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Developmental
model relating white matter volume to neurocognitive deficits in pediatric brain
tumor survivors
Reddick WE, White HA, Glass JO, Wheeler GC, Thompson SJ, Gajjar A, Leigh L,
Mulhern RK
Department of Diagnostic Imaging, St. Jude Children's Research
Hospital, Memphis, Tennessee 38105, USA. gene.reddick@stjude.org
Background. The primary objective of this study was to test the
hypothesis that, among survivors of pediatric brain tumors, the association
between reduced volumes of normal-appearing white matter (NAWM) and
intellectual/academic achievement deficits can be explained by patient problems
with memory and attention.
Methods.
Quantitative tissue volumes from magnetic resonance imaging scans and
neurocognitive assessments were obtained for 40 long-term survivors of pediatric
brain tumors.
They were treated with radiotherapy (RT) with or without chemotherapy 2.6-15.3
years earlier (median, 5.7 years) at an age of 1.7-14.8 years (median, 6.5
years).
Neurocognitive assessments included standardized tests of intellect
(intelligence quotient [IQ]), attention, memory, and academic achievement.
Results.
Analyses revealed significant impairments in patients' neurocognitive test
performance on all measures.
After statistically controlling for age at RT and time from RT, significant
associations were found between NAWM volumes and both attentional abilities and
IQ, and between attentional abilities and IQ.
Subsequent analyses supported the hypothesis that attentional abilities, but not
memory, could explain a significant amount of the relationship between NAWM and
IQ.
The final developmental model predicting academic achievement based on NAWM,
attentional abilities, and IQ explained approximately 60% of the variance in
reading and spelling and almost 80% of the variance in math.
Conclusions.
The authors demonstrated that the primary consequence of reduced NAWM among
pediatric patients treated for brain tumors was decreased attentional abilities,
leading to declining IQ and academic achievement.
Copyright 2003 American Cancer Society.
PMID: 12733151 [PubMed - indexed for MEDLINE]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12733151
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