Brain biomarkers and neuropsychological outcomes of pediatric posterior fossa brain tumor survivors treated with surgical resection with or without adjuvant chemotherapy.
Brain biomarkers and neuropsychological outcomes of pediatric posterior fossa brain tumor survivors treated with surgical resection with or without adjuvant chemotherapy.
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接受手术切除且伴有或不伴有辅助化疗的儿童后颅窝脑肿瘤幸存者的脑部生物标志物和神经心理学结果
DOI：
10.1002/pbc.28817
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发表时间：
2021-03
影响因子：
3.2
通讯作者：
Lepore N
中科院分区：
文献类型：
--
作者：
Baron Nelson MC;O'Neil SH;Tanedo J;Dhanani S;Malvar J;Nuñez C;Nelson MD Jr;Tamrazi B;Finlay JL;Rajagopalan V;Lepore N
患有脑肿瘤的儿童会出现认知方面的后期影响，这通常与颅脑放疗有关。我们试图确定手术和化疗对未接受颅脑放疗（CRT）的儿童的大脑结构和神经心理结果的不同影响。
28名有后颅窝肿瘤病史的儿童（17名接受手术治疗，11名接受手术和化疗）在治疗后平均4.5年（手术组）到9年（手术 + 化疗组）接受了神经影像学检查和神经心理评估，同时还有18名健康的兄弟姐妹作为对照。心理测量评估了智商、语言、执行功能、处理速度、记忆以及社会情感功能。对弥散张量成像结果和心理测量分数之间的组间差异和相关性进行了研究。
Z分数映射显示，患者组之间在白质束、前额叶皮质灰质、海马体、丘脑、基底神经节和脑桥中的部分各向异性（FA）值降低了≥2个标准差，这表明与化疗相关的微观结构损伤。患者在视觉构造推理和记忆方面的得分低于对照组（p≤0.02）。钩束中较低的FA（R -0.82至 -0.91）以及丘脑中较高的FA（R 0.73至0.91）与较高的智商分数相关，丘脑中较高的FA与空间工作记忆的较高分数相关（R 0.82）。
接受手术和化疗的后颅窝脑肿瘤在存活多年后会影响大脑微观结构和神经心理功能，其中空间处理能力最为脆弱。表明丘脑、海马体、脑桥、前额叶皮质和白质束中细胞变化的生物标志物与较低的心理测量分数相关。
Children with brain tumors experience cognitive late effects, often related to cranial radiation. We sought to determine differential effects of surgery and chemotherapy on brain structure and neuropsychological outcomes in children who did not receive CRT. Twenty-eight children with a history of posterior fossa tumor (17 treated with surgery, 11 treated with surgery and chemotherapy) underwent neuroimaging and neuropsychological assessment a mean of 4.5 (surgery group) to 9 years (surgery + chemotherapy group) post-treatment, along with 18 healthy sibling controls. Psychometric measures assessed IQ, language, executive functions, processing speed, memory, and social-emotional functioning. Group differences and correlations between diffusion tensor imaging findings and psychometric scores were examined. Z-score mapping demonstrated fractional anisotropy (FA) values were ≥ 2 standard deviations lower in white matter tracts, prefrontal cortex gray matter, hippocampus, thalamus, basal ganglia, and pons between patient groups, indicating microstructural damage associated with chemotherapy. Patients scored lower than controls on visuoconstructional reasoning and memory (p ≤0.02). Lower FA in the uncinate fasciculus (R −0.82 to −0.91) and higher FA in the thalamus (R 0.73 to 0.91) associated with higher IQ scores, and higher FA in the thalamus associated with higher scores on spatial working memory (R 0.82). Posterior fossa brain tumor treated with surgery and chemotherapy affects brain microstructure and neuropsychological functioning years into survivorship, with spatial processes the most vulnerable. Biomarkers indicating cellular changes in the thalamus, hippocampus, pons, prefrontal cortex and white matter tracts associate with lower psychometric scores.
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影响因子：
5.3
作者：
Mac Donald, C. L.;Dikranian, K.;Brody, D. L.
通讯作者：
Brody, D. L.
影响因子：
3.9
作者：
Kim, Jae Ho;Brown, Stephen L.;Ryu, Samuel
通讯作者：
Ryu, Samuel
影响因子：
45.3
作者：
Aarsen, Femke K.;Paquier, Philippe F.;Catsman-Berrevoets, Coriene E.
通讯作者：
Catsman-Berrevoets, Coriene E.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
2.4
作者：
Fellgiebel, A;Wille, P;Stoeter, P
通讯作者：
Stoeter, P