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Microvascular and microstructural brain abnormalities in paediatric haematological cancer survivors are related to
Faye McKenna1, Shounak Nandi1, Sonya S Henry1
1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York, USA.
Abstract:
Microvascular, inflammatory and myelin pathologies may contribute to chemotherapy-related cognitive impairment (CRCI). This study applied a novel three-compartment intravoxel incoherent motion-free water imaging (IVIM-FWI) technique that estimates the perfusion fraction (PF), free water fraction (FW) and anisotropic diffusion of tissue (FAt) to study microvascular and microstructural changes in grey and white matter regions in 16 cancer survivor (CS) participants compared to 15 matched healthy controls (HCs). We found significantly decreased PF and increased FW in grey and white matter regions and significantly decreased FAt in white matter regions in the CS versus HC group. These changes were located in key regions involved in emotion, cognition and sensory processing. Furthermore, in both groups, decreased FAt and varying changes in PF and FW were significantly associated with poor performance on cognitive tests assessing general cognitive ability, fluid intelligence, inhibition and processing speed. Overall, the three-compartment IVIM-FWI model provides neuroinflammation, myelination and microvascular metrics that may be related to CRCI pathologies and are associated with cognition. This approach may facilitate targeted interventions aimed at preserving cognitive function and improving overall quality of life for paediatric haematological cancer survivors.
Insights
Chemotherapy survivors show microvascular and myelin changes linked to cognitive issues. Novel imaging reveals brain alterations associated with impaired cognitive function, offering hope for targeted interventions.
Area of Science:
- Neuroimaging
- Oncology
- Cognitive Neuroscience
Background:
- Chemotherapy-related cognitive impairment (CRCI) is a significant concern for cancer survivors.
- Microvascular, inflammatory, and myelin pathologies are implicated in CRCI.
- Current understanding of CRCI's underlying neurobiology requires further investigation.
Purpose of the Study:
- To investigate microvascular and microstructural brain changes in cancer survivors (CS) compared to healthy controls (HCs) using a novel imaging technique.
- To explore the relationship between these brain changes and cognitive performance.
- To assess the utility of the three-compartment intravoxel incoherent motion-free water imaging (IVIM-FWI) technique in characterizing CRCI pathologies.
Main Methods:
- Employed a novel three-compartment IVIM-FWI technique to quantify perfusion fraction (PF), free water fraction (FW), and anisotropic diffusion of tissue (FAt).
- Compared 16 CS with 15 matched HCs, analyzing grey and white matter regions.
- Assessed cognitive function using tests for general cognitive ability, fluid intelligence, inhibition, and processing speed.
Main Results:
- CS exhibited significantly decreased PF and increased FW in both grey and white matter compared to HCs.
- Significantly decreased FAt was observed in white matter regions of CS.
- Decreased FAt and altered PF/FW were associated with poorer cognitive test performance in both groups.
Conclusions:
- The three-compartment IVIM-FWI model provides valuable metrics for neuroinflammation, myelination, and microvasculature relevant to CRCI.
- Observed brain changes in CS are located in regions critical for cognition and emotion.
- This imaging approach shows promise for identifying CRCI pathologies and guiding interventions to preserve cognitive function in cancer survivors.
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