Longitudinal change in fine motor skills after brain radiotherapy and in vivo imaging biomarkers associated with decline.

Published on Aug 2, 2021in Neuro-oncology12.3
· DOI :10.1093/NEUONC/NOAB017
Mia A Salans3
Estimated H-index: 3
(UCSD: University of California, San Diego),
Michelle D. Tibbs5
Estimated H-index: 5
(UCSD: University of California, San Diego)
+ 7 AuthorsJona A. Hattangadi-Gluth23
Estimated H-index: 23
(UCSD: University of California, San Diego)
Source
Abstract
BACKGROUND We explored fine motor skills (FMS) before and after brain radiotherapy (RT), analyzing associations between longitudinal FMS and imaging biomarkers of cortical and white matter (WM) integrity in motor regions of interest (ROIs). METHODS On a prospective trial, 52 primary brain tumor patients receiving fractionated brain RT underwent volumetric brain MRI, diffusion tensor imaging, and FMS assessments (Delis-Kaplan Executive Function System Trail Making Test Motor Speed [DKEFS-MS], Grooved Pegboard Dominant [PDH] and Non-dominant [PNDH] Hands) at baseline and 3, 6, and 12 months post-RT. Motor ROIs autosegmented included: sensorimotor cortices and superficial WM, corticospinal tracts, cerebellar cortices and WM, and basal ganglia. Volume (cc) was measured in all ROIs at each timepoint. Diffusion biomarkers (FA and MD) were additionally measured in WM ROIs. Linear mixed-effects models assessed biomarkers as predictors of FMS scores. P-values were corrected for multiple comparisons. RESULTS Higher RT dose was associated with right paracentral cortical thinning (β=-2.42 Gy/(month*mm), p=0.03) and higher right precentral WM MD (β=0.69 Gy/(month*µm 2/ms), p=0.04). Higher left (β=38.7 points/(month*µm 2/ms), p=0.004) and right (β=42.4 points/(month*µm 2/ms), p=0.01) cerebellar WM MD, left precentral cortical atrophy (β=-8.67 points/(month*mm), p=0.02), and reduced right cerebral peduncle FA (β=-0.50 points/month, p=0.01) were associated with worse DKEFS-MS performance. Left precentral cortex thinning was associated with worse PDH scores (β=-17.3 points/(month*mm), p=0.02). Left (β=-0.87 points/(month*cm 3), p=0.001) and right (β=-0.64 points/(month*cm 3), p=0.02) cerebellar cortex, left pons (β=-19.8 points/(month*cm 3), p=0.02), and right pallidum (β=-10.8 points/(month*cm 3), p=0.02) atrophy and reduced right internal capsule FA (β=-1.02 points/month, p=0.03, p=0.03) were associated with worse PNDH performance. CONCLUSIONS Biomarkers of microstructural injury in motor-associated brain regions were associated with worse FMS. Dose avoidance in these areas may preserve FMS.
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#1Michelle D. Tibbs (UCSD: University of California, San Diego)H-Index: 5
#2Minh-Phuong Huynh-Le (UCSD: University of California, San Diego)H-Index: 12
Last. Jona A. Hattangadi-Gluth (UCSD: University of California, San Diego)H-Index: 23
view all 12 authors...
ABSTRACT Purpose To investigate the association between imaging biomarkers of radiation-induced white matter (WM) injury within perisylvian regions and longitudinal language decline in brain tumor patients. Methods and Materials Primary brain tumor patients (n=44) on a prospective trial underwent brain MRI, diffusion-weighted imaging, and language assessments of naming [Boston Naming Test (BNT)] and fluency [DKEFS-Category Fluency (DKEFS-CF)] at baseline, 3, 6, and 12-months post-fractionated ra...
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PURPOSERadiation dose to the neuroregenerative zone of the hippocampus has been found to be associated with cognitive toxicity. Hippocampal avoidance (HA) using intensity-modulated radiotherapy dur...
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#1Kathryn R. Tringale (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 11
#2Tanya T. NguyenH-Index: 18
Last. Jona A. Hattangadi-GluthH-Index: 23
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Abstract Purpose We used quantitative MRI to prospectively analyze the association between microstructural damage to memory-associated structures within the medial temporal lobe and longitudinal memory performance after brain radiotherapy (RT). Methods and Materials Primary brain tumor patients receiving fractionated brain RT were enrolled on a prospective trial (n=27). Patients underwent high resolution volumetric brain MRI, diffusion-weighted imaging, and neurocognitive testing prior to and 3,...
