Child's Nervous System

, Volume 33, Issue 6, pp 965–972 | Cite as

A prospective study of corpus callosum regional volumes and neurocognitive outcomes following cranial radiation for pediatric brain tumors

  • Arif Rashid
  • Ashwin N. Ram
  • Wendy R. Kates
  • Kristin J. Redmond
  • Moody Wharam
  • E. Mark Mahone
  • Alena Horska
  • Stephanie Terezakis
Original Paper
  • 157 Downloads

Abstract

Purpose/objective(s)

Cranial radiation therapy (CRT) may disrupt the corpus callosum (CC), which plays an important role in basic motor and cognitive functions. The aim of this prospective longitudinal study was to assess changes in CC mid-sagittal areas, CC volumes, and performance on neuropsychological (NP) tests related to the CC in children following CRT.

Materials/methods

Twelve pediatric patients were treated with CRT for primary brain malignancies. Thirteen age-matched healthy volunteers served as controls. Brain MRIs and NP assessment emphasizing motor dexterity, processing speed, visuomotor integration, and working memory (visual and verbal) were performed at baseline and at 6, 15, and 27 months following completion of CRT. Linear mixed effects (LME) analyses were used to evaluate patient NP performance and changes in regional CC volumes (genu, anterior body, mid-body, posterior body, and splenium) and mid-sagittal areas over time and with radiation doses, correcting for age at CRT start.

Results

The mean age at CRT was 9.41 (range 1.2–15.7) years. The median prescription dose was 54 (range 18–59.4) Gy. LME analysis revealed a significant decrease in overall CC volumes over time (p < 0.00001), with no overall effect of radiation dose. Analysis of individual CC regions demonstrated a significant decrease in all regional volumes over time (p < 0.00001) in patients, with no effect of radiation dose. Only in the splenium was there a trend toward a dose-dependent effect (p = 0.093). Patients had significantly reduced NP performance across visits—most notably in motor dexterity and visual working memory (both p < 0.0001).

Conclusions

These prospective data demonstrate a significant decrease in CC regional volumes after CRT, with associated decline in neurocognitive function, most notably in manual dexterity, attention, and working memory. Further prospective study of larger cohorts of patients is needed to establish the relationship between CRT dose, neuroanatomical, and functional changes in the CC.

Keywords

CNS tumors Radiation therapy Neurocognitive side effects Neurotoxicity of therapy Volumetric MRI 

Notes

Compliance with ethical standards

This prospective study was approved by the Institutional Review Board. Written informed consent was obtained from participating families before enrollment.

Conflict of interest

None to declare.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of Radiation Oncology and Molecular Radiation SciencesThe Sidney Kimmel Comprehensive Cancer Center at Johns HopkinsBaltimoreUSA
  2. 2.Russell H. Morgan Department of Radiology and Radiological ScienceBaltimoreUSA
  3. 3.Department of NeuropsychologyKennedy Krieger InstituteBaltimoreUSA
  4. 4.Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreUSA
  5. 5.Department of Psychiatry and Behavioral SciencesState University of New York at Upstate Medical UniversitySyracuseUSA

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