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Clinical Article
Correlation between changes of gray matter volume and cognitive function in acute lymphoblastic leukemia children after chemotherapy based on VBM analysis
LI Fangling  GUO Yimin  XU Gaoqiang  LIU Ying  ZHANG Tijiang  CHEN Xiaoxi 

Cite this article as: LI F L, GUO Y M, XU G Q, et al. Correlation between changes of gray matter volume and cognitive function in acute lymphoblastic leukemia children after chemotherapy based on VBM analysis[J]. Chin J Magn Reson Imaging, 2023, 14(1): 72-76. DOI:10.12015/issn.1674-8034.2023.01.013.

[Abstract] Objective To analyze the changes of brain gray matter volume in children with acute lymphoblastic leukemia (ALL) after chemotherapy through voxel-based morphometry (VBM), and to explore the correlation between changes in brain gray matter volume and cognitive function in children with ALL.Materials and Methods A total of 20 children with ALL treated in Affiliated Hospital of Zunyi Medical University were enrolled from March 2021 to July 2022, and all patients completed chemotherapy according to the Chinese Childhood Leukemia Group (CCLG) ALL protocol (version: 2008 and 2018) and Chinese Children's Cancer Group (CCCG) ALL protocol (version: 2015). During the same period, 20 healthy control children were recruited. All subjects underwent 3-dimensional-T1-weighted MR brain images scan, and Chinese Wechsler Intelligence Scale for Children-4th Edition was used to evaluate their cognitive function.Results Compared with the control group, the gray matter volume of right orbital inferior frontal gyrus, right middle frontal gyrus, right superior frontal gyrus, left middle temporal gyrus, left postcentral gyrus, bilateral lingual gyrus and right hippocampal gyrus decreased in the ALL group (P<0.05, FDR correction). In ALL group, gray matter volume of above areas values revealed no significant correlation with the cognitive function parameters (all P>0.05).Conclusions Childhood ALL patients after chemotherapy have multiple brain regions with reduced gray matter volume, but these changes lack association with patients' cognitive function.
[Keywords] acute lymphoblastic leukemia;children;magnetic resonance imaging;voxel-based morphometry;cognitive function

LI Fangling1   GUO Yimin2, 3   XU Gaoqiang1   LIU Ying2, 3   ZHANG Tijiang1   CHEN Xiaoxi1*  

1 Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China

2 Department of Pediatrics, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, China

3 Department of Pediatrics, Guizhou Chlidren's Hospital, Zunyi 563000, China

Corresponding author: Chen XX, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Guizhou Provincial Science and Technology Projects (No. Qian Ke He Jichu〔2020〕1Y347, Qian Ke He Jichu〔2020〕1Y346).
Received  2022-09-16
Accepted  2022-11-29
DOI: 10.12015/issn.1674-8034.2023.01.013
Cite this article as: LI F L, GUO Y M, XU G Q, et al. Correlation between changes of gray matter volume and cognitive function in acute lymphoblastic leukemia children after chemotherapy based on VBM analysis[J]. Chin J Magn Reson Imaging, 2023, 14(1): 72-76. DOI:10.12015/issn.1674-8034.2023.01.013.

