CHU Sainte-Justine Research Center, Montreal, Quebec, Canada.
Department of Psychology, University of Montreal, Montreal, Quebec, Canada.
Cancer. 2019 Oct 15;125(20):3639-3648. doi: 10.1002/cncr.32374. Epub 2019 Jul 16.
Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Treatments against ALL might lead to later cognitive effects and alterations in brain structure in survivors but to the authors' knowledge the observed variability in the severity of neurocognitive deficits is not fully understood. The objective of the current study was to investigate abnormalities in visual short-term memory (VSTM) brain activation in survivors of childhood ALL using magnetoencephalography.
A VSTM task was completed by 40 survivors of ALL and 26 controls. VSTM capacity (Cowan K) and brain activation were assessed during the retention period of the task (400-1400 milliseconds) using a standard minimum norm source localization method.
Performance (Cowan K) was found to be similar between survivors of ALL and controls. Atypical brain activation was found in survivors of ALL during the task, including overactivation of regions usually involved in VSTM (lateral occipital, precentral gyrus, and postcentral gyrus), recruitment of regions that typically are not involved in VSTM (superior/middle temporal gyrus and supramarginal gyrus), and lower activation of frontal brain regions (inferior frontal gyrus). These patterns of activation were modulated by the age at the time of cancer onset (P = .01) because activity was found to be reduced in participants who were younger at diagnosis.
The results of the current study suggest a pattern of neural inefficiency and compensatory activity during VSTM in survivors of ALL.
急性淋巴细胞白血病(ALL)是最常见的儿童癌症。治疗 ALL 可能会导致幸存者出现认知功能障碍和大脑结构改变,但据作者所知,神经认知缺陷严重程度的可变性尚未完全理解。本研究的目的是使用脑磁图研究儿童 ALL 幸存者的视觉短期记忆(VSTM)脑激活异常。
40 名 ALL 幸存者和 26 名对照者完成了 VSTM 任务。使用标准最小范数源定位方法,在任务的保留期(400-1400 毫秒)评估 VSTM 容量(考恩 K)和脑激活。
发现 ALL 幸存者和对照组的表现(考恩 K)相似。在 ALL 幸存者的任务中发现了异常的脑激活,包括通常参与 VSTM 的区域(外侧枕叶、中央前回和中央后回)过度激活、通常不参与 VSTM 的区域(中上颞叶和缘上回)被招募,以及额叶脑区(额下回)的激活降低。这些激活模式受癌症发病时年龄的调节(P=0.01),因为在诊断时年龄较小的参与者中发现活性降低。
本研究结果表明 ALL 幸存者在 VSTM 期间存在神经效率低下和代偿性活动的模式。