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Title: Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy

Abstract

Purpose and Objectives: Neurologic deficits after brain radiation therapy (RT) typically involve decline in higher-order cognitive functions such as attention and memory rather than sensory defects or paralysis. We sought to determine whether areas of the cortex critical to cognition are selectively vulnerable to radiation dose-dependent atrophy. Methods and Materials: We measured change in cortical thickness in 54 primary brain tumor patients who underwent fractionated, partial brain RT. The study patients underwent high-resolution, volumetric magnetic resonance imaging (T1-weighted; T2 fluid-attenuated inversion recovery, FLAIR) before RT and 1 year afterward. Semiautomated software was used to segment anatomic regions of the cerebral cortex for each patient. Cortical thickness was measured for each region before RT and 1 year afterward. Two higher-order cortical regions of interest (ROIs) were tested for association between radiation dose and cortical thinning: entorhinal (memory) and inferior parietal (attention/memory). For comparison, 2 primary cortex ROIs were also tested: pericalcarine (vision) and paracentral lobule (somatosensory/motor). Linear mixed-effects analyses were used to test all other cortical regions for significant radiation dose-dependent thickness change. Statistical significance was set at α = 0.05 using 2-tailed tests. Results: Cortical atrophy was significantly associated with radiation dose in the entorhinal (P=.01) and inferior parietal ROIs (P=.02). By contrast, no significantmore » radiation dose-dependent effect was found in the primary cortex ROIs (pericalcarine and paracentral lobule). In the whole-cortex analysis, 9 regions showed significant radiation dose-dependent atrophy, including areas responsible for memory, attention, and executive function (P≤.002). Conclusions: Areas of cerebral cortex important for higher-order cognition may be most vulnerable to radiation-related atrophy. This is consistent with clinical observations that brain radiation patients experience deficits in domains of memory, executive function, and attention. Correlations of regional cortical atrophy with domain-specific cognitive functioning in prospective trials are warranted.« less

Authors:
; ; ; ;  [1]; ; ; ;  [2];  [1];  [3];  [1];  [2];  [4];  [1];  [4];  [2];  [4];  [4];  [1]
  1. Department of Radiation Medicine and Applied Sciences, University of California, San Diego, La Jolla, California (United States)
  2. Department of Radiology, University of California, San Diego, La Jolla, California (United States)
  3. Department of Psychiatry, University of California, San Diego, La Jolla, California (United States)
  4. (United States)
Publication Date:
OSTI Identifier:
22649879
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 97; Journal Issue: 5; Other Information: Copyright (c) 2017 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ATROPHY; CEREBRAL CORTEX; COMPUTER CODES; NMR IMAGING; PATIENTS; RADIATION DOSES; RADIOTHERAPY; THICKNESS

