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Article: Brain microstructural changes associated with neurocognitive outcome in intracranial germ cell tumor survivors
Title | Brain microstructural changes associated with neurocognitive outcome in intracranial germ cell tumor survivors |
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Authors | |
Keywords | Intracranial germ cell tumor Neurotoxicity Diffusion kurtosis imaging Brain microstructure Cognition Functional outcome |
Issue Date | 2021 |
Publisher | Frontiers Research Foundation. The Journal's web site is located at http://www.frontiersin.org/oncology |
Citation | Frontiers in Oncology, 2021, v. 11, article no. 573798 How to Cite? |
Abstract | Background: Childhood intracranial germ cell tumor (GCT) survivors are prone to radiotherapy-related neurotoxicity, which can lead to neurocognitive dysfunctions. Diffusion kurtosis imaging (DKI) is a diffusion MRI technique that is sensitive to brain microstructural changes. This study aimed to investigate the association between DKI metrics versus cognitive and functional outcomes of childhood intracranial GCT survivors.
Methods: DKI was performed on childhood intracranial GCT survivors (n = 20) who had received cranial radiotherapy, and age and gender-matched healthy control subjects (n = 14). Neurocognitive assessment was performed using the Hong Kong Wechsler Intelligence Scales, and functional assessment was performed using the Lansky/Karnofsky performance scales (KPS). Survivors and healthy controls were compared using mixed effects model. Multiple regression analyses were performed to determine the effects of microstructural brain changes of the whole brain as well as the association between IQ and Karnofsky scores and the thereof.
Results: The mean Intelligence Quotient (IQ) of GCT survivors was 91.7 (95% CI 84.5 – 98.8), which was below the age-specific normative expected mean IQ (P = 0.013). The mean KPS score of GCT survivors was 85.5, which was significantly lower than that of controls (P < 0.001). Cognitive impairments were significantly associated with the presence of microstructural changes in white and grey matter, whereas functional impairments were mostly associated with microstructural changes in white matter. There were significant correlations between IQ versus the mean diffusivity (MD) and mean kurtosis (MK) of specific white matter regions. The IQ scores were negatively correlated with the MD of extensive grey matter regions.
Conclusion: Our study identified vulnerable brain regions whose microstructural changes in white and grey matter were significantly associated with impaired cognitive and physical functioning in survivors of pediatric intracranial GCT. |
Persistent Identifier | http://hdl.handle.net/10722/300661 |
ISSN | 2023 Impact Factor: 3.5 2023 SCImago Journal Rankings: 1.066 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Tso, WWY | - |
dc.contributor.author | Hui, ESK | - |
dc.contributor.author | Lee, TMC | - |
dc.contributor.author | Liu, APY | - |
dc.contributor.author | Ip, P | - |
dc.contributor.author | Vardhanabhuti, V | - |
dc.contributor.author | Cheng, KKF | - |
dc.contributor.author | Fong, DYT | - |
dc.contributor.author | Chang, DHF | - |
dc.contributor.author | Ho, FKW | - |
dc.contributor.author | Yip, KM | - |
dc.contributor.author | Ku, DTL | - |
dc.contributor.author | Cheuk, DKL | - |
dc.contributor.author | Luk, CW | - |
dc.contributor.author | Shing, MK | - |
dc.contributor.author | Leung, LK | - |
dc.contributor.author | Khong, PL | - |
dc.contributor.author | Chan, GCF | - |
dc.date.accessioned | 2021-06-18T14:55:11Z | - |
dc.date.available | 2021-06-18T14:55:11Z | - |
dc.date.issued | 2021 | - |
dc.identifier.citation | Frontiers in Oncology, 2021, v. 11, article no. 573798 | - |
dc.identifier.issn | 2234-943X | - |
dc.identifier.uri | http://hdl.handle.net/10722/300661 | - |
