, irreversible necrosis happens. The aim is to detect any structural or functional imaging biomarker that is sensitive to early irradiation injury, and to understand the recovery and progression of irradiation injury that can shed light on outcome prediction for early clinical intervention. We found an acute increase in local brain activity that is followed by extensive reductions in such activity in the temporal lobe and significant loss of functional connectivity in a distributed, largescale, high-level cognitive function-related brain network. Intriguingly, these radiosensitive functional alterations were found to be fully or partially recoverable. In contrast, progressive late disruptions to the integrity of the related far-end white matter structure began to be significant after one year. Importantly, early increased local brain functional activity was predictive of severe later

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Radiation‐induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction

Ding

Zhang

et al. 2017

Human Brain Mapping

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“…Modern neuroimaging techniques, such as MRS and DTI, have provided fascinating insights into microscopic abnormalities in the normal appearing brain parenchyma in Post-RT. For instance, an MRS study (Chen et al, 2014) found dynamic and transient metabolic alterations in the temporal lobe. Using TBSS, one DTI study demonstrated dynamic and complex WM microstructural changes in the earlier phases of RT (Duan et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Cortical Surface Area Rather Than Cortical Thickness Potentially Differentiates Radiation Encephalopathy at Early Stage in Patients With Nasopharyngeal Carcinoma

Zhang

Chen

et al. 2018

Front. Neurosci.

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Radiation encephalopathy (RE) is one of the most severe complications in nasopharyngeal carcinoma (NPC) patients after radiotherapy (RT). However, the morphological alteration of early RE is insufficiently investigated. We aimed to investigate the cortical thickness and surface area alterations in NPC patients with or without RE in the follow-up. A total of 168 NPC patients each underwent a single scan and analysis at various times either Pre-RT (n = 56) or Post-RT (n = 112). We further divided the Post-RT NPC patients into three groups based on the time of the analysis following RT (Post-RTwithin 6 months and Post-RT7-12 months) or whether RE signs were detected in the analysis (Post-RTRE proved in follow-up). We confined the vertex-wise analyses of the cortical thickness and surface area to the bilateral temporal lobes. Interestingly, we revealed a gradual increase in the cortical surface area of the temporal lobe with increasing time after RT within the Post-RTRE proved in follow-up group, consistent with the between-group findings, which showed a significant increase in cortical surface area in the Post-RTRE proved in follow-up group relative to the Pre-RT group and the Post-RTwithin 6 months group. By contrast, such a trend was not observed in the cortical thickness findings. We concluded that the cortical surface area, rather than cortical thickness, may serve as a potential biomarker for early diagnosis of RE.

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“…Except for the brain structural abnormalities, [6] the radiation-induced functional deficits of NPC patients were also extensively investigated applying statistic analysis, such as performing the Montreal Cognitive Assessment (MoCA). Surveys have indicated that the NPC patients with RT (RT+) generally showed lower MoCA scores than the NPC patients without RT (RT−), demonstrating that RT would induce the cognitive deficits in NPC patients.…”

Section: Introductionmentioning

confidence: 99%

Radiation-induced functional connectivity alterations in nasopharyngeal carcinoma patients with radiotherapy

Zeng

et al. 2016

Medicine

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The study aims to investigate the radiation-induced brain functional alterations in nasopharyngeal carcinoma (NPC) patients who received radiotherapy (RT) using functional magnetic resonance imaging (fMRI) and statistic scale.The fMRI data of 35 NPC patients with RT and 24 demographically matched untreated NPC patients were acquired. Montreal Cognitive Assessment (MoCA) was also measured to evaluate their global cognition performance. Multivariate pattern analysis was performed to find the significantly altered functional connections between these 2 groups, while the linear correlation level was detected between the altered functional connections and the MoCA scores.Forty-five notably altered functional connections were found, which were mainly located between 3 brain networks, the cerebellum, sensorimotor, and cingulo-opercular. With strictly false discovery rate correction, 5 altered functional connections were shown to have significant linear correlations with the MoCA scores, that is, the connections between the vermis and hippocampus, cerebellum lobule VI and dorsolateral prefrontal cortex, precuneus and dorsal frontal cortex, cuneus and middle occipital lobe, and insula and cuneus. Besides, the connectivity between the vermis and hippocampus was also significantly correlated with the attention score, 1 of the 7 subscores of the MoCA.The present study provides new insights into the radiation-induced functional connectivity impairments in NPC patients. The results showed that the RT may induce the cognitive impairments, especially the attention alterations. The 45 altered functional connections, especially the 5 altered functional connections that were significantly correlated to the MoCA scores, may serve as the potential biomarkers of the RT-induced brain functional impairments and provide valuable targets for further functional recovery treatment.

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Magnetic resonance spectroscopic imaging of brain injury after nasopharyngeal cancer radiation in early delayed reaction

Cited by 11 publications

References 15 publications

Radiation‐induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction

Radiation‐induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction

Cortical Surface Area Rather Than Cortical Thickness Potentially Differentiates Radiation Encephalopathy at Early Stage in Patients With Nasopharyngeal Carcinoma

Radiation-induced functional connectivity alterations in nasopharyngeal carcinoma patients with radiotherapy

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