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Regional white matter anisotropy and reading ability in patients treated for pediatric embryonal tumors
Shawna L Palmer1, Wilburn E Reddick, John O Glass
1St. Jude Children's Research Hospital, Memphis, TN, USA. shawna.palmer@stjude.org
Insights
Children receiving cranial irradiation for brain tumors show impaired reading. This study links white matter integrity, measured by fractional anisotropy (FA), to reading ability in these patients.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Radiology
Background:
- Cranial irradiation for pediatric brain tumors can lead to cognitive deficits, including impaired reading ability.
- Reduced white matter volume is a known consequence of this treatment.
Purpose of the Study:
- To prospectively investigate the relationship between reading ability and white matter integrity in children treated for brain tumors.
- To identify specific white matter tracts associated with reading performance.
Main Methods:
- Prospective study of 54 pediatric brain tumor patients treated with cranial irradiation and chemotherapy.
- Neuropsychological evaluation and diffusion tensor imaging (DTI) were performed 12 months post-diagnosis.
- White matter integrity was quantified using fractional anisotropy (FA) measures.
Main Results:
- Significant differences in FA were observed between above-average and below-average readers in key white matter tracts.
- Affected regions included the internal capsule (posterior limb, bilateral) and the right knee of the internal capsule.
- A trend for differences was noted in the left temporal-occipital region.
Conclusions:
- White matter integrity in specific regions is associated with reading ability in children treated for brain tumors.
- These white matter tracts are crucial for communication between cortical areas involved in reading.
- Findings highlight potential targets for neuroprotective strategies and reading interventions.
Abstract:
Children treated with cranial irradiation for brain tumors have reduced white matter volume and deficits in reading ability. This study prospectively examined the relationship between reading and white matter integrity within this patient group. Patients (n = 54) were treated with post-surgical radiation followed by 4 cycles of high-dose chemotherapy with stem cell support. At 12 months post-diagnosis, all patients completed a neuropsychology evaluation and a diffusion tensor imaging (DTI) exam. White matter integrity was determined through measures of fractional anisotropy (FA). Significant group differences in FA were found between above average readers and below average readers within the left and right posterior limb of the internal capsule, and right knee of the internal capsule with a trend within the left temporaloccipital region. The integrity of the white matter in these regions may affect communication among visual, auditory, and language cortical areas that are engaged during reading.
