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Brain Microstructural Changes Associated With Neurocognitive Outcome in Intracranial Germ Cell Tumor Survivors.
Winnie Wan Yee Tso1, Edward Sai Kam Hui2, Tatia Mei Chun Lee3,4
1Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing (LKS) Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong.
Frontiers in Oncology
|June 24, 2021
Summary
Childhood brain tumor survivors show cognitive and functional deficits linked to white and grey matter changes. Diffusion kurtosis imaging reveals specific brain regions affected by radiotherapy, impacting neurocognition and performance.
Area of Science:
- Neuroimaging
- Pediatric Oncology
- Radiotherapy
Background:
- Childhood intracranial germ cell tumor (GCT) survivors often experience neurocognitive deficits due to radiotherapy-related neurotoxicity.
- Diffusion kurtosis imaging (DKI) is a sensitive MRI technique for detecting microstructural brain changes.
Purpose of the Study:
- To investigate the association between DKI metrics and cognitive/functional outcomes in childhood intracranial GCT survivors.
- To identify specific brain regions affected by radiotherapy and their impact on survivors' functioning.
Main Methods:
- DKI was performed on 20 GCT survivors and 14 healthy controls.
- Neurocognitive and functional assessments used the Hong Kong Wechsler Intelligence Scales and Lansky/Karnofsky performance scales (KPS).
- Mixed effects models and multiple regression analyses were used to compare groups and assess associations.
Main Results:
- GCT survivors had lower mean Intelligence Quotient (IQ) (91.7) and KPS scores (85.5) compared to controls.
- Cognitive impairments correlated with microstructural changes in both white and grey matter.
- Functional impairments were primarily associated with white matter microstructural changes.
Conclusions:
- Vulnerable brain regions in white and grey matter show microstructural changes linked to impaired cognitive and physical functioning in pediatric GCT survivors.
- DKI metrics are associated with neurocognitive and functional outcomes, highlighting potential imaging biomarkers.
