White Matter Fractional Anisotropy Correlates With Speed of Processing and Motor Speed in Young Childhood Cancer Survivors

Aukema, Eline J.; Caan, Matthan W.A.; Oudhuis, Nienke; Majoie, Charles B. L. M.; Vos, Frans M.; Reneman, Liesbeth; Grootenhuis, Martha A.; Meeteren, A.Y.N. Schouten-van

doi:10.1016/j.ijrobp.2008.08.060

Cited by 138 publications

(146 citation statements)

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“…Such early response to irradiation may be useful for predicting subsequent progression that may vary individually (10). Several studies have reported correlation between changes in DTI indices and decreased neurocognitive functionality such as intelligence quotient scores and processing speeds (11)(12)(13)(14), suggesting DTI as a potential imaging biomarker for treatmentrelated neurotoxicity. A notable finding in these studies is that radiation dose-effect is fiber tract-or region-dependent (15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

Hua

Ogg

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To determine the radiation dose-effect on the structural integrity of cerebral white matter in craniopharyngioma patients receiving surgery and proton therapy.Methods and Materials-Fifty-one patients (aged 2.1-19.3 years) with craniopharyngioma underwent surgery and proton therapy in a prospective therapeutic trial. Anatomical magnetic resonance images acquired after surgery but before proton therapy were inspected to identify white matter structures intersected by surgical corridors and catheter tracks. Longitudinal diffusion tensor imaging (DTI) was performed to measure microstructural integrity changes in cerebral white matter. Fractional anisotropy (FA) derived from DTI was statistically analyzed for 51 atlasbased white matter structures of the brain to determine radiation dose-effect. FA in surgeryaffected regions in the corpus callosum was compared to that in its intact counterpart to determine whether surgical defects affect radiation dose-effect.Results-Surgical defects were seen most frequently in the corpus callosum because of transcallosal resection of tumors and insertion of ventricular or cyst catheters. The longitudinal DTI data indicated reductions in FA 3 months after therapy, which was followed by a recovery in most white matter structures. A greater FA reduction was correlated with a higher radiation dose in 20 white matter structures, indicating a radiation dose-effect. The average FA in the surgery- Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript affected regions before proton therapy was smaller (P =0.0001) than that in their non-surgery affected counterparts with more intensified subsequent reduction of FA (P=0.0083) after therapy, suggesting that surgery accentuated the radiation dose-effect.Conclusions-DTI data suggest that mild radiation dose-effects occur in patients with craniopharyngioma receiving surgery and proton therapy. Surgical defects present at the time of proton therapy appear to accentuate the radiation dose-effect longitudinally. This study supports consideration of pre-existing surgical defects and their locations in proton therapy planning and studies of treatment effect.

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Section: Introductionmentioning

confidence: 99%

Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

Hua

Ogg

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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“…Given the widespread interhemispheric connections that course through the CC and its primary function in mediating interhemispheric communication [Pannek et al, 2010], callosal pathway disruptions can have a profound impact on cognitive functioning, including the speed of information processing [Aukema et al, 2009;Biegon et al, 1994;Chepuri et al, 2002;Jokinen et al, 2007;Turken et al, 2008]. Patients with TBI often demonstrate slowed information processing on neuropsychological testing [Battistone et al, 2008;Johansson et al, 2009;Madigan et al, 2000].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Changes in the Corpus Callosum following Pediatric Traumatic Brain Injury

