Reduced Frontal White Matter Volume in Long-Term Childhood Leukemia Survivors: A Voxel-Based Morphometry Study
Autor: | J.J. Hutter, S.L. Reminger, K.L. Kaemingk, Marc W. Haut, Rebecca J. Theilmann, Marissa E. Carey |
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Rok vydání: | 2008 |
Předmět: |
Adult
Male medicine.medical_specialty Adolescent Childhood leukemia Neuropsychological Tests Audiology computer.software_genre Pediatrics Developmental psychology White matter Voxel Humans Medicine Radiology Nuclear Medicine and imaging Survivors Child Intelligence Tests medicine.diagnostic_test business.industry Neuropsychology Cognitive flexibility Magnetic resonance imaging Voxel-based morphometry Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Magnetic Resonance Imaging Frontal Lobe medicine.anatomical_structure El Niño Female Neurology (clinical) business computer |
Zdroj: | AJNR Am J Neuroradiol |
ISSN: | 1936-959X 0195-6108 |
Popis: | BACKGROUND AND PURPOSE: To our knowledge, no published studies have examined whole-brain regional differences to identify more discrete volumetric changes in the brains of childhood leukemia survivors. We used voxel-based morphometry (VBM) to examine regional gray and white matter differences in a group of long-term survivors of acute lymphoblastic leukemia (ALL) compared with a group of healthy controls. Differences in regional white matter volume were expected, given previous reports of white matter changes during treatment for ALL and reduced brain white matter volumes in long-term survivors. Follow-up analyses examined the relationship of regional brain volumes to cognitive function. MATERIALS AND METHODS: We compared 9 long-term survivors of ALL with 14 healthy controls. Survivors of ALL were treated with systemic and intrathecal chemotherapy only. T1-weighted axial 3D spoiled gradient high-resolution images collected on a 1.5T MR imaging scanner were used for the VBM analysis. Neuropsychological evaluations were conducted within 2 months of the MR imaging to assess cognitive function. RESULTS: VBM analysis revealed 2 specific regions of reduced white matter in the right frontal lobes of survivors of ALL compared with healthy controls. Survivors of ALL had lower performances on tests of attention, visual-constructional skills, mental flexibility, and math achievement compared with healthy individuals. Decreased performance on neuropsychological measures was associated with decreased regional white matter volumes. No differences were found between the groups with respect to gray matter regions. CONCLUSION: These findings are consistent with previous literature describing the long-term cognitive, academic, and imaging findings of survivors of ALL and suggest that right frontal white matter is particularly vulnerable to disruption following intensive chemotherapy for ALL. Future studies should focus on further clarifying the white matter changes observed. |
Databáze: | OpenAIRE |
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