Radiation-induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction
Radiation-induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction
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症状前阶段辐射引起的大脑结构和功能异常及结果预测。
DOI：
10.1002/hbm.23852
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发表时间：
2018-01-01
影响因子：
4.8
通讯作者：
Shen, Dinggang
中科院分区：
文献类型：
--
作者：
Ding, Zhongxiang;Zhang, Han;Shen, Dinggang
放射治疗是治疗脑癌的主要方法，多年后可能导致严重的脑损伤。我们使用了一个罕见的和独特的鼻咽癌患者的队列与正常外观的大脑，以研究可能的早期辐射损伤，在其症状前阶段之前，严重的，不可逆的坏死发生。其目的是检测对早期放射损伤敏感的任何结构或功能成像生物标志物，并了解放射损伤的恢复和进展，从而为早期临床干预提供结果预测。我们发现局部大脑活动急剧增加，随后颞叶的这种活动大量减少，分布式，大规模，高水平认知功能相关的大脑网络的功能连接显著丧失。有趣的是，这些放射敏感的功能改变被发现是完全或部分恢复。相比之下，一年后，相关远端白色物质结构的完整性的渐进性晚期破坏开始显着。重要的是，早期增加的局部脑功能活动是严重的颞叶坏死的预测。基于这些发现，我们提出了一个动态的，多因素模型的辐射损伤和另一种预防模型，及时的临床干预。《脑地图》39：407-427，2018年。(c)2017年Wiley Periodicals，Inc.
Radiation therapy, a major method of treatment for brain cancer, may cause severe brain injuries after many years. We used a rare and unique cohort of nasopharyngeal carcinoma patients with normal-appearing brains to study possible early irradiation injury in its presymptomatic phase before severe, irreversible necrosis happens. The aim is to detect any structural or functional imaging biomarker that is sensitive to early irradiation injury, and to understand the recovery and progression of irradiation injury that can shed light on outcome prediction for early clinical intervention. We found an acute increase in local brain activity that is followed by extensive reductions in such activity in the temporal lobe and significant loss of functional connectivity in a distributed, large-scale, high-level cognitive function-related brain network. Intriguingly, these radiosensitive functional alterations were found to be fully or partially recoverable. In contrast, progressive late disruptions to the integrity of the related far-end white matter structure began to be significant after one year. Importantly, early increased local brain functional activity was predictive of severe later temporal lobe necrosis. Based on these findings, we proposed a dynamic, multifactorial model for radiation injury and another preventive model for timely clinical intervention. Hum Brain Mapp 39:407-427, 2018. (c) 2017 Wiley Periodicals, Inc.