et al. 2010

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Background: Atrophy of the corpus callosum (CC) is a documented consequence of moderate-to-severe traumatic brain injury (TBI), which has been expressed as volume loss using quantitative magnetic resonance imaging (MRI). Other advanced imaging modalities such as diffusion tensor imaging (DTI) have also detected white matter microstructural alteration following TBI in the CC. The manner and degree to which macrostructural changes such as volume and microstructural changes develop over time following pediatric TBI, and their relation to a measure of processing speed is the focus of this longitudinal investigation. As such, DTI and volumetric changes in the CC in participants with TBI and a comparison group at approximately 3 and 18 months after injury as well as their relation to processing speed were determined. Methods: Forty-eight children and adolescents aged 7–17 years who sustained either complicated mild or moderate-to-severe TBI (n = 23) or orthopedic injury (OI; n = 25) were studied. The participants underwent brain MRI and were administered the Eriksen flanker task at both time points. Results: At 3 months after injury, there were significant group differences in DTI metrics in the total CC and its subregions (genu/anterior, body/central and splenium/posterior), with the TBI group demonstrating significantly lower fractional anisotropy (FA) and a higher apparent diffusion coefficient (ADC) in comparison to the OI group. These group differences were also present at 18 months after injury in all CC subregions, with lower FA and a higher ADC in the TBI group. In terms of longitudinal changes in DTI, despite the group difference in mean FA, both groups generally demonstrated a modest increase in FA over time though this increase was only significant in the splenium/posterior subregion. Interestingly, the TBI group also generally demonstrated ADC increases from 3 to 18 months though the OI group demonstrated ADC decreases over time. Volumetrically, the group differences at 3 months were marginal for the midanterior and body/central subregions and total CC. However, by 18 months, the TBI group demonstrated a significantly decreased volume in all subregions except the splenium/posterior area relative to the OI group. Unlike the OI group, which showed a significant volume increase in subregions of the CC over time, the TBI group demonstrated a significant and consistent volume decrease. Performance on a measure of processing speed did not differentiate the groups at either visit, and only the OI group showed significantly improved performance over time. Processing speed was related to FA in the splenium/posterior and total CC only in the TBI group on both occasions, with a stronger relation at 18 months. Conclusion: In response to TBI, macrostructural volume loss in the CC occurred over time; yet, at the microstructural level, DTI demonstrated both indicators of continued maturation and development even in the damaged CC, as well as evidence of potential degenerative change. Unlike volumetrics, which likely refle...

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“…The results regarding overall IQ estimates and their relationship to white matter changes are mixed. For example, Aukema et al (2009) observed differences in processing speed measures from the Dutch WISC-IV though no differences in full-scale IQ. Others have observed nonsignificant differences in mean FSIQ in a sample of children with medulloblastoma compared to the standardization mean (Palmer et al 2010).…”

Section: Diffusion Tensor Imaging and Functionmentioning

confidence: 95%

“…In general, studies have observed decreased FA values in several white matter networks including frontal and parietal periventricular white matter, corpus callosum, corona radiata, right inferior fronto-occipital fasciculus, anterior and posterior limbs of the internal capsule, inferior frontal white matter, high frontal white matter, pons, medulla oblongata, and cerebello-thalamo-cerebral tracts (Aukema et al 2009;Khong et al 2003;Khong et al 2005;Law et al 2011;Leung et al 2004;Mabbott et al 2005). …”

Section: Diffusion Tensor Imaging and White Matter Integritymentioning

confidence: 98%

“…For example, information processing speed, as measured by the Dutch Wechsler Intelligence Scale for Children 3rd Edition (Dutch WISC-III), and fine-motor control were positively correlated with FA values in the splenium of the corpus callosum and inferior frontal-occipital fasciculus, respectively, in children with medulloblastoma compared to controls (Aukema et al 2009). This was a somewhat surprising finding given that the full-scale intelligence measure (FSIQ) and perceptual reasoning composite scores for the control group were both in the low average range.…”

Section: Diffusion Tensor Imaging and Functionmentioning

confidence: 99%

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Effects of Cranial Radiation on Structural and Functional Brain Development in Pediatric Brain Tumors

Bledsoe

2015

J Pediatr Neuropsychol

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There is emerging research connecting neuroimaging correlates and neurocognitive functioning in pediatric brain tumors. Current work has attempted to measure the impact of cranial radiation on brain and behavior outcomes with the goal of better understanding the mechanisms of treatment late effects. While critical for treatment, cranial radiation can have a substantial impact on the developing brain and on neuropsychological development. This paper provides a critical review of the most recent empirical structural and functional neuroimaging research evaluating the impact of cranial radiation on neuropsychological functioning in pediatric brain tumors. The importance in study methodology, potential outcome moderating variables, limitations, and future directions is discussed.

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White Matter Fractional Anisotropy Correlates With Speed of Processing and Motor Speed in Young Childhood Cancer Survivors

Cited by 138 publications

References 33 publications

Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

Effects of Surgery and Proton Therapy on Cerebral White Matter of Craniopharyngioma Patients

Longitudinal Changes in the Corpus Callosum following Pediatric Traumatic Brain Injury

Effects of Cranial Radiation on Structural and Functional Brain Development in Pediatric Brain Tumors

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