Functional brain networks in survivors of a pediatric brain tumor and its relation to cognition.
Poster No:
1449
Submission Type:
Abstract Submission
Authors:
Kristien Bullens1, Rebeca Alejandra Gavrila Laic2, Charlotte Sleurs3, Jeroen Blommaert1, Stefan Sunaert2, Jurgen Lemiere1, Sandra Jacobs1
Institutions:
1KU Leuven, Leuven, Belgium, 2KU Leuven, Leuven, Vlaams-Brabant, 3Tilburg University, Tilburg, Netherlands
First Author:
Co-Author(s):
Introduction:
Radio therapy (RT) during childhood is associated with cognitive impairment in long-term survivors of a pediatric brain tumor, although effects of RT are complex and not yet fully understood(Bledsoe, 2016). There is a growing understanding that functional brain network dysfunction is related to impairments in higher-order cognitive functioning (CF)(Müller et al., 2022). We investigated CF and organization of the functional brain network in long-term pediatric brain tumor survivors.
Methods:
MRI-scans and CF were acquired from 46 survivors of pediatric brain tumors (mean age 23.99±4.71y, mean age at diagnosis 9.29±4.54y) and 47 controls (mean age 24.30±4.99y). CF scores (Controlled Oral Word Association Test, Peabody Picture Vocabulary Test (PPVT), Rey Auditory Verbal Learning Test, Rey Visual Design Learning Test, Amsterdam Neuropsychological Task and WAIS-IV-NL) were transformed into a normalized w-scores adjusted for age, education and sex. T1-weighted (voxel size 1x0.9x0.9mm, TR/TE 0.0097/0.0046s) and rs-fMRI (voxel size 2.5x2.5x2.5mm, TR/TE 1/0.0330s) images were acquired on a 3T Philips Achieva and processed using fMRIPrep and CONN toolbox4,5. An in-house developed MATLAB script was used to calculate whole-brain and nodal graph measures. Betweenness centrality, nodal strength, clustering coefficient, and shortest path length were used to define a hubscore6,7. Graph measures were normalized by dividing them by the median values of 1000 equivalent random graphs7. Group differences in CF and organization of functional brain networks between irradiated (IR, n=20), non-irradiated survivors (Non-IR, n=26) and controls (C) were explored with an ANOVA model or a non-parametric alternative. Post-hoc-analyses were conducted when applicable. Whole-brain graph measures were correlated with CF scores in the survivor group. All tests were false discovery rate (FDR) corrected.
Results:
Both IR and Non-IR survivors scored significantly worse on the PPVT (2(2)14.48;pFDR<0.01;2=0.14) and some tasks of the WAIS-IV-NL (Vocabulary, Information, and Symbol Search; F(2,90)13.35-7.31;pFDR<0.01; 20.14). Only for the Symbol Coding tasks of the WAIS-IV-NL (F(2,90)9.01;pFDR<0.01;2=0.17) and the ANT (Finger tapping; F(2,89)5.70,pFDR=0.03;2= 0.11), where IR survivors scored worse than C, and worse than Non-IR survivors and C, respectively. Analyses of functional brain network organization showed a group difference for whole-brain clustering coefficient, being higher in controls (punadj.=0.03) however, significance was not maintained after FDR correction (pFDR=0.12). Analyses of nodal organization suggested differences in multiple brain regions across several measures, although significance of these differences was not maintained after FDR correction. No significant correlations were observed between CF and whole brain graph measures among the survivor population. Only 4 out of 78 nodes were identified as a functional network hub in controls, namely left fusiform gyrus, left isthmus cingulate, left middle temporal gyrus, and left parsopercularis. These hubs were also identified as hubs in Non-IR survivors, except the left fusiform gyrus. Non-IR survivors showed one additional hub in the right fusiform gyrus. IR survivors only showed a hub in the left middle temporal gyrus and left parsopercularis.
Conclusions:
Long-term pediatric brain tumor survivors experience lower cognitive functioning compared to controls alongside differential functional hub organization. Furthermore, these effects appear more pronounced in irradiated survivors compared to non-irradiated survivors. Nevertheless, the differences in functional network measures are rather subtle and the association with cognitive functioning remains inconclusive. More research is needed to improve our understanding on the impact of a brain tumor and treatment during childhood.
Disorders of the Nervous System:
Neurodevelopmental/ Early Life (eg. ADHD, autism)
Higher Cognitive Functions:
Higher Cognitive Functions Other 2
Language:
Language Other
Learning and Memory:
Learning and Memory Other
Modeling and Analysis Methods:
fMRI Connectivity and Network Modeling 1
Keywords:
Cognition
FUNCTIONAL MRI
Other - Brain Tumor
1|2Indicates the priority used for review
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Provide references using APA citation style.
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