分次放疗后原发性脑肿瘤患者的网络拓扑结构改变
Altered Network Topology in Patients with Primary Brain Tumors After Fractionated Radiotherapy.
作者信息
Bahrami Naeim, Seibert Tyler M, Karunamuni Roshan, Bartsch Hauke, Krishnan AnithaPriya, Farid Nikdokht, Hattangadi-Gluth Jona A, McDonald Carrie R
机构信息
1 Center for Multimodal Imaging and Genetics (CMIG), University of California , San Diego, La Jolla, California.
2 Department of Psychiatry, University of California , San Diego, La Jolla, California.
出版信息
Brain Connect. 2017 Jun;7(5):299-308. doi: 10.1089/brain.2017.0494.
Radiation therapy (RT) is a critical treatment modality for patients with brain tumors, although it can cause adverse effects. Recent data suggest that brain RT is associated with dose-dependent cortical atrophy, which could disrupt neocortical networks. This study examines whether brain RT affects structural network properties in brain tumor patients. We applied graph theory to MRI-derived cortical thickness estimates of 54 brain tumor patients before and after RT. Cortical surfaces were parcellated into 68 regions and correlation matrices were created for patients pre- and post-RT. Significant changes in graph network properties were tested using nonparametric permutation tests. Linear regressions were conducted to measure the association between dose and changes in nodal network connectivity. Increases in transitivity, modularity, and global efficiency (n = 54, p < 0.0001) were all observed in patients post-RT. Decreases in local efficiency (n = 54, p = 0.007) and clustering coefficient (n = 54, p = 0.005) were seen in regions receiving higher RT doses, including the inferior parietal lobule and rostral anterior cingulate. These findings demonstrate alterations in global and local network topology following RT, characterized by increased segregation of brain regions critical to cognition. These pathological network changes may contribute to the late delayed cognitive impairments observed in many patients following brain RT.
放射治疗(RT)是脑肿瘤患者的一种关键治疗方式,尽管它可能会产生不良反应。最近的数据表明,脑部放疗与剂量依赖性皮质萎缩有关,这可能会破坏新皮质网络。本研究旨在探讨脑部放疗是否会影响脑肿瘤患者的结构网络特性。我们将图论应用于54例脑肿瘤患者放疗前后MRI衍生的皮质厚度估计值。将皮质表面划分为68个区域,并为患者放疗前后创建相关矩阵。使用非参数置换检验测试图网络属性的显著变化。进行线性回归以测量剂量与节点网络连通性变化之间的关联。放疗后患者的传递性、模块化和全局效率均增加(n = 54,p < 0.0001)。在接受较高放疗剂量的区域,包括顶下小叶和喙前扣带回,局部效率(n = 54,p = 0.007)和聚类系数(n = 54,p = 0.005)降低。这些发现表明放疗后全局和局部网络拓扑结构发生改变,其特征是对认知至关重要的脑区分离增加。这些病理性网络变化可能导致许多患者在脑部放疗后出现晚期延迟认知障碍。