Brain biomarkers and neuropsychological outcomes of pediatric posterior fossa brain tumor survivors treated with surgical resection with or without adjuvant chemotherapy
| Autor: | Jemily Malvar, Natasha Lepore, Sofia Dhanani, Sharon H. O'Neil, Vidya Rajagopalan, Christopher Nuñez, Mary Baron Nelson, Jonathan L. Finlay, Jeffrey Tanedo, Marvin D. Nelson, Benita Tamrazi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Psychometrics Brain tumor Uncinate fasciculus Prefrontal Cortex Antineoplastic Agents Infratentorial Neoplasms Neuropsychological Tests Hippocampus Article White matter 03 medical and health sciences 0302 clinical medicine Thalamus Pons Fractional anisotropy medicine Humans Neuropsychological assessment Prefrontal cortex Child medicine.diagnostic_test business.industry Brain Neoplasms Neuropsychology Hematology Executive functions medicine.disease White Matter medicine.anatomical_structure Cross-Sectional Studies Oncology 030220 oncology & carcinogenesis Brain Injuries Pediatrics Perinatology and Child Health Anisotropy Female Neurotoxicity Syndromes Radiology business 030215 immunology |
| Zdroj: | Pediatr Blood Cancer |
| ISSN: | 1545-5017 |
| Popis: | Purpose Children with brain tumors experience cognitive late effects, often related to cranial radiation. We sought to determine differential effects of surgery and chemotherapy on brain structure and neuropsychological outcomes in children who did not receive cranial radiation therapy (CRT). Methods Twenty-eight children with a history of posterior fossa tumor (17 treated with surgery, 11 treated with surgery and chemotherapy) underwent neuroimaging and neuropsychological assessment a mean of 4.5 years (surgery group) to 9 years (surgery + chemotherapy group) posttreatment, along with 18 healthy sibling controls. Psychometric measures assessed IQ, language, executive functions, processing speed, memory, and social-emotional functioning. Group differences and correlations between diffusion tensor imaging findings and psychometric scores were examined. Results The z-score mapping demonstrated fractional anisotropy (FA) values were ≥2 standard deviations lower in white matter tracts, prefrontal cortex gray matter, hippocampus, thalamus, basal ganglia, and pons between patient groups, indicating microstructural damage associated with chemotherapy. Patients scored lower than controls on visuoconstructional reasoning and memory (P ≤ .02). Lower FA in the uncinate fasciculus (R = -0.82 to -0.91) and higher FA in the thalamus (R = 0.73-0.91) associated with higher IQ scores, and higher FA in the thalamus associated with higher scores on spatial working memory (R = 0.82). Conclusions Posterior fossa brain tumor treatment with surgery and chemotherapy affects brain microstructure and neuropsychological functioning years into survivorship, with spatial processes the most vulnerable. Biomarkers indicating cellular changes in the thalamus, hippocampus, pons, prefrontal cortex, and white matter tracts associate with lower psychometric scores. |
| Databáze: | OpenAIRE |
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