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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.
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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.
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2
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Peterson RK, King TZ. A systematic review of pediatric neuropsychological outcomes with proton versus photon radiation therapy: A call for equity in access to treatment. J Int Neuropsychol Soc 2023; 29:798-811. [PMID: 36323679 DOI: 10.1017/s1355617722000819] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There is increasing interest in the utilization of proton beam radiation therapy (PRT) to treat pediatric brain tumors based upon presumed advantages over traditional photon radiation therapy (XRT). PRT provides more conformal radiation to the tumor with reduced dose to healthy brain parenchyma. Less radiation exposure to brain tissue beyond the tumor is thought to reduce neuropsychological sequelae. This systematic review aimed to provide an overview of published studies comparing neuropsychological outcomes between PRT and XRT. METHOD PubMed, PsychINFO, Embase, Web of Science, Scopus, and Cochrane were systematically searched for peer-reviewed published studies that compared neuropsychological outcomes between PRT and XRT in pediatric brain tumor patients. RESULTS Eight studies were included. Six of the studies utilized retrospective neuropsychological data; the majority were longitudinal studies (n = 5). XRT was found to result in lower neuropsychological functioning across time. PRT was associated with generally stable neuropsychological functioning across time, with the exception of working memory and processing speed, which showed variable outcomes across studies. However, studies inconsistently included or considered medical and sociodemographic differences between treatment groups, which may have impacted neuropsychological outcomes. CONCLUSIONS Despite methodological limitations, including limited baseline neuropsychological evaluations, temporal variability between radiation treatment and first evaluation or initial and follow-up evaluations, and heterogenous samples, there is emerging evidence of sociodemographic inequities in access to PRT. With more institutions dedicating funding towards PRT, there may be the opportunity to objectively evaluate the neuropsychological benefits of patients matched on medical and sociodemographic variables.
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Affiliation(s)
- Rachel K Peterson
- Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, USA
- Neuroscience Institute, Georgia State University, Atlanta, USA
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3
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Kautiainen R, Aleksonis H, King TZ. A Systematic Review of Host Genomic Variation and Neuropsychological Outcomes for Pediatric Cancer Survivors. Neuropsychol Rev 2023; 33:278-306. [PMID: 35305234 DOI: 10.1007/s11065-022-09539-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 01/25/2022] [Indexed: 10/18/2022]
Abstract
Pediatric survivors of brain tumors and acute lymphoblastic leukemia (ALL) are at risk for long-term deficits in their neuropsychological functioning. Researchers have begun examining associations between germline single nucleotide polymorphisms (SNPs), which interact with cancer treatment, and neuropsychological outcomes. This review synthesizes the impact of treatment-related toxicity from germline SNPs by neuropsychological domain (i.e., working memory, processing speed, psychological functioning) in pediatric survivors. By focusing on specific neuropsychological domains, this review will examine outcome measurement and critique methodology. Fourteen studies were identified and included in this review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All studies were published in peer-reviewed journals in English by November 24th, 2021. Reviewed studies were not of sufficient quality for a meta-analysis due to varying measurement strategies, gaps in reported descriptive variables, and low power. All neuropsychological domains evaluated in this review had associations with SNPs, except fine motor and visual integration abilities. Only five SNPs had consistent neuropsychological findings in more than one study or cohort. Future research and replication studies should use validated measures of discrete skills that are central to empirically validated models of survivors' long-term outcomes (i.e., attention, working memory, processing speed). Researchers should examine SNPs across pathophysiological pathways to investigate additive genetic risk in pediatric cancer survivors. Two SNPs were identified that confer resiliency in neuropsychological functioning, and future work should investigate resiliency genotypes and their underlying biological mechanisms.
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Affiliation(s)
- Rella Kautiainen
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Holly Aleksonis
- Department of Psychology, Georgia State University, Atlanta, Georgia
| | - Tricia Z King
- Department of Psychology and the Neuroscience Institute, Georgia State University, Atlanta, Georgia.
