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La relación dosis-dependiente de la red medial temporal, la red de memoria parietal y la red visual en el deterioro

Zhihua Liu¹, Stephanie Zhao¹, Timothy J Mitchell¹

¹Department of Radiation Oncology, Washington University School of Medicine, St Louis, MO, USA.

International journal of radiation oncology, biology, physics

|February 13, 2026

Abstracto

Background:

In this prospective observational study, we evaluated dose-response relationships between radiation dose to the brain's resting-state networks (RSNs) and neurocognitive function (NCF) changes following radiation therapy (RT) in adult patients with diffuse glioma.

Methods:

Adult patients with IDH-wild-type and IDH-mutant gliomas underwent NCF testing using the NIH Toolbox Cognition Battery and resting-state functional magnetic resonance imaging (rs-fMRI) before (baseline) and six months after RT. The battery assessed five cognitive domains and generated a fluid cognition composite score. NCF change (ΔNCF) was defined as the percent change in age-adjusted scores from baseline to follow-up. Radiation dosimetric parameters were extracted for 13 RSNs and 3 sub-cortical regions, defined by 300 rs-fMRI-derived regions of interests. Correlations between ΔNCF and dosimetric parameters were assessed using Spearman's rank correlation test (ρ). Linear regression models were compared using nested analysis of variance (ANOVA), Akaike Information Criterion (AIC), and adjusted R².

Results:

Among 48 patients enrolled, 36 patients were evaluable with paired rs-fMRI and NCF data. Moderate negative correlations were observed between change in episodic memory (ΔNCF_EM) and mean dose to the medial temporal lobe network (MTL: ρ=-0.41, 95% CI=(-0.66, -0.08), P=0.01), visual network (VN: ρ=-0.42, 95% CI=(-0.67, -0.09), P=0.01), and parietal memory network (PMN: ρ=-0.40, 95% CI=(-0.65, -0.07), P=0.01). No significant correlations were found for other RSNs or NCF domains. A linear regression model incorporating MTL dose and its interaction with age outperformed the age-alone model in explaining variance in ΔNCF_EM (P=0.046; ΔAIC= -2.95; adjusted R²=0.313).

Conclusions:

Focal dose-response relationships were observed between radiation dose to specific RSNs and episodic memory changes following RT, highlighting the prognostic and therapeutic potential of rs-fMRI for identifying targets for cognitive preservation in patients undergoing RT.

Palabras clave:

Glioma dosis-respuesta deterioro cognitivo inducido por radiación red en reposo Resonancia magnética funcional en reposo

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