Perez Whitney D, Perez-Torres Carlos J
School of Health Sciences, Purdue University, West Lafayette, IN, USA.
Purdue University Center for Cancer Research, Purdue University, West Lafayette, IN, USA.
Int J Radiat Biol. 2023;99(2):119-137. doi: 10.1080/09553002.2022.2074167. Epub 2022 May 24.
Radiation-induced brain injury is a common long-term side effect for brain cancer survivors, leading to a reduced quality of life. Although there is growing research pertaining to this topic, the relationship between cognitive and radiologically detected lesions of radiation-induced brain injury in humans remains unclear. Furthermore, clinically translatable similarities between rodent models and human findings are also undefined. The objective of this review is to then identify the current evidence of radiation-induced brain injury in humans and to compare these findings to current rodent models of radiation-induced brain injury.
This review includes an examination of the current literature on cognitive and radiological characteristics of radiation-induced brain injury in humans and rodents. A thorough search was conducted on PubMed, Web of Science, and Scopus to identify studies that performed cognitive assessments and magnetic resonance imaging techniques on either humans or rodents after cranial radiation therapy. A qualitative synthesis of the data is herein reported.
A total of 153 studies pertaining to cognitively or radiologically detected radiation injury of the brain are included in this systematic review; 106 studies provided data on humans while 47 studies provided data on rodents. Cognitive deficits in humans manifest across multiple domains after brain irradiation. Radiological evidence in humans highlight various neuroimaging-detectable changes post-irradiation. It is unclear, however, whether these findings reflect ground truth or research interests. Additionally, rodent models do not comprehensively reproduce characteristics of cognitive and radiological injury currently identified in humans.
This systematic review demonstrates that associations between and within cognitive and radiological radiation-induced brain injuries often rely on the type of assessment. Well-designed studies that evaluate the spectrum of potential injury are required for a precise understanding of not only the clinical significance of radiation-induced brain injury in humans, but also how to replicate injury development in pre-clinical models.
放射性脑损伤是脑癌幸存者常见的长期副作用，会导致生活质量下降。尽管关于这一主题的研究越来越多，但人类放射性脑损伤的认知与放射学检测病变之间的关系仍不明确。此外，啮齿动物模型与人类研究结果在临床上的可转化相似性也未明确。本综述的目的是确定人类放射性脑损伤的现有证据，并将这些结果与当前放射性脑损伤的啮齿动物模型进行比较。
本综述包括对当前关于人类和啮齿动物放射性脑损伤的认知和放射学特征的文献进行研究。在PubMed、科学网和Scopus上进行了全面搜索，以确定在颅脑放射治疗后对人类或啮齿动物进行认知评估和磁共振成像技术的研究。本文报告了数据的定性综合分析。
本系统综述共纳入153项关于脑放射性损伤的认知或放射学检测研究；106项研究提供了人类数据，47项研究提供了啮齿动物数据。人类脑照射后认知缺陷在多个领域表现出来。人类的放射学证据突出了照射后各种神经影像学可检测到的变化。然而，尚不清楚这些发现是反映了基本事实还是研究兴趣。此外，啮齿动物模型并未全面再现目前在人类中发现的认知和放射学损伤特征。
本系统综述表明，认知和放射学放射性脑损伤之间及内部的关联通常取决于评估类型。需要精心设计的研究来评估潜在损伤的范围，以便不仅能精确了解人类放射性脑损伤的临床意义，还能了解如何在临床前模型中复制损伤发展过程。
