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.

中文翻译：

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白质高信号量与儿童小脑肿瘤长期幸存者的处理速度有关

目的

在多个临床人群中，较高的白质高信号 (WMH) 负担始终与认知能力下降有关，尤其是处理速度下降。对儿童癌症幸存者的研究尚未使用 WMH 量化方法来更好地了解 WMH 负担的影响及其与核心认知技能的关系。本研究旨在量化儿童小脑肿瘤长期幸存者样本中的 WMH 体积，并调查口腔处理速度与表现的关系。为了进一步探索大脑-行为关系，采用多元稀疏典型相关性来识别预测处理速度性能的 WMH 区域。

方法

35 名幸存者和 56 名健康对照者接受了神经影像学检查并完成了口语处理速度的测量。幸存者组根据治疗（即放化疗（n = 20）与仅手术（n = 15））进一步划分，以更好地了解治疗的影响。

结果

幸存者，尤其是接受化放疗的幸存者，显示出更高的总 WMH 体积和更慢的处理速度。较高的 WMH 总体积与较差的处理速度显着相关（r = - 0.492，p = 0.003）。多变量大脑-行为关系显示，脑室周围 WMH 与较慢的处理速度性能显着相关（p < 0.05）。

结论

结果表明，与健康同龄人相比，接受和不接受放化疗的长期幸存者发生更高 WMH 体积的风险增加。此外，使用自动神经影像管道，处理速度被强有力地证明与脑室周围 WMH 相关。这种监测 WMH 负担的方法有可能通过癌症幸存者的常规临床神经影像学有效实施。