1
|
Hou J, King TZ, Chen H, Wang Q, Xie Y, Mao H, Wang L, Cheng L. Concurrent brain structural and functional alterations in the thalamus of adult survivors of childhood brain tumors: a multimodal MRI study. Brain Res Bull 2024; 211:110937. [PMID: 38570077 DOI: 10.1016/j.brainresbull.2024.110937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 03/20/2024] [Accepted: 03/31/2024] [Indexed: 04/05/2024]
Abstract
Adult survivors of childhood brain tumors often present with cognitive deficits that affect their quality of life. Studying brain structure and function in brain tumor survivors can help understand the underlying mechanisms of their cognitive deficits to improve long-term prognosis of these patients. This study analyzed voxel-based morphometry (VBM) derived from T1-weighted MRI and the amplitude of low-frequency fluctuation (ALFF) from resting-state functional magnetic resonance imaging (rs-fMRI) to examine the structural and functional alterations in 35 brain tumor survivors using 35 matching healthy individuals as controls. Compared with healthy controls, brain tumor survivors had decreased gray matter volumes (GMV) in the thalamus and increased GMV in the superior frontal gyrus. Functionally, brain tumor survivors had lower ALFF values in the inferior temporal gyrus and medial prefrontal area and higher ALFF values in the thalamus. Importantly, we found concurrent but negatively correlated structural and functional alterations in the thalamus based on observed significant differences in GMV and ALFF values. These findings on concurrent brain structural and functional alterations provide new insights towards a better understanding of the cognitive deficits in brain tumor survivors.
Collapse
Affiliation(s)
- Jinfeng Hou
- School of Life and Environmental Sciences, Guilin University of Electronic Technology, Guilin 541004, China; Nanning Research Institute, Guilin University of Electronic Technology, Nanning 530000, China
| | - Tricia Z King
- Department of Psychology and the Neuroscience Institute, Georgia State University, Atlanta, GA, USA
| | - Hongbo Chen
- School of Life and Environmental Sciences, Guilin University of Electronic Technology, Guilin 541004, China; Guangxi Colleges and Universities Key Laboratory of Biomedical Sensors and Intelligent Instruments, Guilin 541004, China; Guangxi Human Physiological Information Non-Invasive Detection Engineering Technology Research Center, Guilin 541004, China; Guangxi Key Laboratory of Metabolic Reprogramming and Intelligent Medical Engineering for Chronic Diseases, Guilin 541004, China
| | - Qian Wang
- School of Life and Environmental Sciences, Guilin University of Electronic Technology, Guilin 541004, China; Nanning Research Institute, Guilin University of Electronic Technology, Nanning 530000, China
| | - You Xie
- Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin 541004, China
| | - Hui Mao
- Department of Radiology and Imaging Science, Emory University, Atlanta, GA, USA
| | - Liya Wang
- Department of Radiology, The Fist Affiliated Hospital of Nanchang University, Shenzhen Hezheng Hospital, Shenzhen, Guangdong 518109, China.
| | - Luqi Cheng
- School of Life and Environmental Sciences, Guilin University of Electronic Technology, Guilin 541004, China; Guangxi Colleges and Universities Key Laboratory of Biomedical Sensors and Intelligent Instruments, Guilin 541004, China; Guangxi Human Physiological Information Non-Invasive Detection Engineering Technology Research Center, Guilin 541004, China; Guangxi Key Laboratory of Metabolic Reprogramming and Intelligent Medical Engineering for Chronic Diseases, Guilin 541004, China; Zhejiang Lab, Hangzhou 311100, China.
| |
Collapse
|
2
|
Haller OC, Aleksonis HA, Krishnamurthy LC, King TZ. White matter hyperintensities relate to executive dysfunction, apathy, but not disinhibition in long-term adult survivors of pediatric cerebellar tumor. Neuroimage Clin 2022; 33:102891. [PMID: 34922123 PMCID: PMC8686062 DOI: 10.1016/j.nicl.2021.102891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/20/2021] [Accepted: 11/19/2021] [Indexed: 11/04/2022]
Abstract
Pediatric brain tumor survivors have more executive dysfunction than controls. White matter hyperintensities are positively associated with executive dysfunction. White matter hyperintensities are positively associated with apathy. Multivariate regression supports white matter hyperintensity associations. Survivors appear to drive white matter hyperintensities associations.