Citation Formats

Seibert, Tyler M., Karunamuni, Roshan, Kaifi, Samar, Burkeen, Jeffrey, Connor, Michael, Krishnan, Anitha Priya, White, Nathan S., Farid, Nikdokht, Bartsch, Hauke, Murzin, Vyacheslav, Nguyen, Tanya T., Moiseenko, Vitali, Brewer, James B., Department of Neurosciences, University of California, San Diego, La Jolla, California, McDonald, Carrie R., Department of Psychiatry, University of California, San Diego, La Jolla, California, Dale, Anders M., Department of Psychiatry, University of California, San Diego, La Jolla, California, Department of Neurosciences, University of California, San Diego, La Jolla, California, and Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu. Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy. United States: N. p., 2017. Web. doi:10.1016/J.IJROBP.2017.01.005.
Seibert, Tyler M., Karunamuni, Roshan, Kaifi, Samar, Burkeen, Jeffrey, Connor, Michael, Krishnan, Anitha Priya, White, Nathan S., Farid, Nikdokht, Bartsch, Hauke, Murzin, Vyacheslav, Nguyen, Tanya T., Moiseenko, Vitali, Brewer, James B., Department of Neurosciences, University of California, San Diego, La Jolla, California, McDonald, Carrie R., Department of Psychiatry, University of California, San Diego, La Jolla, California, Dale, Anders M., Department of Psychiatry, University of California, San Diego, La Jolla, California, Department of Neurosciences, University of California, San Diego, La Jolla, California, & Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu. Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy. United States. doi:10.1016/J.IJROBP.2017.01.005.
Seibert, Tyler M., Karunamuni, Roshan, Kaifi, Samar, Burkeen, Jeffrey, Connor, Michael, Krishnan, Anitha Priya, White, Nathan S., Farid, Nikdokht, Bartsch, Hauke, Murzin, Vyacheslav, Nguyen, Tanya T., Moiseenko, Vitali, Brewer, James B., Department of Neurosciences, University of California, San Diego, La Jolla, California, McDonald, Carrie R., Department of Psychiatry, University of California, San Diego, La Jolla, California, Dale, Anders M., Department of Psychiatry, University of California, San Diego, La Jolla, California, Department of Neurosciences, University of California, San Diego, La Jolla, California, and Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu. Sat . "Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy". United States. doi:10.1016/J.IJROBP.2017.01.005.
@article{osti_22649879,
title = {Cerebral Cortex Regions Selectively Vulnerable to Radiation Dose-Dependent Atrophy},
author = {Seibert, Tyler M. and Karunamuni, Roshan and Kaifi, Samar and Burkeen, Jeffrey and Connor, Michael and Krishnan, Anitha Priya and White, Nathan S. and Farid, Nikdokht and Bartsch, Hauke and Murzin, Vyacheslav and Nguyen, Tanya T. and Moiseenko, Vitali and Brewer, James B. and Department of Neurosciences, University of California, San Diego, La Jolla, California and McDonald, Carrie R. and Department of Psychiatry, University of California, San Diego, La Jolla, California and Dale, Anders M. and Department of Psychiatry, University of California, San Diego, La Jolla, California and Department of Neurosciences, University of California, San Diego, La Jolla, California and Hattangadi-Gluth, Jona A., E-mail: jhattangadi@ucsd.edu},
abstractNote = {Purpose and Objectives: Neurologic deficits after brain radiation therapy (RT) typically involve decline in higher-order cognitive functions such as attention and memory rather than sensory defects or paralysis. We sought to determine whether areas of the cortex critical to cognition are selectively vulnerable to radiation dose-dependent atrophy. Methods and Materials: We measured change in cortical thickness in 54 primary brain tumor patients who underwent fractionated, partial brain RT. The study patients underwent high-resolution, volumetric magnetic resonance imaging (T1-weighted; T2 fluid-attenuated inversion recovery, FLAIR) before RT and 1 year afterward. Semiautomated software was used to segment anatomic regions of the cerebral cortex for each patient. Cortical thickness was measured for each region before RT and 1 year afterward. Two higher-order cortical regions of interest (ROIs) were tested for association between radiation dose and cortical thinning: entorhinal (memory) and inferior parietal (attention/memory). For comparison, 2 primary cortex ROIs were also tested: pericalcarine (vision) and paracentral lobule (somatosensory/motor). Linear mixed-effects analyses were used to test all other cortical regions for significant radiation dose-dependent thickness change. Statistical significance was set at α = 0.05 using 2-tailed tests. Results: Cortical atrophy was significantly associated with radiation dose in the entorhinal (P=.01) and inferior parietal ROIs (P=.02). By contrast, no significant radiation dose-dependent effect was found in the primary cortex ROIs (pericalcarine and paracentral lobule). In the whole-cortex analysis, 9 regions showed significant radiation dose-dependent atrophy, including areas responsible for memory, attention, and executive function (P≤.002). Conclusions: Areas of cerebral cortex important for higher-order cognition may be most vulnerable to radiation-related atrophy. This is consistent with clinical observations that brain radiation patients experience deficits in domains of memory, executive function, and attention. Correlations of regional cortical atrophy with domain-specific cognitive functioning in prospective trials are warranted.},
doi = {10.1016/J.IJROBP.2017.01.005},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 5,
volume = 97,
place = {United States},
year = {Sat Apr 01 00:00:00 EDT 2017},
month = {Sat Apr 01 00:00:00 EDT 2017}
}