TY - JOUR
T1 - Association between radiation dose to neuronal progenitor cell niches and temporal lobes and performance on neuropsychological testing in children
T2 - A prospective study
AU - Redmond, Kristin J.
AU - Mark Mahone, E.
AU - Terezakis, Stephanie
AU - Ishaq, Omar
AU - Ford, Eric
AU - McNutt, Todd
AU - Kleinberg, Lawrence
AU - Cohen, Kenneth J.
AU - Wharam, Moody
AU - Horska, Alena
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2013/3/1
Y1 - 2013/3/1
N2 - BackgroundNeurocognitive toxicity from radiation therapy (RT) for brain tumors may be related to damage to neural progenitor cells that reside in the subventricular zone and hippocampus. This prospective study examines the relationship between RT dose to neural progenitor cell niches, temporal lobes, and cerebrum and neurocognitive dysfunction following cranial irradiation.MethodsStandardized assessments of motor speed/dexterity, verbal memory, visual perception, vocabulary, and visuospatial working memory were conducted in 19 pediatric patients receiving cranial RT and 55 controls at baseline and 6, 15, and 27 months following completion of RT. Prescription doses ranged from 12 Gy to 59.4 Gy. Linear mixed effects regression model analyses were used to examine the relationships among neuropsychological performance, age, and radiation dose to the subventricular zone, hippocampus, temporal lobes, and cerebrum.ResultsPerformance on all neuropsychological tests, except vocabulary, was significantly reduced in patients relative to controls, particularly among younger children. Performance on motor speed/dexterity decreased with increasing dose to hippocampus (P <. 05) and temporal lobes (P <. 035). There was also a significant relationship between (i) reduced performance on verbal learning and increasing dose to the cerebrum (P =. 022) and (ii) reduced performance on visual perception and increasing dose to the left temporal lobe (P =. 038). There was no association between radiation dose to evaluated structures and performance on vocabulary or visuospatial working memory.ConclusionsThese prospective data demonstrate a significant association between increasing RT dose to hippocampus and temporal lobes and decline in neurocognitive skills following cranial irradiation. These findings have important implications for trials, including RTOG 0933 (hippocampal-sparing whole brain radiation therapy for brain metastases).
AB - BackgroundNeurocognitive toxicity from radiation therapy (RT) for brain tumors may be related to damage to neural progenitor cells that reside in the subventricular zone and hippocampus. This prospective study examines the relationship between RT dose to neural progenitor cell niches, temporal lobes, and cerebrum and neurocognitive dysfunction following cranial irradiation.MethodsStandardized assessments of motor speed/dexterity, verbal memory, visual perception, vocabulary, and visuospatial working memory were conducted in 19 pediatric patients receiving cranial RT and 55 controls at baseline and 6, 15, and 27 months following completion of RT. Prescription doses ranged from 12 Gy to 59.4 Gy. Linear mixed effects regression model analyses were used to examine the relationships among neuropsychological performance, age, and radiation dose to the subventricular zone, hippocampus, temporal lobes, and cerebrum.ResultsPerformance on all neuropsychological tests, except vocabulary, was significantly reduced in patients relative to controls, particularly among younger children. Performance on motor speed/dexterity decreased with increasing dose to hippocampus (P <. 05) and temporal lobes (P <. 035). There was also a significant relationship between (i) reduced performance on verbal learning and increasing dose to the cerebrum (P =. 022) and (ii) reduced performance on visual perception and increasing dose to the left temporal lobe (P =. 038). There was no association between radiation dose to evaluated structures and performance on vocabulary or visuospatial working memory.ConclusionsThese prospective data demonstrate a significant association between increasing RT dose to hippocampus and temporal lobes and decline in neurocognitive skills following cranial irradiation. These findings have important implications for trials, including RTOG 0933 (hippocampal-sparing whole brain radiation therapy for brain metastases).
KW - brain irradiation
KW - brain tumor
KW - neural progenitor cell niches
KW - neuropsychological performance
UR - http://www.scopus.com/inward/record.url?scp=84874514691&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874514691&partnerID=8YFLogxK
U2 - 10.1093/neuonc/nos303
DO - 10.1093/neuonc/nos303
M3 - Article
C2 - 23322748
AN - SCOPUS:84874514691
SN - 1522-8517
VL - 15
SP - 360
EP - 369
JO - Neuro-Oncology
JF - Neuro-Oncology
IS - 3
ER -