White matter hyperintensities (WMHs) have been related to executive dysfunction, apathy and disinhibition in a wide range of neurological populations. However, this relationship has not been examined in survivors of pediatric brain tumor. The goal of this study was to investigate how executive dysfunction, apathy, and disinhibition relate to WMHs in 31 long-term survivors of pediatric cerebellar brain tumor and 58 controls, using informant-report data from the Frontal Systems Behavior Scale. Total WMH volume was quantified using the Lesion Growth Algorithm. Further, periventricular, and subcortical volumes were identified based on proximity to custom ventricle masks generated in FSL. A ratio of WMH volume to whole brain volume was used to obtain normalized WMH volumes. Additionally, a multivariate regression analysis was performed. On average, informant-report scores were within normal limits and only executive dysfunction was significantly higher in survivors compared to controls (t(47.9) = -2.4, p=.023). Informants reported clinically significant levels of apathy in 32.3% of survivors. Informants also reported clinically significant executive dysfunction in 19.4 % of survivors and clinically significant disinhibition in, again, 19.4 % of survivors. Increased volume of WMHs was positively correlated with executive dysfunction (r = 0.33, p = 0.02) and apathy (r = 0.23, p = .04). Similarly, multivariate regression demonstrated correlations with executive dysfunction (p=.05, FDR corrected) and apathy (p=.05, FDR corrected). Exploratory analysis demonstrated an interaction wherein the relationship between total WMHs and executive dysfunction and apathy depends on whether the participant was a survivor. The current findings indicate that increased WMH volumes are associated with higher ratings of apathy and executive dysfunction, and that these results are likely unique to cerebellar brain tumor survivors. WMH burden may serve as a useful marker to identify survivors at risk of executive dysfunction or increased apathy.
Collapse
Affiliation(s)
- Olivia C Haller
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Holly A Aleksonis
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Lisa C Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA, Decatur, GA, USA; Department of Physics and Astronomy, Georgia State University, Atlanta, GA, USA
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, GA, USA; Neuroscience Institute, Georgia State University, Atlanta, GA, USA.
| |
Collapse
|
3
|
De Benedictis A, Rossi-Espagnet MC, de Palma L, Carai A, Marras CE. Networking of the Human Cerebellum: From Anatomo-Functional Development to Neurosurgical Implications. Front Neurol 2022; 13:806298. [PMID: 35185765 PMCID: PMC8854219 DOI: 10.3389/fneur.2022.806298] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/13/2022] [Indexed: 11/13/2022] Open
Abstract
In the past, the cerebellum was considered to be substantially involved in sensory-motor coordination. However, a growing number of neuroanatomical, neuroimaging, clinical and lesion studies have now provided converging evidence on the implication of the cerebellum in a variety of cognitive, affective, social, and behavioral processes as well. These findings suggest a complex anatomo-functional organization of the cerebellum, involving a dense network of cortical territories and reciprocal connections with many supra-tentorial association areas. The final architecture of cerebellar networks results from a complex, highly protracted, and continuous development from childhood to adulthood, leading to integration between short-distance connections and long-range extra-cerebellar circuits. In this review, we summarize the current evidence on the anatomo-functional organization of the cerebellar connectome. We will focus on the maturation process of afferent and efferent neuronal circuitry, and the involvement of these networks in different aspects of neurocognitive processing. The final section will be devoted to identifying possible implications of this knowledge in neurosurgical practice, especially in the case of posterior fossa tumor resection, and to discuss reliable strategies to improve the quality of approaches while reducing postsurgical morbidity.
Collapse
Affiliation(s)
- Alessandro De Benedictis
- Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- *Correspondence: Alessandro De Benedictis
| | - Maria Camilla Rossi-Espagnet
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Luca de Palma
- Neurology Unit, Department of Neurosciences, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Andrea Carai
- Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Carlo Efisio Marras
- Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| |
Collapse
|
4
|
Graph Theoretical Analysis of Brain Network Characteristics in Brain Tumor Patients: A Systematic Review. Neuropsychol Rev 2021; 32:651-675. [PMID: 34235627 DOI: 10.1007/s11065-021-09512-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 04/23/2021] [Indexed: 10/20/2022]
Abstract
Graph theory is a branch of mathematics that allows for the characterization of complex networks, and has rapidly grown in popularity in network neuroscience in recent years. Researchers have begun to use graph theory to describe the brain networks of individuals with brain tumors to shed light on disrupted networks. This systematic review summarizes the current literature on graph theoretical analysis of magnetic resonance imaging data in the brain tumor population with particular attention paid to treatment effects and other clinical factors. Included papers were published through June 24th, 2020. Searches were conducted on Pubmed, PsycInfo, and Web of Science using the search terms (graph theory OR graph analysis) AND (brain tumor OR brain tumour OR brain neoplasm) AND (MRI OR EEG OR MEG). Studies were eligible for inclusion if they: evaluated participants with a primary brain tumor, used graph theoretical analyses on structural or functional MRI data, MEG, or EEG, were in English, and were an empirical research study. Seventeen papers met criteria for inclusion. Results suggest alterations in network properties are often found in people with brain tumors, although the directions of differences are inconsistent and few studies reported effect sizes. The most consistent finding suggests increased network segregation. Changes are most prominent with more intense treatment, in hub regions, and with factors such as faster tumor growth. The use of graph theory to study brain tumor patients is in its infancy, though some conclusions can be drawn. Future studies should focus on treatment factors, changes over time, and correlations with functional outcomes to better identify those in need of early intervention.