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4
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Fox ME, King TZ. Considerations for Reliable Digit Span as a performance validity test for long-term survivors of childhood brain tumors. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:469-477. [PMID: 32503366 DOI: 10.1080/23279095.2020.1771714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The Reliable Digit Span (RDS) is a performance validity test (PVT) used widely within non-clinical samples, but its utility is in question in clinical groups with cognitive impairment. To investigate, RDS scores were calculated and correlated with the Neurological Predictor Scale, an informant-reported Activities of Daily Living score, and a proxy measure of intelligence (Vocabulary) for 83 adult survivors of childhood brain tumors and 105 healthy controls. Analyses were covaried for age at examination. Participants were divided into passing and failing groups at each RDS cutoff, and ANCOVAs for each of the three variables of interest covaried for age at the examination were run. RDS was correlated with all three variables of interest in survivors but only Vocabulary in controls. At the ≤7 cutoff, passing and failing survivors demonstrated significant differences across all variables of interest, while passing and failing controls differed only on Vocabulary. Differences were also found between passing and failing survivors at lower cutoffs. RDS is related to and likely impacted by various neurological and cognitive challenges faced by brain tumor survivors. Using the standard RDS cutoff of ≤7 may result in inaccurate interpretation of valid performance in this population; therefore, the use of other PVTs is recommended.
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Affiliation(s)
| | - Tricia Z King
- Department of Psychology and the Neuroscience Institute, Georgia State University, Atlanta, GA, USA
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5
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Yang A, Rolls ET, Dong G, Du J, Li Y, Feng J, Cheng W, Zhao XM. Longer screen time utilization is associated with the polygenic risk for Attention-deficit/hyperactivity disorder with mediation by brain white matter microstructure. EBioMedicine 2022; 80:104039. [PMID: 35509143 PMCID: PMC9079003 DOI: 10.1016/j.ebiom.2022.104039] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/06/2022] [Accepted: 04/14/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) has been reported to be associated with longer screen time utilization (STU) at the behavioral level. However, whether there are shared neural links between ADHD symptoms and prolonged STU is not clear and has not been explored in a single large-scale dataset. METHODS Leveraging the genetics, neuroimaging and behavioral data of 11,000+ children aged 9-11 from the Adolescent Brain Cognitive Development cohort, this study investigates the associations between the polygenic risk and trait for ADHD, STU, and white matter microstructure through cross-sectionally and longitudinal analyses. FINDINGS Children with higher polygenic risk scores for ADHD tend to have longer STU and more severe ADHD symptoms. Fractional anisotropy (FA) values in several white matter tracts are negatively correlated with both the ADHD polygenic risk score and STU, including the inferior frontal-striatal tract, inferior frontal-occipital fasciculus, superior longitudinal fasciculus and corpus callosum. Most of these tracts are linked to visual-related functions. Longitudinal analyses indicate a directional effect of white matter microstructure on the ADHD scale, and a bi-directional effect between the ADHD scale and STU. Furthermore, reduction of FA in several white matter tracts mediates the association between the ADHD polygenic risk score and STU. INTERPRETATION These findings shed new light on the shared neural overlaps between ADHD symptoms and prolonged STU, and provide evidence that the polygenic risk for ADHD is related, via white matter microstructure and the ADHD trait, to STU. FUNDING This study was mainly supported by NSFC and National Key R&D Program of China.
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Affiliation(s)
- Anyi Yang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China
| | - Edmund T Rolls
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Shanghai, China; Department of Computer Science, University of Warwick, Coventry, UK; Oxford Centre for Computational Neuroscience, Oxford, UK
| | - Guiying Dong
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Shanghai, China
| | - Jingnan Du
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Shanghai, China
| | - Yuzhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Shanghai, China
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Shanghai, China; Department of Computer Science, University of Warwick, Coventry, UK; Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Zhangjiang Fudan International Innovation Center, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Shanghai, China; Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, China.
| | - Xing-Ming Zhao
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai 200433, China; Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education, Shanghai, China; MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China; Research Institute of Intelligent Complex Systems, Fudan University, Shanghai, China.
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6
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Clark SV, Satterthwaite TD, King TZ, Morris RD, Zendehrouh E, Turner JA. Cerebellum-cingulo-opercular network connectivity strengthens in adolescence and supports attention efficiency only in childhood. Dev Cogn Neurosci 2022; 56:101129. [PMID: 35820341 PMCID: PMC9284395 DOI: 10.1016/j.dcn.2022.101129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/10/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sarah V Clark
- VA Palo Alto Health Care System, Psychology Service, United States.
