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14 April 2005 Neurocognitive correlates of white matter in children surviving cancer: a quantitative MR imaging study
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Due to the inherent risk of central nervous system (CNS) dissemination, children treated for either acute lymphoblastic leukemia (ALL) or malignant brain tumors (BT) receive aggressive CNS therapy. The primary objective of this study was to confirm a previously observed association between reduced volumes of normal-appearing white matter (NAWM) and intellectual and attentional deficits in survivors. A combined MR imaging set consisting of T1, T2, and PD images were collected for 221 children (110 BT; 112 ALL). MR imaging sets were segmented with a hybrid neural network algorithm and volumetric measurements were calculated for five slices centered on the basal ganglia. Summary measures of Overall Index, Omissions, d’ (attentiveness), and beta (risk-taking) were derived from the computer-administered Conners’ Continuous Performance Test (CPT). Age-corrected estimates of Full-Scale IQ (FSIQ) were also obtained. Pearson correlation analyses were performed between each neurocognitive measure and the volume of NAWM. The correlation between FSIQ and NAWM failed to reach statistical significance for the BT group but was highly significant for the more homogeneous ALL group. Larger Omission rates, decreased attentiveness and more risk taking were significantly associated with lower NAWM volumes in both groups of survivors. Long-term survivors are at increased risk for cognitive delays or deficits, which oftentimes impair future academic performance, employment, and quality of life. These long-term adverse effects of treatment appear to be due to a diminished ability to acquire new information and may be secondary to deficits in attention, which is thought to be supported by interhemispheric and intrahemispheric white matter tracts.
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Wilburn E. Reddick, John O. Glass, Zuyao Y. Shan, Shengjie Wu, Susan Helton, and Raymond K. Mulhern "Neurocognitive correlates of white matter in children surviving cancer: a quantitative MR imaging study", Proc. SPIE 5746, Medical Imaging 2005: Physiology, Function, and Structure from Medical Images, (14 April 2005);

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