Collapse
|
5
|
Fox ME, Turner JA, Crosson B, Morris RD, King TZ. Functional Connectivity Networks and Their Recruitment During Working Memory Tasks in Adult Survivors of Childhood Brain Tumors. Brain Connect 2021; 11:822-837. [PMID: 33858201 DOI: 10.1089/brain.2020.0800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Background: Assessments of functional connectivity of default mode network (DMN) and positive task-related networks (TRNs) using independent component analysis (ICA) may help describe long-term effects of childhood brain tumors and adjuvant treatments. Methods: Aiming to identify potential neuronal markers that may aid in prognosis and inform interventions to optimize outcomes, this study used ICA to evaluate the presence of functional connectivity networks and their recruitment during a letter n-back task in 23 adult survivors of childhood posterior fossa tumors (9 low grade, 14 high grade) at least 5 years past diagnosis compared with 40 age- and sex-matched healthy peers. Results: DMN components generally demonstrated increasing disengagement as task difficulty increased, and relationships between effective DMN disengagement and improved performance were observed in healthy controls (HCs). Low-grade brain tumor survivors (LGS) demonstrated unique patterns in DMN recruitment that suggested increased involvement of the medial prefrontal cortex in LGS during tasks. TRN components generally demonstrated increasing engagement, which was related to improved task performance in HCs for one executive control network (ECN) component. High-grade brain tumor survivors (HGS) demonstrated distinct challenges recruiting an ECN component at more difficult task levels and showed a relationship between recruitment of another ECN component and task performance, indicating a potential compensatory mechanism for some HGS. Conclusions: Findings suggest the importance of cognitive intervention in both survivor groups and the necessity to track LGS despite their cognitive abilities often resembling those of their healthy peers. Impact statement Distinct functional connectivity patterns were identified between both adult survivor of childhood brain tumor groups and peers during attention and working memory tasks, reflecting different damage and recovery from treatment. Survivors of low-grade tumors demonstrated unique patterns of recruitment of default mode network components in the context of similar cognitive abilities, whereas survivors of high-grade tumors demonstrated poorer cognitive abilities and may be utilizing compensatory executive control network components in the face of challenging tasks. Long-term clinical follow-up and cognitive remediation is warranted for both groups, including low grade cerebellar tumor patients who have traditionally not been monitored as closely.
Collapse
Affiliation(s)
- Michelle E Fox
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Jessica A Turner
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
| | - Bruce Crosson
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA.,Departments of Neurology and of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Atlanta VA Center of Excellence for Visual and Neurocognitive Rehabilitation, Decatur, Georgia, USA
| | - Robin D Morris
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA.,Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
| |
Collapse
|
6
|
Clark SV, Semmel ES, Aleksonis HA, Steinberg SN, King TZ. Cerebellar-Subcortical-Cortical Systems as Modulators of Cognitive Functions. Neuropsychol Rev 2021; 31:422-446. [PMID: 33515170 DOI: 10.1007/s11065-020-09465-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 11/10/2020] [Indexed: 02/07/2023]
Abstract
Over the past few decades, research has established that the cerebellum is involved in executive functions; however, its specific role remains unclear. There are numerous theories of cerebellar function and numerous cognitive processes falling under the umbrella of executive function, making investigations of the cerebellum's role in executive functioning challenging. In this review, we explored the role of the cerebellum in executive functioning through clinical and cognitive neuroscience frameworks. We reviewed the neuroanatomical systems and theoretical models of cerebellar functions and the multifaceted nature of executive functions. Using attention deficit hyperactivity disorder and cerebellar tumor as clinical developmental models of cerebellar dysfunction, and the functional magnetic resonance imaging literature, we reviewed evidence for cerebellar involvement in specific components of executive function in childhood, adolescence, and adulthood. There is evidence for posterior cerebellar contributions to working memory, planning, inhibition, and flexibility, but the heterogeneous literature that largely was not designed to study the cerebellum makes it difficult to determine specific functions of the cerebellum or cerebellar regions. In addition, while it is clear that cerebellar insult in childhood affects executive function performance later in life, more work is needed to elucidate the mechanisms by which executive dysfunction occurs and its developmental course. The limitations of the current literature are discussed and potential directions for future research are provided.
