Early changes in white matter predict intellectual outcome in children treated for posterior fossa tumors

Autor: Marita Partanen, Eric Bouffet, Suzanne Laughlin, Douglas Strother, Juliette Hukin, Jovanka Skocic, Kamila Szulc-Lerch, Donald J. Mabbott
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: NeuroImage: Clinical, Vol 20, Iss , Pp 697-704 (2018)
Druh dokumentu: article
ISSN: 2213-1582
DOI: 10.1016/j.nicl.2018.09.005
Popis: Purpose: Prospective and longitudinal neuroimaging studies of posterior fossa tumors are scarce. Here we evaluate the early changes in white matter and intellectual outcome up to 3 years after diagnosis. Patients and methods: Twenty-two children with posterior fossa tumors and 24 similarly-aged healthy children participated. Patients included: (a) 12 individuals who received surgery, cranial-spinal radiation (CSR), and focal radiation to the tumor bed (CSR group) and (b) 10 individuals who received local therapy, either surgery only or surgery and focal radiation to the tumor bed (Local group). Diffusion tensor imaging (DTI) and intelligence measures were obtained an average of 3 months after diagnosis and then at 12, 24, and 36 months later. DTI tractography and voxel-wise approaches were employed. The Neurological Predictor Scale was used to summarize the type and amount of treatment for PF tumor patients. Linear mixed modelling was used to evaluate group differences at baseline and changes over time in DTI metrics for both the specific white matter tracts and voxel-wise, as well as for intelligence measures. Results: Based on tractography, patients treated with CSR had significantly higher Axial and Mean diffusivity in the cortical-spinal tracts (CST) 3 month after diagnosis – particularly on the right side, p .10. Voxel-wise analyses revealed multiple areas of white matter compromise in both patients groups. Notably, both patient groups had lower scores on intelligence measures compared to the Control group: The CSR group displayed lower performance 3 months following diagnosis, ps 0.10, whereas the Local group displayed no differences at 3 months, ps> 0.10, but their performance declined over time, ps
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