dc.description.abstract | Background: Childhood intracranial germ cell tumor (GCT) survivors are prone to radiotherapy-related neurotoxicity, which can lead to neurocognitive dysfunctions. Diffusion kurtosis imaging (DKI) is a diffusion MRI technique that is sensitive to brain microstructural changes. This study aimed to investigate the association between DKI metrics versus cognitive and functional outcomes of childhood intracranial GCT survivors. Methods: DKI was performed on childhood intracranial GCT survivors (n = 20) who had received cranial radiotherapy, and age and gender-matched healthy control subjects (n = 14). Neurocognitive assessment was performed using the Hong Kong Wechsler Intelligence Scales, and functional assessment was performed using the Lansky/Karnofsky performance scales (KPS). Survivors and healthy controls were compared using mixed effects model. Multiple regression analyses were performed to determine the effects of microstructural brain changes of the whole brain as well as the association between IQ and Karnofsky scores and the thereof. Results: The mean Intelligence Quotient (IQ) of GCT survivors was 91.7 (95% CI 84.5 – 98.8), which was below the age-specific normative expected mean IQ (P = 0.013). The mean KPS score of GCT survivors was 85.5, which was significantly lower than that of controls (P < 0.001). Cognitive impairments were significantly associated with the presence of microstructural changes in white and grey matter, whereas functional impairments were mostly associated with microstructural changes in white matter. There were significant correlations between IQ versus the mean diffusivity (MD) and mean kurtosis (MK) of specific white matter regions. The IQ scores were negatively correlated with the MD of extensive grey matter regions. Conclusion: Our study identified vulnerable brain regions whose microstructural changes in white and grey matter were significantly associated with impaired cognitive and physical functioning in survivors of pediatric intracranial GCT. | - |
dc.language | eng | - |
dc.publisher | Frontiers Research Foundation. The Journal's web site is located at http://www.frontiersin.org/oncology | - |
dc.relation.ispartof | Frontiers in Oncology | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Intracranial germ cell tumor | - |
dc.subject | Neurotoxicity | - |
dc.subject | Diffusion kurtosis imaging | - |
dc.subject | Brain microstructure | - |
dc.subject | Cognition | - |
dc.subject | Functional outcome | - |
dc.title | Brain microstructural changes associated with neurocognitive outcome in intracranial germ cell tumor survivors | - |
dc.type | Article | - |
dc.identifier.email | Tso, WWY: wytso@hku.hk | - |
dc.identifier.email | Lee, TMC: tmclee@hku.hk | - |
dc.identifier.email | Liu, APY: apyliu@hku.hk | - |
dc.identifier.email | Ip, P: patricip@hku.hk | - |
dc.identifier.email | Vardhanabhuti, V: varv@hku.hk | - |
dc.identifier.email | Cheng, KKF: kfckevin@hku.hk | - |
dc.identifier.email | Fong, DYT: dytfong@hku.hk | - |
dc.identifier.email | Chang, DHF: changd@hku.hk | - |
dc.identifier.email | Yip, KM: kmanyip@hku.hk | - |
dc.identifier.email | Leung, LK: oscarlk@hku.hk | - |
dc.identifier.email | Khong, PL: plkhong@hku.hk | - |
dc.identifier.email | Chan, GCF: gcfchan@hku.hk | - |
dc.identifier.authority | Tso, WWY=rp01517 | - |
dc.identifier.authority | Hui, ESK=rp01832 | - |
dc.identifier.authority | Lee, TMC=rp00564 | - |
dc.identifier.authority | Liu, APY=rp01357 | - |
dc.identifier.authority | Ip, P=rp01337 | - |
dc.identifier.authority | Vardhanabhuti, V=rp01900 | - |
dc.identifier.authority | Fong, DYT=rp00253 | - |
dc.identifier.authority | Chang, DHF=rp02272 | - |
dc.identifier.authority | Khong, PL=rp00467 | - |
dc.identifier.authority | Chan, GCF=rp00431 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.3389/fonc.2021.573798 | - |
dc.identifier.pmid | 34164332 | - |
dc.identifier.pmcid | PMC8216078 | - |
dc.identifier.scopus | eid_2-s2.0-85108381927 | - |
dc.identifier.hkuros | 322810 | - |
dc.identifier.volume | 11 | - |
dc.identifier.spage | article no. 573798 | - |
dc.identifier.epage | article no. 573798 | - |
dc.identifier.isi | WOS:000663830400001 | - |
dc.publisher.place | Switzerland | - |