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Cortical thinning and altered functional brain coherence in survivors of childhood sarcoma
Brain Imaging and Behavior ( IF 3.2 ) Pub Date : 2020-04-25 , DOI: 10.1007/s11682-020-00276-9
Charlotte Sleurs 1 , Jeroen Blommaert 1 , Dafnis Batalle 2, 3 , Marjolein Verly 4 , Stefan Sunaert 5, 6 , Ron Peeters 5 , Jurgen Lemiere 7 , Anne Uyttebroeck 1, 7 , Sabine Deprez 6
Affiliation  

High-dose chemotherapy is increasingly evidenced to be neurotoxic and result in long-term neurocognitive sequelae. However, research investigating grey matter alterations in childhood cancer patients remains limited. As childhood sarcoma patients receive high-dose chemotherapy, we aimed to investigate cortical brain alterations in adult survivors. We analyzed high-resolution structural (T1-weighted) MRI and resting-state functional MRI (rsfMRI), to derive structural and functional cortical information in survivors of childhood sarcoma, treated with high-dose intravenous chemotherapy (n = 33). These scans were compared to age- and gender- matched controls (n = 34). Cortical volume and thickness were investigated using voxel-based morphometry and vertex-wise surface-based morphometry. Brain regions showing significant group differences in volume or thickness were implemented as seeds of interest to estimate their resting state co-activity with other areas (i.e. functional coherence). We explored whether structural measures were associated with potential risk factors, such as age at diagnosis, and cumulative doses of chemotherapeutic agents (methotrexate, ifosfamide). Finally, we investigated the link between functional regional strength, neurocognitive assessments and daily life complaints. In patients relative to controls we observed lower grey matter volumes in cerebellar and frontal areas, as well as frontal cortical thinning. Cerebellar volume and orbitofrontal thickness appeared dose- and age-related, respectively. Cortical thickness of the parahippocampal area appeared lower, only if the group comparison was not adjusted for depression. This region specifically showed lower functional coherence, which was associated with lower processing speed. This study suggests cortical thinning as well as decreased functional coherence in survivors of childhood sarcoma, which could be important for both long-term attentional functioning and emotional distress in daily life. Frontal areas might be specifically vulnerable during adolescence.



中文翻译:

儿童肉瘤幸存者的皮质变薄和功能性脑相干性改变

大剂量化学疗法被越来越多地证明具有神经毒性,并导致长期的神经认知后遗症。然而,研究儿童癌症患者灰质改变的研究仍然有限。随着儿童肉瘤患者接受大剂量化疗,我们旨在研究成年幸存者的皮质大脑改变。我们分析了高分辨率的(T1加权)MRI和静息状态功能性MRI(rsfMRI),以得出儿童肉瘤幸存者的结构和功能性皮层信息,并用大剂量静脉化疗治疗(n  = 33)。这些扫描进行比较,以年龄和性别匹配的对照(Ñ = 34)。使用基于体素的形态学和基于顶点表面的形态学研究皮质的体积和厚度。表现出明显不同的体积或厚度的群体差异的大脑区域被用作感兴趣的种子,以估计它们与其他区域的静息状态共同活动(即功能连贯性))。我们探讨了结构性措施是否与潜在的危险因素相关,例如诊断时的年龄和化学治疗剂(甲氨蝶呤,异环磷酰胺)的累积剂量。最后,我们调查了功能区域强度,神经认知评估和日常生活投诉之间的联系。在相对于对照组的患者中,我们观察到小脑和额叶区域的灰质体积较低,额叶皮质变薄。小脑体积和眶额厚度分别与剂量和年龄有关。仅在不对抑郁症进行分组比较的情况下,海马旁区域的皮质厚度才显得较低。该区域特别显示出较低的功能相干性,这与较低的处理速度有关。这项研究表明,儿童肉瘤幸存者的皮层变薄以及功能连贯性降低,这对于长期的注意功能和日常生活中的情绪困扰都可能是重要的。额叶在青春期可能特别脆弱。

更新日期:2020-04-25
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