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The Long Term Effects of Radiation Therapy on White Matter Integrity and Information Processing Speed: A Diffusion Tensor Imaging Study in Pediatric Brain Tumor Patients

Makola, Monwabisi F
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504878431395029

Abstract Details

2017, PhD, University of Cincinnati, Medicine: Neuroscience/Medical Science Scholars Interdisciplinary.
Background – Radiation therapy (RT) is a very common treatment for pediatric brain tumors. Unfortunately, RT is associated with long-term cognitive impairments. White matter (WM) tracts, such as the corpus callosum (CC), mediate processing speed which , in turn, mediates overall cognitive ability. Pediatric RT patients experience WM deficits and long-term deficits in processing speed and intelligence quotient (IQ). However, long-term effects of RT on WM integrity in these patients are unknown. Patients who receive RT frequently undergo surgery, but it is unclear how surgery affects long-term WM integrity and cognitive ability. WM integrity, age, gender, highest parent education and occupation, and family income are affecters of intelligence, but their effects on cognitive ability in pediatric RT patients are unknown. Objective - 1) to determine the long-term effects of RT on CC integrity as well as processing speed and IQ two years after treatment while controlling for surgery; 2) To determine the effects of non-treatment, intelligence-associated factors on post-treatment cognitive ability; 3) to quantity the relationship between radiation dose and WM integrity in pediatric brain tumor patients. Methods –Diffusion tensor imaging (DTI) was used to quantify WM integrity of the genu (GCC), body (BCC), and splenium (SCC) of the CC. Preschool, child, and adult variants of the Wechsler intelligence assessments measured processing speed and IQ. Participants included pediatric brain tumor patients diagnosed between 3 and 16 years old. They underwent baseline evaluations 3 to 12 months after surgery, and approximately two years later. Participants treated with surgery and RT were matched to those who didn’t receive RT. Baseline and two-year DTI, processing speed, and IQ data were compared between groups at each time point and to each other within each group. Along with RT status, factors including baseline BCC integrity, age, gender, highest parent education and occupation, and family income were evaluated as predictors of change in processing speed and IQ. Correlations were carried out between biologically corrected doses and WM integrity. Results – Compared to the no-radiation group, the radiation group exhibited significant reductions in BCC integrity at two years. The no-radiation group displayed a significant reduction in processing speed, compared to the population average, at baseline and both groups did so at two years. While neither group exhibited significant changes in IQ, compared to the population mean, at either time point, a significant temporal reduction in IQ occurred in the radiation group. Baseline WM integrity of the BCC, age at diagnosis, highest parent education, and family income significantly predicted processing speed change. No significant correlations were observed between biologically corrected doses and WM integrity. Conclusion - Pediatric brain tumor patients treated with RT may be at greater risk of experiencing long-term damage to the BCC than those treated without RT. All patients are at risk of experiencing processing speed deficits and radiation patients are at risk for significant temporal reductions in IQ. Lastly, non-treatment factors such as WM integrity, age, highest parent education, and family income may be more important predictors of processing speed change than radiation status.
Kim Cecil, Ph.D. (Committee Chair)
Caleb Adler, Ph.D. (Committee Member)
Scott Holland, Ph.D. (Committee Member)
Trent Hummel, M.D. (Committee Member)
Michael Lamba, Ph.D. (Committee Member)
106 p.
Neurology
diffusion tensor imaging; processing speed; white matter integrity; integral biologically effective dose; pediatric brain tumors

Recommended Citations

Citations

  • Makola, M. F. (2017). The Long Term Effects of Radiation Therapy on White Matter Integrity and Information Processing Speed: A Diffusion Tensor Imaging Study in Pediatric Brain Tumor Patients [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504878431395029

    APA Style (7th edition)

  • Makola, Monwabisi. The Long Term Effects of Radiation Therapy on White Matter Integrity and Information Processing Speed: A Diffusion Tensor Imaging Study in Pediatric Brain Tumor Patients. 2017. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504878431395029.

    MLA Style (8th edition)

  • Makola, Monwabisi. "The Long Term Effects of Radiation Therapy on White Matter Integrity and Information Processing Speed: A Diffusion Tensor Imaging Study in Pediatric Brain Tumor Patients." Doctoral dissertation, University of Cincinnati, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1504878431395029

    Chicago Manual of Style (17th edition)

ucin1504878431395029
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This open access ETD is published by University of Cincinnati and OhioLINK.