White Matter Anisotropy in Post-Treatment Childhood Cancer Survivors: Preliminary Evidence of Association With Neurocognitive Function

Khong, Pek‐Lan; Leung, LP; Fung, A.; Fong, Daniel Yee Tak; Qiu, Deqiang; Kwong, Dora Lai-Wan; Ooi, G. C.; McAlanon, Grainne; Cao, Guang; Chan, Godfrey Chi-Fung

doi:10.1200/jco.2005.02.4505

Cited by 177 publications

(153 citation statements)

References 30 publications

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“…With the exception of one patient, low IQ was associated with low FA. Although this group of researchers used a different statistical approach to examining the relationship between FA and intellectual outcome, the results nevertheless replicate those of Khong et al (2006). The authors offer valuable discussion with regard to the possible meaning(s) behind the decreased FA values following radiation treatment among these patients and caution that mechanisms other than demyelination should also be considered.…”

Section: Impact On the Brainmentioning

confidence: 51%

“…DTI studies are now emerging within the pediatric brain tumor literature as well (Khong et al 2003;Khong et al 2005;Khong et al 2006Khong et al , 2007Mabbott et al 2006;Qui et al 2007). The first pilot study utilizing DTI evaluated 9 medulloblastoma survivors (Khong et al 2003).…”

Section: Impact On the Brainmentioning

confidence: 99%

“…FA may be a critical biomarker of treatment-induced white matter damage, allowing early detection and identification of those at risk for neurocognitive deficits, and evidence-based initiation of appropriate intervention. It may also be a useful application in testing the effectiveness of potential neuroprotective drugs or treatment alterations (Khong et al 2006).…”

Section: Impact On the Brainmentioning

confidence: 99%

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Neurodevelopmental impact on children treated for medulloblastoma: A review and proposed conceptual model

Palmer¹

2008

Dev Disabil Res Revs

116

131

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The population of survivors following diagnosis and treatment for medulloblastoma is thankfully on the rise. An increased focus on the quality of that survivorship has expanded the concept of cure to include efforts aimed at improving long-term cognitive outcome. It is well established in the literature that decline in overall intellect and academic performance is experienced by a majority of those undergoing treatment for pediatric medulloblastoma. This decline is believed to be secondary to decline in core cognitive abilities, which in turn are related to underlying damage to neuroanatomical substrates. A review of research on neurodevelopmental impacts following diagnosis and treatment for pediatric medulloblastoma is presented. Particular consideration is given to studies recently published that also reflect critical collaboration among those within the fields of neuropsychology and neuro-imaging. Results from the review are combined within a conceptual model upon which to guide future research and clinical efforts. Keywords medulloblastoma; cognitive deficits; brain tumor; model; processing speed; attention; working memory Callouts 1. Based on the knowledge derived from studies of long term outcomes, it is important to consider medulloblastoma, as well as other pediatric cancers, as a condition resulting in life long morbidities related to the treatment for, but separate from, the primary presenting disease. 2.Intellectual and academic outcomes are considered distal markers and secondary to changes in underlying core cognitive skills.3. While much of the research to date has focused on risk for deficits in cognitive function, attention should also be paid to resilience. 4.Consideration of the current literature on children diagnosed and treated for medulloblastoma reveals there is at least the start of a conceptual model illustrating the likely relationships between treatment, underlying

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Section: Impact On the Brainmentioning

confidence: 51%

Section: Impact On the Brainmentioning

confidence: 99%

Section: Impact On the Brainmentioning

confidence: 99%

See 1 more Smart Citation

Neurodevelopmental impact on children treated for medulloblastoma: A review and proposed conceptual model

Palmer¹

2008

Dev Disabil Res Revs

116

131

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“…Compared with normal children, children treated for medulloblastoma had a decreased fractional anisotropy in multiple white matter regions (14,15,43). Decreases in fractional anisotropy also correlated with the craniospinal radiation dose (16) and IQ (17,43).…”

Section: Discussionmentioning

confidence: 97%

Changes in Cerebral Cortex of Children Treated for Medulloblastoma

Liu

Marcus

Fischl

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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“…Evidence has shown an association between cranial radiotherapy and a reduction in white matter, which led Khong et al to suggest that white matter volume could be used as a biological marker to verify the neurotoxicity of radiotherapy (Khong et al, 2006). The fact that children subjected to radiotherapy do not process information at the same speed as their peers leads to significant gaps that negatively affect the development of their abilities and acquisition of new knowledge (Mabbot et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Intellectual aspects of cognitive performance in children after treatment for medulloblastoma and astrocytoma.

Hazin¹,

Dellatolas²,

Garcia³

et al. 2010

Psychology & Neuroscience

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The present study investigated the relationship between posterior fossa tumors (astrocytoma and medulloblastoma) and their respective treatments and cognitive performance in Brazilian children by measuring Intelligence Quotient (IQ). Twenty children were enrolled in the study, of whom 13 were diagnosed with astrocytoma (average age at evaluation, 10.2 years; eight girls and five boys) and seven were diagnosed with medulloblastoma (average age at evaluation, 9.2 years; five girls and two boys). The first subgroup underwent exclusively tumor resection surgery, and the second subgroup underwent surgery, chemotherapy (Vincristine, Cisplatine, and Carmustine), and radiotherapy (total dose, 54 Gy). The inclusion criteria for the clinical group were normal social and emotional behavior before the diagnosis and motor and visual performance not excessively deteriorated after surgery. All participants were submitted to the Wechsler Intelligence Scale for Children -third version, and their scores were related to standard norms established for Brazilian children and compared with regard to the diagnosis subgroups and treatment modalities. Statistically significant differences were identified between the two diagnosis subgroups in Performance IQ and Processing Speed scores. The medulloblastoma subgroup presented poorer performance in all domains compared with the astrocytoma subgroup. Time interval between diagnosis and neuropsychological evaluation also had a significant effect on Processing Speed and Freedom from Distractibility in the medulloblastoma subgroup. These results provide empirical evidence of a possible significant effect of radiotherapy exposure on processing speed and global intellectual capacity.

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White Matter Anisotropy in Post-Treatment Childhood Cancer Survivors: Preliminary Evidence of Association With Neurocognitive Function

Abstract: Our preliminary findings suggest that white matter FA may be a clinically useful biomarker for the assessment of treatment-related neurotoxicity in post-treatment childhood cancer survivors.

Cited by 177 publications

References 30 publications

Neurodevelopmental impact on children treated for medulloblastoma: A review and proposed conceptual model

Neurodevelopmental impact on children treated for medulloblastoma: A review and proposed conceptual model

Changes in Cerebral Cortex of Children Treated for Medulloblastoma

Intellectual aspects of cognitive performance in children after treatment for medulloblastoma and astrocytoma.

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