Collapse
Affiliation(s)
- Sarah V Clark
- Department of Psychology, Georgia State University, GA, 30303, Atlanta, USA
| | - Eric S Semmel
- Department of Psychology, Georgia State University, GA, 30303, Atlanta, USA
| | - Holly A Aleksonis
- Department of Psychology, Georgia State University, GA, 30303, Atlanta, USA
| | | | - Tricia Z King
- Department of Psychology, Georgia State University, GA, 30303, Atlanta, USA. .,Neuroscience Institute, Georgia State University, GA, 30303, Atlanta, USA.
| |
Collapse
|
7
|
The Neurological Predictor Scale Predicts Adaptive Functioning via Executive Dysfunction in Young Adult Survivors of Childhood Brain Tumor. J Int Neuropsychol Soc 2021; 27:1-11. [PMID: 32641194 DOI: 10.1017/s1355617720000624] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Survivors of childhood brain tumors experience neurological sequelae that disrupt everyday adaptive functioning (AF) skills. The Neurological Predictor Scale (NPS), a cumulative measure of tumor treatments and sequelae, predicts cognitive outcomes, but findings on its relation to informant-reported executive dysfunction (ED) and AF are mixed. Given known effects of frontal-subcortical system disruptions on AF, this study assessed the NPS' relationship with AF as mediated by frontal systems dysfunction, measured by the Frontal Systems Behavior Scale (FrSBe). METHODS 75 participants (Mage = 23.5, SDage = 4.5) were young adult survivors of childhood brain tumors at least 5 years past diagnosis. FrSBe and Scales of Independent Behavior-Revised (SIB-R), a measure of AF, were administered to informants. Parallel multiple mediator models included Apathy and ED as mediators, and age at diagnosis and time between diagnosis and assessment as covariates. RESULTS More complex treatment and sequelae were correlated with poorer functioning. Mediation models were significant for all subscales: Motor Skills (MS), p = .0001; Social Communication (SC), p = .002; Personal Living (PL), p = .004; Community Living (CL), p = .007. The indirect effect of ED on SC and CL was significant; the indirect effect of Apathy was not significant for any subscales. CONCLUSIONS More complex tumor treatment and sequelae were associated with poorer long-term AF via increased ED. Cognitive rehabilitation programs may focus on the role of executive function and initiation that contribute to AF, particularly SC and CL skills, to help survivors achieve comparable levels of independence in everyday function as their peers.
Collapse
|
8
|
Yuan Q, Ma F, Zhang M, Chen M, Zhang Z, Wu J, Lu C, Guo T. Neural interaction between language control and cognitive control: Evidence from cross-task adaptation. Behav Brain Res 2020; 401:113086. [PMID: 33359369 DOI: 10.1016/j.bbr.2020.113086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/13/2020] [Accepted: 12/16/2020] [Indexed: 01/28/2023]
Abstract
It has been documented that conflict adaptation (conflict resolution in a task enhanced by that in a previous task) exists not only in the same domain but also across different domains with shared cognitive control mechanisms. For the first time, the present study adopted a cross-task adaptive blocked design to examine the relationship between bilingual language control and cognitive control from the perspective of the immediately adjacent, mutual influence on the neural connectivity level. The results showed that the conflict setting induced by previous tasks changed the nodal degrees of the anterior cingulate cortex/presupplementary motor area and the right thalamus, and connectivity strength of shared links between adjacent language and cognitive control tasks. In addition, pre-activation of the cognitive control network affected the transitivity of the successive use of the language control network. These findings not only indicate a cross-task adaptation effect on the neural connectivity level, but also provide evidence for similarities in conflict detection and inhibition control between language-specific control and domain-general cognitive control. In addition, our results also suggest that there is only partial overlap between bilingual language control and domain-general cognitive control.