| | - Theodore D Satterthwaite
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania Perelman School of Medicine, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, United States
| | - Tricia Z King
- Georgia State University, Department of Psychology, United States; Georgia State University, Neuroscience Institute, United States
| | - Robin D Morris
- Georgia State University, Department of Psychology, United States
| | - Elaheh Zendehrouh
- Georgia State University, Department of Computer Science, United States
| | - Jessica A Turner
- Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, United States
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7
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Starowicz-Filip A, Prochwicz K, Kłosowska J, Chrobak AA, Myszka A, Bętkowska-Korpała B, Kwinta B. Cerebellar Functional Lateralization From the Perspective of Clinical Neuropsychology. Front Psychol 2021; 12:775308. [PMID: 34955995 PMCID: PMC8703197 DOI: 10.3389/fpsyg.2021.775308] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/10/2021] [Indexed: 11/29/2022] Open
Abstract
Objective: The cerebellar functional laterality, with its right hemisphere predominantly involved in verbal performance and the left one engaged in visuospatial processes, has strong empirical support. However, the clinical observation and single research results show that the damage to the right cerebellar hemisphere may cause extralinguistic and more global cognitive decline. The aim of our research was to assess the pattern of cognitive functioning, depending on the cerebellar lesion side, with particular emphasis on the damage to the right cerebellar hemisphere. Method: The study sample consisted of 31 patients with focal cerebellar lesions and 31 controls, free of organic brain damage. The Addenbrooke’s Cognitive Examination ACE III and the Trail Making Test TMT were used to assess patients’ cognitive functioning. Results: Left-sided cerebellar lesion patients scored lower than controls in attention and visuospatial domain, but not in language, fluency, and memory functions. Participants with right-sided cerebellar lesion demonstrated a general deficit of cognitive functioning, with impairments not only in language and verbal fluency subscales but also in all ACE III domains, including memory, attention, and visuospatial functions. The TMT results proved that cerebellar damage is associated with executive function impairment, regardless of the lesion side. Conclusion: The cognitive profiles of patients with cerebellum lesions differ with regard to the lesion side. Left-sided cerebellar lesions are associated with selective visuospatial and attention impairments, whereas the right-sided ones may result in a more global cognitive decline, which is likely secondary to language deficiencies, associated with this lateral cerebellar injury.
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Affiliation(s)
- Anna Starowicz-Filip
- Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland.,Department of Neurosurgery, University Hospital in Krakow, Kraków, Poland
| | | | - Joanna Kłosowska
- Institute of Psychology, Jagiellonian University, Kraków, Poland
| | | | - Aneta Myszka
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
| | | | - Borys Kwinta
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
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8
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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.
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9
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Aleksonis HA, Krishnamurthy LC, King TZ. White matter hyperintensity volumes are related to processing speed in long-term survivors of childhood cerebellar tumors. J Neurooncol 2021; 154:63-72. [PMID: 34231115 DOI: 10.1007/s11060-021-03799-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/25/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Across several clinical populations, higher white matter hyperintensity (WMH) burden is consistently associated with decreases in cognitive performance, especially processing speed. Research of childhood cancer survivors has not utilized WMH quantification methodology to better understand the impact of WMH burden and its relationship with core cognitive skills. The present study aimed to quantify WMH volumes in a sample of long-term survivors of childhood cerebellar tumor and investigate the relationships with performance on a measure of oral processing speed. To further explore brain-behavior relationships, multivariate sparse canonical correlations was employed to identify WMH areas that predict processing speed performance. METHODS Thirty-five survivors and 56 healthy controls underwent neuroimaging and completed a measure of oral processing speed. The survivor group was further divided based on treatment (i.e., chemoradiation therapy (n = 20) vs. surgery only (n = 15)) to better understand the impact of treatment. RESULTS Survivors, and especially those treated with chemoradiation therapy, showed higher total WMH volumes and slower processing speed. Higher total WMH volumes were significantly associated with poorer processing speed (r = - 0.492, p = 0.003). Multivariate brain-behavior relationships revealed that periventricular WMHs were significantly associated with slower processing speed performance (p < 0.05). CONCLUSION Results exemplify that long-term survivors treated with and without chemoradiation therapy are at increased risk of developing higher WMH volumes compared to healthy peers. In addition, processing speed was robustly shown to be related to periventricular WMHs using an automated neuroimaging pipeline. This methodology to monitor WMH burden has the potential to be implemented efficiently with routine clinical neuroimaging of cancer survivors.
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Affiliation(s)
- Holly A Aleksonis
- Department of Psychology and the Neuroscience Institute, Georgia State University, Urban Life Building, 11th Floor, 140 Decatur St, Atlanta, GA, 30303, USA
| | - Lisa C Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta Veteran's Affairs Medical Center, Decatur, GA, USA
- Department of Physics and Astronomy, Georgia State University, Atlanta, GA, USA
| | - Tricia Z King
- Department of Psychology and the Neuroscience Institute, Georgia State University, Urban Life Building, 11th Floor, 140 Decatur St, Atlanta, GA, 30303, USA.
