Functional MRI in medulloblastoma survivors supports prophylactic reading intervention during tumor treatment.
Functional MRI in medulloblastoma survivors supports prophylactic reading intervention during tumor treatment.
复制标题
DOI：
10.1007/s11682-015-9390-8
复制
发表时间：
2016-03
影响因子：
3.2
通讯作者：
Ogg RJ
中科院分区：
文献类型：
--
作者：
Zou P;Conklin HM;Scoggins MA;Li Y;Li X;Jones MM;Palmer SL;Gajjar A;Ogg RJ
在接受脑瘤治疗的儿童中，阅读技能的发展很容易受到干扰。需要采取补救和预防性的干预措施，以减轻幸存者面临的阅读和其他学习困难。一项功能磁共振成像(FMRI)研究被用来调查在接受髓母细胞瘤治疗的儿童中，预防性阅读干预在放射治疗期间的长期效果。FMRI研究包括19名阅读干预组(年龄11.7±0.6岁)和21名标准护理组(12.1±0.6岁)髓母细胞瘤幸存者，以及21名典型发育儿童(年龄12.3±0.6岁)。肿瘤治疗结束后生存期为2.5[1.2，5.4]年，阅读干预后生存期为2.9[1.6，5.9]年。采用5项fMRI任务(快速自动命名、使用面孔和字母的连续操作测试、字母对的拼写和语音加工、内隐单词阅读和故事阅读)来探索与阅读相关的神经激活。使用Woodcock-Johnson阅读流利性、单词攻击和声音意识分测验来评估阅读能力。在功能磁共振成像时，阅读干预组的声音意识得分显著高于护理标准组(p=0.046)。在fMRI任务中，大脑激活在左侧额叶下部、颞部、枕颞部腹侧和皮质下区域被检测到，并且在不同组之间存在差异(p<；0.05，fwe)。在阅读干预组中，不同脑区和不同任务的群体激活差异模式是一种正常趋势。标准化阅读分数和大脑激活模式提供了预防性阅读干预对治疗髓母细胞瘤儿童的长期效果的证据。
Development of reading skills is vulnerable to disruption in children treated for brain tumors. Interventions, remedial and prophylactic, are needed to mitigate reading and other learning difficulties faced by survivors. A functional magnetic resonance imaging (fMRI) study was conducted to investigate long-term effects of a prophylactic reading intervention administered during radiation therapy in children treated for medulloblastoma. The fMRI study included 19 reading-intervention (age 11.7±0.6 years) and 21 standard-of-care (age 12.1±0.6 years) medulloblastoma survivors, and 21 typically developing children (age 12.3±0.6 years). The survivors were 2.5 [1.2, 5.4] years after completion of tumor therapies and reading-intervention survivors were 2.9 [1.6, 5.9] years after intervention. Five fMRI tasks (Rapid Automatized Naming, Continuous Performance Test using faces and letters, orthographic and phonological processing of letter pairs, implicit word reading, and story reading) were used to probe reading-related neural activation. Woodcock-Johnson Reading Fluency, Word Attack, and Sound Awareness subtests were used to evaluate reading abilities. At the time of fMRI, Sound Awareness scores were significantly higher in the reading-intervention group than in the standard-of-care group (p = 0.046). Brain activation during the fMRI tasks was detected in left inferior frontal, temporal, ventral occipitotemporal, and subcortical regions, and differed among the groups (p<0.05, FWE). The pattern of group activation differences, across brain areas and tasks, was a normative trend in the reading-intervention group. Standardized reading scores and patterns of brain activation provide evidence of long-term effects of prophylactic reading intervention in children treated for medulloblastoma.