Collapse
Affiliation(s)
- Qiming Yuan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Fengyang Ma
- School of Education, University of Cincinnati, Cincinnati, USA
| | - Man Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Mo Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zhaoqi Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Junjie Wu
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Chunming Lu
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Taomei Guo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China; IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China.
| |
Collapse
|
9
|
Semmel ES, Quadri TR, King TZ. Oral processing speed as a key mechanism in the relationship between neurological risk and adaptive functioning in survivors of pediatric brain tumors. Pediatr Blood Cancer 2020; 67:e28575. [PMID: 32813316 DOI: 10.1002/pbc.28575] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/11/2022]
Abstract
PURPOSE Brain tumor (BT) survivors are at risk for difficulties with adaptive functioning (AF). Recent work has associated neurological risk with poorer AF outcomes using the Neurological Predictor Scale (NPS), a quantification of neurological risk factors. Survivors also have poorer attention, processing speed, and working memory, which are all important for AF. The current study examined whether these cognitive constructs explain the relationship between the NPS and AF in survivors. METHODS Ninety-five adult BT survivors and 135 healthy controls were recruited from the Atlanta area. The Oral Symbol Digits Modalities test was used to measure processing speed, Digit Span Backward assessed working memory, and Digit Span Forward measured attention. Informants completed the Scales of Independent Behavior (SIB-R) to measure AF. Group differences and correlations were assessed, and the PROCESS macro for SPSS tested indirect effects. RESULTS Survivors were significantly lower on AF and cognitive measures compared with controls. Attention span and processing speed had significant indirect effects in relationship between NPS and AF individually, but processing speed was the only variable with a significant indirect effect when all cognitive variables were included in the model. The NPS and processing speed together account for approximately 39% of variance in AF outcomes. CONCLUSIONS BT survivors in our sample have lower AF than controls, and processing speed appears to be particularly important in explaining the relationship between neurological risk and AF. In the future, the development of interventions aimed at increasing young adult independence should target both cognitive processing speed and AF skills.
Collapse
Affiliation(s)
- Eric S Semmel
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, Georgia
| | - Tobiloba R Quadri
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, Georgia
| | - Tricia Z King
- Department of Psychology and Neuroscience Institute, Georgia State University, Atlanta, Georgia
| |
Collapse
|
10
|
Double Dissociation of Auditory Attention Span and Visual Attention in Long-Term Survivors of Childhood Cerebellar Tumor: A Deterministic Tractography Study of the Cerebellar-Frontal and the Superior Longitudinal Fasciculus Pathways. J Int Neuropsychol Soc 2020; 26:939-953. [PMID: 32342828 DOI: 10.1017/s1355617720000417] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Right cerebellar-left frontal (RC-LF) white matter integrity (WMI) has been associated with working memory. However, prior studies have employed measures of working memory that include processing speed and attention. We examined the relationships between the RC-LF WMI and processing speed, attention, and working memory to clarify the relationship of RC-LF WMI with a specific cognitive function. Right superior longitudinal fasciculus II (SLF II) WMI and visual attention were included as a negative control tract and task to demonstrate a double dissociation. METHODS Adult survivors of childhood brain tumors [n = 29, age: M = 22 years (SD = 5), 45% female] and demographically matched controls were recruited (n = 29). Tests of auditory attention span, working memory, and visual attention served as cognitive measures. Participants completed a 3-T MRI diffusion-weighted imaging scan. Fractional anisotropy (FA) and radial diffusivity (RD) served as WMI measures. Partial correlations between WMI and cognitive scores included controlling for type of treatment. RESULTS A correlational double dissociation was found. RC-LF WMI was associated with auditory attention (FA: r = .42, p = .03; RD: r = -.50, p = .01) and was not associated with visual attention (FA: r = -.11, p = .59; RD: r = -.11, p = .57). SLF II FA WMI was associated with visual attention (FA: r = .44, p = .02; RD: r = -.17, p = .40) and was not associated with auditory attention (FA: r = .24, p = .22; RD: r = -.10, p = .62). CONCLUSIONS The results show that RC-LF WMI is associated with auditory attention span rather than working memory per se and provides evidence for a specificity based on the correlational double dissociation.
