Cerebellar Atrophy in Adult Survivors of Childhood Cerebellar Tumor
Cerebellar Atrophy in Adult Survivors of Childhood Cerebellar Tumor
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DOI：
10.1017/s1355617716000138
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发表时间：
2016-05-01
影响因子：
2.6
通讯作者：
Crosson, Bruce
中科院分区：
文献类型：
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作者：
Ailion, Alyssa S.;King, Tricia Z.;Crosson, Bruce
目标：小脑 (CB) 以其在支持处理速度 (PS) 和认知效率方面的作用而闻名。患有后颅窝肿瘤的儿科患者的治疗和切除常常会导致 CB 受到损害。有限的研究表明，CB 萎缩可能与童年时期经历的放射治疗有关。该研究的目的是测量小脑萎缩以确定其神经行为相关性。方法：收集 25 名 CB 肿瘤成年幸存者以及年龄和性别匹配的对照组（M 年龄 = 24 岁（SD = 5），52% 女性）的脑磁共振图像。诊断时的平均年龄为 9 岁 (SD = 5)，诊断后的平均时间为 15 年 (SD = 5)。 PS 通过符号数字模态测试来测量。为了量化萎缩，根据先前的文献开发了一个客观公式，其中萎缩=[（CB白色+CB灰色体积）/颅内穹窿（ICV）]（对照）-[（CB白色+CB灰色+病变大小体积）/ICV]（幸存者）。结果：回归分析发现，交互作用项（诊断时年龄*辐射）可预测 CB 萎缩；回归方程包括神经预测量表、病变大小、萎缩和交互项，占口头 PS 方差的 33% 和书面 PS 方差的 48%。这两种相互作用表明，CB 病变尺寸较小但 CB 萎缩程度较高的个体 PS 较慢，而 CB 病变尺寸较大且 CB 萎缩程度较小的个体受影响较小。结论：当前研究的结果表明，诊断和放疗时的年轻年龄与 CB 萎缩有关，CB 萎缩与病变大小相互作用，从而影响书面和口头 PS。
Objectives: The cerebellum (CB) is known for its role in supporting processing speed (PS) and cognitive efficiencies. The CB often sustains damage from treatment and resection in pediatric patients with posterior fossa tumors. Limited research suggests that CB atrophy may be associated with the radiation treatment experienced during childhood. The purpose of the study was to measure cerebellar atrophy to determine its neurobehavioral correlates. Methods: Brain magnetic resonance images were collected from 25 adult survivors of CB tumors and age- and gender-matched controls (M-age = 24 years (SD = 5), 52% female). Average age at diagnosis was 9 years (SD = 5) and average time since diagnosis was 15 years (SD = 5). PS was measured by the Symbol Digit Modality Test. To quantify atrophy, an objective formula was developed based on prior literature, in which Atrophy = [(CB White + CB Gray Volume)/Intracranial Vault (ICV)](controls) - [(CB White + CB Gray + Lesion Size Volume)/ICV](survivors). Results: Regression analyses found that the interaction term (age at diagnosis*radiation) predicts CB atrophy; regression equations included the Neurological Predictor Scale, lesion size, atrophy, and the interaction term and accounted for 33% of the variance in oral PS and 48% of the variance in written PS. Both interactions suggest that individuals with smaller CB lesion size but a greater degree of CB atrophy had slower PS, whereas individuals with a larger CB lesion size and less CB atrophy were less affected. Conclusion: The results of the current study suggest that young age at diagnosis and radiation is associated with CB atrophy, which interacts with lesion size to impact both written and oral PS.