Neural Correlates of Reading in Medulloblastoma Survivor

描述（由申请人提供）：至少60%的髓母细胞瘤儿童接受当代多模式治疗（即，手术切除、放射治疗和高剂量化疗）在初步诊断后将存活5年以上。不幸的是，这些幸存者中的大多数最终都会经历智商下降、学习困难和学业失败。我们研究的长期目标是确定儿童癌症长期幸存者中认知缺陷的神经基质。本申请的重点是阅读能力的缺陷。本研究旨在验证这一假设，即髓母细胞瘤幸存者阅读解码的行为缺陷反映了阅读技能发展过程中治疗诱导的腹侧视觉处理中断。将在纵向研究中使用功能性磁共振成像（fMRI）和扩散张量成像（DTI），以比较患者和年龄相似的对照组的正字法处理神经系统。神经影像学数据（fMRI和DTI）将在一个全面的神经心理测试电池的行为表现进行分析。这项研究将产生重要的见解与髓母细胞瘤治疗相关的认知缺陷的根本原因，确定潜在的目标，药理学和行为干预，以改善认知功能的幸存者谁已经接受治疗，并发现机会，以减少髓母细胞瘤治疗的负面影响对患者的治疗在未来。此外，髓母细胞瘤幸存者将作为与明确的治疗性损伤相关的获得性阅读障碍的模型人群。对患者和健康对照的纵向行为和成像研究可能会产生新的见解腹侧视觉系统在正常和异常阅读能力的发展，否则健康的儿童。

DESCRIPTION (provided by applicant): At least 60% of children treated for medulloblastoma with contemporary multimodality therapy (i.e., surgical resection, radiation therapy, and high-dose chemotherapy) will live more than 5 years after initial diagnosis. Unfortunately, the majority of these survivors ultimately experience IQ loss, learning difficulties, and academic failure. The long-term goal of our research is to identify neural substrates of cognitive deficits among long-term survivors of childhood cancer. The focus of this application is deficits in reading ability. The study is designed to test the hypothesis that behavioral deficits in reading decoding among medulloblastoma survivors reflect therapy-induced disruption of ventral visual processing during the development of reading skills. Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) will be used in a longitudinal study to compare neural systems for orthographic processing in patients and age-similar controls. The neuroimaging data (fMRI and DTI) will be analyzed in relation to behavioral performance on a comprehensive battery of neuropsychological tests. This research will generate important insights into the fundamental causes of cognitive deficits associated with medulloblastoma therapy, identify potential targets for pharmacological and behavioral interventions to improve cognitive function in survivors who have already been treated, and discover opportunities to reduce the negative impact of medulloblastoma therapy on patients treated in the future. Furthermore, the medulloblastoma survivors will serve as a model population with acquired dyslexia related to well-defined therapeutic insult. The longitudinal behavioral and imaging studies in patients and healthy controls may yield new insights into the role of the ventral visual system in development of normal and abnormal reading ability in otherwise healthy children.