Department of Psychology, University of Bern, Bern, Switzerland.
Neuropediatrics, Development and Rehabilitation, University Children's Hospital Bern, and University of Bern, Bern, Switzerland.
Brain Behav. 2021 Jan;11(1):e01931. doi: 10.1002/brb3.1931. Epub 2020 Nov 18.
Non-central nervous system cancer in childhood (non-CNS CC) and its treatments pose a major threat to brain development, with implications for functional networks. Structural and functional alterations might underlie the cognitive late-effects identified in survivors of non-CNS CC. The present study evaluated resting-state functional networks and their associations with cognition in a mixed sample of non-CNS CC survivors (i.e., leukemia, lymphoma, and other non-CNS solid tumors).
Forty-three patients (off-therapy for at least 1 year and aged 7-16 years) were compared with 43 healthy controls matched for age and sex. High-resolution T1-weighted structural magnetic resonance and resting-state functional magnetic resonance imaging were acquired. Executive functions, attention, processing speed, and memory were assessed outside the scanner.
Cognitive performance was within the normal range for both groups; however, patients after CNS-directed therapy showed lower executive functions than controls. Seed-based connectivity analyses revealed that patients exhibited stronger functional connectivity between fronto- and temporo-parietal pathways and weaker connectivity between parietal-cerebellar and temporal-occipital pathways in the right hemisphere than controls. Functional hyperconnectivity was related to weaker memory performance in the patients' group.
These data suggest that even in the absence of brain tumors, non-CNS CC and its treatment can lead to persistent cerebral alterations in resting-state network connectivity.
儿童期非中枢神经系统癌症（非 CNS CC）及其治疗方法对大脑发育构成重大威胁，对功能网络也有影响。结构和功能的改变可能是 CNS CC 幸存者认知晚期效应的基础。本研究评估了混合非 CNS CC 幸存者（即白血病、淋巴瘤和其他非 CNS 实体瘤）的静息态功能网络及其与认知的关联。
将 43 名患者（治疗后至少 1 年，年龄为 7-16 岁）与 43 名年龄和性别匹配的健康对照进行比较。采集高分辨率 T1 加权结构磁共振和静息态功能磁共振成像。在扫描外评估执行功能、注意力、处理速度和记忆力。
两组的认知表现均在正常范围内；然而，接受过 CNS 定向治疗的患者的执行功能比对照组差。基于种子的连通性分析显示，与对照组相比，患者的右侧额-颞叶和顶-颞叶通路之间的功能连通性增强，而顶-小脑和颞-枕叶通路之间的连通性减弱。功能连接性增强与患者组的记忆表现减弱有关。
这些数据表明，即使没有脑瘤，非 CNS CC 及其治疗也会导致静息状态网络连通性的持续脑改变。
