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Morrison MA, Walter S, Mueller S, Felton E, Jakary A, Stoller S, Molinaro AM, Braunstein SE, Hess CP, Lupo JM. Functional network alterations in young brain tumor patients with radiotherapy-induced memory impairments and vascular injury. Front Neurol 2022; 13:921984. [PMID: 36172034 PMCID: PMC9511024 DOI: 10.3389/fneur.2022.921984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/22/2022] [Indexed: 12/05/2022] Open
Abstract
Background Cognitive impairment and cerebral microbleeds (CMBs) are long-term side-effects of cranial radiation therapy (RT). Previously we showed that memory function is disrupted in young patients and that the rate of cognitive decline correlates with CMB development. However, vascular injury alone cannot explain RT-induced cognitive decline. Here we use resting-state functional MRI (rsfMRI) to further investigate the complex mechanisms underlying memory impairment after RT. Methods Nineteen young patients previously treated with or without focal or whole-brain RT for a brain tumor underwent cognitive testing followed by 7T rsfMRI and susceptibility-weighted imaging for CMB detection. Global brain modularity and efficiency, and rsfMRI signal variability within the dorsal attention, salience, and frontoparietal networks were computed. We evaluated whether MR metrics could distinguish age- and sex-matched controls (N = 19) from patients and differentiate patients based on RT exposure and aggressiveness. We also related MR metrics with memory performance, CMB burden, and risk factors for cognitive decline after RT. Results Compared to controls, patients exhibited widespread hyperconnectivity, similar modularity, and significantly increased efficiency (p < 0.001) and network variability (p < 0.001). The most abnormal values were detected in patients treated with high dose whole-brain RT, having supratentorial tumors, and who did not undergo RT but had hydrocephalus. MR metrics and memory performance were correlated (R = 0.34–0.53), though MR metrics were more strongly related to risk factors for cognitive worsening and CMB burden with evidence of functional recovery. Conclusions MR metrics describing brain connectivity and variability represent promising candidate imaging biomarkers for monitoring of long-term cognitive side-effects after RT.
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Affiliation(s)
- Melanie A. Morrison
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- *Correspondence: Melanie A. Morrison
| | - Sadie Walter
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- College of Osteopathic Medicine, Pacific Northwest University of Health Sciences, Yakima, WA, United States
| | - Sabine Mueller
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Erin Felton
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Angela Jakary
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Schuyler Stoller
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Annette M. Molinaro
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Steve E. Braunstein
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA, United States
| | - Christopher P. Hess
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Janine M. Lupo
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
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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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