TY - JOUR
T1 - Radiation-induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction
AU - Ding, Zhongxiang
AU - Zhang, Han
AU - Lv, Xiao Fei
AU - Xie, Fei
AU - Liu, Lizhi
AU - Qiu, Shijun
AU - Li, Li
AU - Shen, Dinggang
N1 - Funding Information:
Zhongxiang Ding, Han Zhang, and Xiao-Fei Lv contributed equally to this work. Contract grant sponsor: Natural Science Foundation of China; Contract grant numbers: 81401399, 81401395, 81271517, 81201156; Contract grant sponsor: Fundamental Research Funds for the Central Universities; Contract grant number: 15ykpy35; Contract grant sponsor: Medical Scientific Research Foundation of Guangdong Province; Contract grant number: B2014162; Contract grant sponsor: Zhejiang Provincial Natural Science Foundation of China; Contract grant numbers: LY16H180007, LY13H180016; Contract grant sponsor: National Key Technology R&D Program of China; Contract grant number: 2014BAI04B05; Contract grant sponsor: Science Foundation from the Health Commission of Zhe-jiang Province; Contract grant number: 201342245; 2013RCA001.; Contract grant sponsor: National Institutes of Health (NIH);
Funding Information:
Contract grant number: EB022880; AG041721; AG049371; AG042599; Contract grant sponsor: Health & Medical Collaborative Innovation Project of Guangzhou City; Contract grant number: 201604020003 *Correspondence to: Prof. Dinggang Shen, PhD; Biomedical Research Imaging Center, CB #7513, 130 Mason Farm Road, Chapel Hill, NC 27599, USA. E-mail: dgshen@med.unc.edu or Prof. Li Li, MD, PhD, 651 Dongfeng Road East, Guangzhou 510060, China. E-mail: li2@mail.sysu.edu.cn Received for publication 18 November 2016; Revised 7 July 2017; Accepted 9 October 2017. DOI: 10.1002/hbm.23852 Published online 23 October 2017 in Wiley Online Library (wileyonlinelibrary.com).
PY - 2018/1
Y1 - 2018/1
N2 - Radiation therapy, a major method of treatment for brain cancer, may cause severe brain injuries after many years. We used a rare and unique cohort of nasopharyngeal carcinoma patients with normal-appearing brains to study possible early irradiation injury in its presymptomatic phase before severe, irreversible necrosis happens. The aim is to detect any structural or functional imaging biomarker that is sensitive to early irradiation injury, and to understand the recovery and progression of irradiation injury that can shed light on outcome prediction for early clinical intervention. We found an acute increase in local brain activity that is followed by extensive reductions in such activity in the temporal lobe and significant loss of functional connectivity in a distributed, large-scale, high-level cognitive function-related brain network. Intriguingly, these radiosensitive functional alterations were found to be fully or partially recoverable. In contrast, progressive late disruptions to the integrity of the related far-end white matter structure began to be significant after one year. Importantly, early increased local brain functional activity was predictive of severe later temporal lobe necrosis. Based on these findings, we proposed a dynamic, multifactorial model for radiation injury and another preventive model for timely clinical intervention. Hum Brain Mapp 39:407–427, 2018.
AB - Radiation therapy, a major method of treatment for brain cancer, may cause severe brain injuries after many years. We used a rare and unique cohort of nasopharyngeal carcinoma patients with normal-appearing brains to study possible early irradiation injury in its presymptomatic phase before severe, irreversible necrosis happens. The aim is to detect any structural or functional imaging biomarker that is sensitive to early irradiation injury, and to understand the recovery and progression of irradiation injury that can shed light on outcome prediction for early clinical intervention. We found an acute increase in local brain activity that is followed by extensive reductions in such activity in the temporal lobe and significant loss of functional connectivity in a distributed, large-scale, high-level cognitive function-related brain network. Intriguingly, these radiosensitive functional alterations were found to be fully or partially recoverable. In contrast, progressive late disruptions to the integrity of the related far-end white matter structure began to be significant after one year. Importantly, early increased local brain functional activity was predictive of severe later temporal lobe necrosis. Based on these findings, we proposed a dynamic, multifactorial model for radiation injury and another preventive model for timely clinical intervention. Hum Brain Mapp 39:407–427, 2018.
KW - amplitude of low-frequency fluctuations
KW - diffusion tensor imaging
KW - functional connectivity
KW - functional magnetic resonance imaging
KW - irradiation injury
KW - nasopharyngeal carcinoma
KW - prognosis
KW - radiation therapy
KW - resting state
KW - structural connectivity
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U2 - 10.1002/hbm.23852
DO - 10.1002/hbm.23852
M3 - Article
C2 - 29058342
AN - SCOPUS:85037069677
VL - 39
SP - 407
EP - 427
JO - Human Brain Mapping
JF - Human Brain Mapping
SN - 1065-9471
IS - 1
ER -