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

Abstract

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.

Identify the radiotherapy-induced abnormal changes in the patients with nasopharyngeal carcinoma

“…The method of PCA+SVM was quite helpful to improve the accuracy of the classification, and validly detected the abnormal brain regions, which widely contained the previous research achievement. As shown in Table 1, our results were consistent with previous studies, suggesting that the method was in favour of identifying the injury caused by RT [5][6][7]9]. The classification accuracy was 82.5 %, indicating that the method could well identify the abnormal changes induced by RT.…”

“…Previous studies have found that radiation therapy for NPC resulted in multiple regions abnormalities, such as temporal lobe necrosis [3,4], precuneus, cuneus, lateral occipital cortex [5], the vermis, hippocampus, cerebellum lobule, middle occipital lobe, and insula [6,7]. However, it was difficult for doctors to identify the abnormal changes after radiotherapy (RT) based on original image features.…”

Machine-learning based MRI radiomics models for early detection of radiation-induced brain injury in nasopharyngeal carcinoma

“…Diffusion kurtosis imaging (DKI) can detect the early presence of relatively subtle radiation-induced changes before temporal lobe necrosis [25,26]. Altered brain functional connections were significantly correlated to the Montreal Cognitive Assessment scores in NPC patients, which may serve as a potential biomarker of the brain functional impairments [27,28]. Thus, structural and functional MRI were more sensitive than conventional MRI in determining radiation induced brain damage.…”

Dosimetric comparison and observation of three-dimensional conformal radiotherapy for recurrent nasopharyngeal carcinoma

“…Nasopharyngeal carcinoma, after a timely and standardized radical radiotherapy or integrated radiotherapy and chemotherapy, can lead to local and/or regional recurrence in 20–30% of patients. Local nasopharyngeal and skull-based recurrence are the main reasons for the failure of local treatment of NPC after radiotherapy ( 9 – 11 ). Retrospective studies have shown that salvage therapy can improve survival in patients with a single local recurrence (especially those with local recurrence of T1-2) ( 12 ).…”