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#1Darren M. Lipnicki (UNSW: University of New South Wales)H-Index: 27
#2Steve R. Makkar (UNSW: University of New South Wales)H-Index: 14
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Background With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority. This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. Methods and findings We harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54–105 (mean...
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#1Rachel K. Peterson (U of T: University of Toronto)H-Index: 7
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BACKGROUND: Little is known about cognition and predictors of neuropsychological outcomes in pediatric low-grade glioma (PLGG) survivors treated without radiation therapy. This research expands upon our previous work by further identifying the cognitive profile of PLGG patients treated without radiation therapy, investigating the specific medical and demographic variables that predict functioning, and examining white matter structure and its relationship to neuropsychological performance. PROCED...
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#1Kathryn R. Tringale (UCSD: University of California, San Diego)H-Index: 11
#2Tanya T. Nguyen (UCSD: University of California, San Diego)H-Index: 18
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Abstract Background and purpose Executive function (EF) decline is common after brain radiation therapy (RT), yet the etiology is unclear. We analyzed the association between longitudinal changes in frontal lobe white matter microstructure and decline in EF following RT in brain tumor patients on a prospective clinical trial. Materials and methods Diffusion tensor imaging was obtained on 22 patients with brain tumors prior to RT, as well as 3- and 6-months post-RT, in a prospective, observationa...
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#1Mingmei Li (ACU: Australian Catholic University)H-Index: 1
#2Karen Caeyenberghs (ACU: Australian Catholic University)H-Index: 38
Abstract In addition to the burden of a life-threatening diagnosis, cancer patients are struggling with adverse side-effects from cancer treatment. Chemotherapy has been linked to an array of cognitive impairments and alterations in brain structure and function (“chemobrain”). In this review, we summarized the existing evidence that evaluate the changes in cognitive functioning and brain with chemotherapy, as assessed using structural and functional MRI-based techniques in a longitudinal design....
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#1Maarten Lambrecht (Katholieke Universiteit Leuven)H-Index: 18
#2Daniëlle B.P. Eekers (Maastricht University Medical Centre)H-Index: 18
Last. Esther G.C. TroostH-Index: 38
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Purpose: For unbiased comparison of different radiation modalities and techniques, consensus on delineation of radiation sensitive organs at risk (OARs) and on their dose constraints is warranted. Following the publication of a digital, online atlas for OAR delineation in neuro-oncology by the same group, we assessed the brain OAR-dose constraints in a follow-up study. Methods: We performed a comprehensive search to identify the current papers on OAR dose constraints for normofractionated photon...
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#1Quentin Welniarz (University of Paris)H-Index: 7
#2Isabelle Dusart (University of Paris)H-Index: 35
Last. Emmanuel Roze (University of Paris)H-Index: 58
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The corticospinal tract (CST) plays a major role in cortical control of spinal cord activity. In particular, it is the principal motor pathway for voluntary movements. Here, we discuss: (i) the anatomic evolution and development of the CST across mammalian species, focusing on its role in motor functions; (ii) the molecular mechanisms regulating corticospinal tract formation and guidance during mouse development; and (iii) human disorders associated with abnormal CST development. A comparison of...
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#1Michael Connor (UCSD: University of California, San Diego)H-Index: 9
#2Roshan Karunamuni (UCSD: University of California, San Diego)H-Index: 17
Last. Jona A. Hattangadi-Gluth (UCSD: University of California, San Diego)H-Index: 23
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Abstract Background and purpose Regional differences in sensitivity to white matter damage after brain radiotherapy (RT) are not well-described. We characterized the spatial heterogeneity of dose–response across white matter tracts using diffusion tensor imaging (DTI). Materials and methods Forty-nine patients with primary brain tumors underwent MRI with DTI before and 9–12months after partial-brain RT. Maps of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial...
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PURPOSECognitive decline is frequently observed after chemotherapy. As chemotherapy is associated with changes in brain white matter microstructure, we investigated whether white matter microstruct...
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ABSTRACT Gliomas are the most common primary brain cancer, yet are extraordinarily challenging to treat because they can be aggressive and infiltrative, locally recurrent, and resistant to standard treatments. Furthermore, the treatments themselves, including radiation therapy, can affect patients' neurocognitive function and quality of life. Noninvasive imaging is the standard of care for primary brain tumors, including diagnosis, treatment planning, and monitoring for treatment response. This ...
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