Collapse
|
11
|
O’Neil SH, Whitaker AM, Kayser K, Nelson MB, Finlay JL, Dhall G, Sands S. Neuropsychological outcomes on Head Start III: a prospective, multi-institutional clinical trial for young children diagnosed with malignant brain tumors. Neurooncol Pract 2020; 7:329-337. [PMID: 32537181 PMCID: PMC7274184 DOI: 10.1093/nop/npz071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Current pediatric brain tumor treatment focuses on titrating toxicity based on risk factors while simultaneously improving survivorship. The Head Start (HS) protocols I to IV (1991-present) use high-dose chemotherapy (HDCTx) with an aim of reducing or eliminating cranial irradiation in very young children, the most vulnerable to its effects. METHODS We examined estimated Full Scale IQ, overall Adaptive Functioning, Working Memory, Processing Speed, and Verbal and Nonverbal Memory outcome data for 43 HS III patients diagnosed between ages 2 months and 7 years from 15 institutions in the United States and Canada. RESULTS At a mean of 5.12 years postdiagnosis, the HS III patients performed within the average to low-average ranges across these variables; however, individual variability was noted with scores ranging from superior to impaired, and the sample as a whole performed lower than age expectations. Performance did not significantly differ by sex or ethnicity, diagnosis, or for those treated with an intravenous methotrexate dose of 400 mg/kg vs 270 mg/kg. Additionally, performance did not significantly differ by age at diagnosis or length of follow-up. CONCLUSIONS The results, indicating overall average to low-average neurocognitive functioning, are encouraging, though significant individual variability was noted. Those who were younger at diagnosis, received more intensive methotrexate, and were further out from treatment were not at significantly increased risk of cognitive decline within our sample, suggesting a strategy of using HDCTx and autologous hematopoietic progenitor cell rescue to reduce or eliminate irradiation may allow for continued CNS development in young children treated for a brain tumor.
Collapse
Affiliation(s)
- Sharon H O’Neil
- The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA
- Division of Neurology, Children’s Hospital Los Angeles, Los Angeles, CA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ashley M Whitaker
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Kimberly Kayser
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Mary Baron Nelson
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Jonathan L Finlay
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Nationwide Children’s Hospital, Columbus, OH
- Department of Pediatrics, The Ohio State University, Columbus, OH
| | - Girish Dhall
- University of Alabama at Birmingham Division of Hematology, Oncology, and Blood & Marrow Transplantation, Birmingham, AL
| | - Stephen Sands
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering, New York, NY
- Department of Pediatrics, Memorial Sloan Kettering, New York, NY
| |
Collapse
|
12
|
Meoded A, Goldenberg NA, Huisman TAGM. Structural Connectomics: State of the Art and Applications in Pediatric Neurodevelopmental Disorders, Neuro-Oncology, and Arterial Ischemic Stroke. J Pediatr 2020; 221S:S37-S42. [PMID: 32482233 DOI: 10.1016/j.jpeds.2020.01.056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Avner Meoded
- Edward B. Singleton Department of Radiology, Section of Pediatric Neuroradiology, Texas Children's Hospital, Houston, TX.
| | - Neil A Goldenberg
- Department of Pediatrics and Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Stroke Program, Johns Hopkins Institute for Brain Protection Sciences, Johns Hopkins All Children's Hospital, St Petersburg, FL
| | - Thierry A G M Huisman
- Edward B. Singleton Department of Radiology, Section of Pediatric Neuroradiology, Texas Children's Hospital, Houston, TX
| |
Collapse
|
13
|
Abstract
PURPOSE OF REVIEW Adverse late effects of pediatric brain tumors can be numerous and complex and potentially alter the life trajectories of survivors in a multitude of ways. We review these inter-related late effects that compromise neurocognitive function, general health, social and psychological adjustment, and overall adaptive and vocational outcomes, and threaten to undermine the ability of survivors to transition independently into adulthood and effectively manage their care. Intervention/prevention strategies and advances in treatment that may reduce such late effects are discussed. RECENT FINDINGS Studies of neuropsychological late effects have revealed specific deficits in core cognitive functions of attention, working memory and processing speed, with many survivors demonstrating decline in working memory and processing speed over time, irrespective of tumor type or treatment. This in turn affects the ongoing development of higher order neurocognitive skills. Research also highlights the increasing burden of health-related, neuropsychological and psychosocial late effects into adulthood and impact across life outcomes. SUMMARY Pediatric brain tumor survivors require coordinated interdisciplinary care, ongoing evaluation and management of late effects, and timely interventions focused on mitigating the impact of late effects. The transition to adulthood can be especially vulnerable and addressing barriers to care is of paramount importance.
Collapse
Affiliation(s)
- Celiane Rey-Casserly
- Department of Psychiatry, Boston Children's Hospital
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Tanya Diver
- Department of Psychiatry, Boston Children's Hospital
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|