Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 407-427 |
| Number of pages | 21 |
| Journal | Human Brain Mapping |
| Volume | 39 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2018 Jan 1 |
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Keywords
- amplitude of low-frequency fluctuations
- diffusion tensor imaging
- functional connectivity
- functional magnetic resonance imaging
- irradiation injury
- nasopharyngeal carcinoma
- prognosis
- radiation therapy
- resting state
- structural connectivity
ASJC Scopus subject areas
- Anatomy
- Radiological and Ultrasound Technology
- Radiology Nuclear Medicine and imaging
- Neurology
- Clinical Neurology
Cite this
Radiation-induced brain structural and functional abnormalities in presymptomatic phase and outcome prediction. / Ding, Zhongxiang; Zhang, Han; Lv, Xiao Fei; Xie, Fei; Liu, Lizhi; Qiu, Shijun; Li, Li; Shen, Dinggang.
In: Human Brain Mapping, Vol. 39, No. 1, 01.01.2018, p. 407-427.Research output: Contribution to journal › Article
}
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
PY - 2018/1/1
Y1 - 2018/1/1
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
UR - http://www.scopus.com/inward/record.url?scp=85037069677&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85037069677&partnerID=8YFLogxK
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 -