Hu Zhanqi, Zou Dongfang, Mai Huirong, Yuan Xiuli, Wang Lihong, Li Yue, Liao Jianxiang, Liu Liwei, Liu Guosheng, Zeng Hongwu, Wen Feiqiu
Department of Pediatrics, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong, China; Department of Neurology, Shenzhen Children's Hospital, Shenzhen 518038, Guangdong, China.
Department of Neurology, Shenzhen Children's Hospital, Shenzhen 518038, Guangdong, China.
Brain Dev. 2017 Oct;39(9):743-750. doi: 10.1016/j.braindev.2017.04.014. Epub 2017 May 22.
Cognitive impairments had been reported in childhood acute lymphoblastic leukemia, what caused the impairments needed to be demonstrated, chemotherapy-related or the disease itself. The primary aim of this exploratory investigation was to determine if there were changes in brain function of children with acute lymphoblastic leukemia before chemotherapy.
In this study, we advanced a measure named regional homogeneity to evaluate the resting-state brain activities, intelligence quotient test was performed at same time. Using regional homogeneity, we first investigated the resting state brain function in patients with new onset childhood acute lymphoblastic leukemia before chemotherapy, healthy children as control.
The decreased ReHo values were mainly founded in the default mode network and left frontal lobe, bilateral inferior parietal lobule, bilateral temporal lobe, bilateral occipital lobe, precentral gyrus, bilateral cerebellum in the newly diagnosed acute lymphoblastic leukemia patients compared with the healthy control. While in contrast, increased ReHo values were mainly shown in the right frontal lobe (language area), superior frontal gyrus-R, middle frontal gyrus-R and inferior parietal lobule-R for acute lymphoblastic leukemia patients group. There were no significant differences for intelligence quotient measurements between the acute lymphoblastic leukemia patient group and the healthy control in performance intelligence quotient, verbal intelligence quotient, total intelligence quotient.
The altered brain functions are associated with cognitive change and language, it is suggested that there may be cognition impairment before the chemotherapy. Regional homogeneity by functional magnetic resonance image is a sensitive way for early detection on brain damage in childhood acute lymphoblastic leukemia.
已有报道称儿童急性淋巴细胞白血病存在认知障碍，但其病因（化疗相关还是疾病本身）仍有待证实。本探索性研究的主要目的是确定急性淋巴细胞白血病患儿在化疗前脑功能是否有变化。
在本研究中，我们采用一种名为局部一致性的测量方法来评估静息态脑活动，同时进行智商测试。我们首先利用局部一致性研究初发儿童急性淋巴细胞白血病患者化疗前的静息态脑功能，以健康儿童作为对照。
与健康对照相比，新诊断的急性淋巴细胞白血病患者默认模式网络、左侧额叶、双侧顶下小叶、双侧颞叶、双侧枕叶、中央前回、双侧小脑的局部一致性值降低。而相比之下，急性淋巴细胞白血病患者组右侧额叶（语言区）、右侧额上回、右侧额中回和右侧顶下小叶的局部一致性值升高。急性淋巴细胞白血病患者组与健康对照在操作智商、言语智商、总智商方面的智商测量无显著差异。
脑功能改变与认知和语言变化相关，提示化疗前可能存在认知障碍。功能磁共振成像的局部一致性是早期检测儿童急性淋巴细胞白血病脑损伤的一种敏感方法。