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10
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Starowicz-Filip A, Prochwicz K, Kłosowska J, Chrobak AA, Krzyżewski R, Myszka A, Rajtar-Zembaty A, Bętkowska-Korpała B, Kwinta B. Is Addenbrooke's Cognitive Examination III Sensitive Enough to Detect Cognitive Dysfunctions in Patients with Focal Cerebellar Lesions? Arch Clin Neuropsychol 2021; 37:423-436. [PMID: 34128041 DOI: 10.1093/arclin/acab045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The main aim of the study was to evaluate whether the available brief test of mental functions Addenbrooke's cognitive examination III (ACE III) detects cognitive impairment in patients with cerebellar damage. The second goal was to show the ACE III cognitive impairment profile of patients with focal cerebellar lesions. METHOD The study sample consisted of 31 patients with focal cerebellar lesions, 78 patients with supratentorial brain damage, and 31 subjects after spine surgery or with spine degeneration considered as control group, free of organic brain damage. The ACE III was used. RESULTS Patients with cerebellar damage obtained significantly lower results in the ACE III total score and in several subscales: attention, fluency, language, and visuospatial domains than healthy controls without brain damage. With the cut-off level of 89 points, the ACE III was characterized by the sensitivity of 71%, specificity of 72%, and accuracy of 72%. The cerebellar cognitive impairment profile was found to be "frontal-like" and similar to that observed in patients with anterior supratentorial brain damage, with decreased ability to retrieve previously learned material and its preserved recognition, impaired word fluency, and executive dysfunction. The results are consistent with cerebellar cognitive affective syndrome. CONCLUSIONS The ACE III can be used as a sensitive screening tool to detect cognitive impairments in patients with cerebellar damage.
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Affiliation(s)
- Anna Starowicz-Filip
- Chair of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland.,Department of Neurosurgery, University Hospital, Kraków, Poland
| | | | | | | | - Roger Krzyżewski
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
| | - Aneta Myszka
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Rajtar-Zembaty
- Chair of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Bętkowska-Korpała
- Chair of Psychiatry, Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland
| | - Borys Kwinta
- Department of Neurosurgery, Jagiellonian University Medical College, Kraków, Poland
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11
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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.
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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
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12
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Narayan A, Rowe MA, Palacios EM, Wren-Jarvis J, Bourla I, Gerdes M, Brandes-Aitken A, Desai SS, Marco EJ, Mukherjee P. Altered Cerebellar White Matter in Sensory Processing Dysfunction Is Associated With Impaired Multisensory Integration and Attention. Front Psychol 2021; 11:618436. [PMID: 33613368 PMCID: PMC7888341 DOI: 10.3389/fpsyg.2020.618436] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/28/2020] [Indexed: 01/04/2023] Open
Abstract
Sensory processing dysfunction (SPD) is characterized by a behaviorally observed difference in the response to sensory information from the environment. While the cerebellum is involved in normal sensory processing, it has not yet been examined in SPD. Diffusion tensor imaging scans of children with SPD (n = 42) and typically developing controls (TDC; n = 39) were compared for fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) across the following cerebellar tracts: the middle cerebellar peduncles (MCP), superior cerebellar peduncles (SCP), and cerebral peduncles (CP). Compared to TDC, children with SPD show reduced microstructural integrity of the SCP and MCP, characterized by reduced FA and increased MD and RD, which correlates with abnormal auditory behavior, multisensory integration, and attention, but not tactile behavior or direct measures of auditory discrimination. In contradistinction, decreased CP microstructural integrity in SPD correlates with abnormal tactile and auditory behavior and direct measures of auditory discrimination, but not multisensory integration or attention. Hence, altered cerebellar white matter organization is associated with complex sensory behavior and attention in SPD, which prompts further consideration of diagnostic measures and treatments to better serve affected individuals.
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Affiliation(s)
- Anisha Narayan
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.,Department of Medicine, Tulane University School of Medicine, New Orleans, LA, United States
| | - Mikaela A Rowe
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.,Cortica Healthcare, San Rafael, CA, United States
| | - Eva M Palacios
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Jamie Wren-Jarvis
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Ioanna Bourla
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Molly Gerdes
- Cortica Healthcare, San Rafael, CA, United States
| | - Annie Brandes-Aitken
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Shivani S Desai
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Elysa J Marco
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.,Cortica Healthcare, San Rafael, CA, United States
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.,Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA, United States
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13
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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.
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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.
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14
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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.
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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
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