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鼻咽癌患者亚致死性颅脑照射后海马功能预后。

Prognosis of Hippocampal Function after Sub-lethal Irradiation Brain Injury in Patients with Nasopharyngeal Carcinoma.

机构信息

Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

出版信息

Sci Rep. 2017 Oct 31;7(1):14697. doi: 10.1038/s41598-017-13972-2.

Abstract

This work emphasizes the value of assessing hippocampal function by making a timely MRI-based prognosis following a minor dose of hippocampal irradiation after nasopharyngeal carcinomas (NPC) radiotherapy. A quasi-experiment with case-control design and functional assessments (e.g., neuroimaging analysis with fMRI) was conducted to assess hippocampal function after radiotherapy. We delivered 70 Gy of irradiation to nasopharyngeal carcinomas by 6MV helical radiotherapy and collected data from twenty NPC patients and 24 healthy age-matched subjects. Inevitably, hippocampi also received an average dose of 6.89 Gy (range, 2.0-14 Gy). Seed-based functional connectivity of the hippocampus was applied to estimate the cognitive alteration by time before, one month, and four months after irradiation. Afterward, longitudinal-and-cross-sessional statistical inference was determined with time-dependent measurement analysis of variance (ANOVA) with controlled covariance. Over time, there were longitudinal changes in the functional connectivity of hippocampal-related cortices, including the right middle frontal lobe, left superior temporal lobe, and left postcentral gyrus. The findings indicate the presence of functional plasticity, demonstrating how minor irradiation affects functional performance during the early delayed phase of irradiation-induced brain injury.

摘要

这项工作强调了通过在鼻咽癌(NPC)放疗后对小剂量海马照射进行及时的基于 MRI 的预后评估来评估海马功能的价值。采用准实验病例对照设计和功能评估(例如,使用 fMRI 的神经影像学分析)来评估放疗后的海马功能。我们通过 6MV 螺旋放疗对鼻咽癌进行了 70Gy 的照射,并从 20 名 NPC 患者和 24 名年龄匹配的健康受试者中收集了数据。不可避免的是,海马也受到了 6.89Gy 的平均剂量(范围为 2.0-14Gy)。基于种子的海马功能连接被应用于通过在照射前、照射后一个月和四个月的时间来估计认知改变。之后,采用具有协方差控制的时间依赖性测量方差分析(ANOVA)进行纵向和交叉会话统计推断。随着时间的推移,海马相关皮质的功能连接发生了纵向变化,包括右侧额中回、左侧颞上回和左侧后中央回。研究结果表明存在功能可塑性,证明了轻微照射如何在照射诱导的脑损伤的早期延迟阶段影响功能表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97f8/5665929/9d9debbe7dfe/41598_2017_13972_Fig1_HTML.jpg

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