INABA H, PUI C H. Advances in the diagnosis and treatment of pediatric acute lymphoblastic leukemia[J/OL]. J Clin Med, 2021, 10(9): 1926 [2022-09-15]. DOI: 10.3390/jcm10091926.
SNODGRASS R, NGUYEN L T, GUO M, et al. Incidence of acute lymphocytic leukemia in Calgary, Alberta, Canada: a retrospective cohort study[J/OL]. BMC Res Notes, 2018, 11(1): 104 [2022-09-15]. DOI: 10.1186/s13104-018-3225-9.
TANG J Y, YU J, CAI J Y, et al. Prognostic factors for CNS control in children with acute lymphoblastic leukemia treated without cranial irradiation[J]. Blood, 2021, 138(4): 331-343. DOI: 10.1182/blood.2020010438.
JEHA S, PEI D Q, CHOI J, et al. Improved CNS control of childhood acute lymphoblastic leukemia without cranial irradiation: st Jude total therapy study 16[J]. J Clin Oncol, 2019, 37(35): 3377-3391. DOI: 10.1200/JCO.19.01692.
ZHOU C D, ZHUANG Y, LIN X J, et al. Changes in neurocognitive function and central nervous system structure in childhood acute lymphoblastic leukaemia survivors after treatment: a meta-analysis[J]. Br J Haematol, 2020, 188(6): 945-961. DOI: 10.1111/bjh.16279.
MOUNIER N M, ABDEL-MAGED A E S, WAHDAN S A, et al. Chemotherapy-induced cognitive impairment (CICI): an overview of etiology and pathogenesis[J/OL]. Life Sci, 2020, 258: 118071 [2022-9-15]. DOI: 10.1016/j.lfs.2020.118071.
VAN DER PLAS E, SCHACHAR R J, HITZLER J, et al. Brain structure, working memory and response inhibition in childhood leukemia survivors[J/OL]. Brain Behav, 2016, 7(2): e00621 [2022-09-15]. DOI: 10.1002/brb3.621.
GENSCHAFT M, HUEBNER T, PLESSOW F, et al. Impact of chemotherapy for childhood leukemia on brain morphology and function[J/OL]. PLoS One, 2013, 8(11): e78599 [2022-09-15]. DOI: 10.1371/journal.pone.0078599.
ZELLER B, TAMNES C K, KANELLOPOULOS A, et al. Reduced neuroanatomic volumes in long-term survivors of childhood acute lymphoblastic leukemia[J]. J Clin Oncol, 2013, 31(17): 2078-2085. DOI: 10.1200/JCO.2012.47.4031.2012.47.4031.
HU J, YANG Z Q, ZHANG J J, et al. Correlation between grey matter volume and motor function in children with periventricular leukomalacia and spastic cerebral palsy: a voxel based morphometry study[J]. Chin J Med Imaging, 2022, 30(1): 12-16, 28. DOI: 10.3969/j.issn.1005-5185.2022.01.003.
ZHANG H C. The revision of WISC-IV Chinese version[J]. Psychol Sci, 2009, 32(5): 1177-1179. DOI: 10.16719/j.cnki.1671-6981.2009.05.026.
WEI K, LIANG Y W, YANG B R, et al. An observational MRI study of methotrexate-treated children with acute lymphoblastic leukemia in remission and subtle cognitive decline[J]. Quant Imaging Med Surg, 2022, 12(4): 2474-2486. DOI: 10.21037/qims-21-748.
LI Y, VIJAYANATHAN V, GULINELLO M, et al. Intrathecal methotrexate induces focal cognitive deficits and increases cerebrospinal fluid homocysteine[J]. Pharmacol Biochem Behav, 2010, 95(4): 428-433. DOI: 10.1016/j.pbb.2010.03.003.
VEZMAR S, BECKER A, BODE U, et al. Biochemical and clinical aspects of methotrexate neurotoxicity[J]. Chemotherapy, 2003, 49(1/2): 92-104. DOI: 10.1159/000069773.
CHEN L L, ZENG X J. Advances in imaging technology of acute lymphoblastic leukemia related neurocognitive impairment[J]. Chin J Med Imaging Technol, 2018, 34(1): 136-139. DOI: 10.13929/j.1003-3289.201704064.
XI Y L, WANG R Z, XU H F, et al. Evalation of cognitive function before and after chemotherapy in children with actue lymphoblastic leukemia using 3.0 T MR diffusion tensor imaging[J]. J Clin Radiol, 2021, 40(4): 783-789. DOI: 10.13437/j.cnki.jcr.2021.04.035.
CAO W G, GAN Y G, ZHAO C L, et al. Diffusion tensor MR imaging in the evaluation of brain in children with acute lymphoblastic leukemia[J]. J Clin Radiol, 2017, 36(7): 1019-1023. DOI: 10.13437/j.cnki.jcr.2017.07.027.
PORTO L, PREIBISCH C, HATTINGEN E, et al. Voxel-based morphometry and diffusion-tensor MR imaging of the brain in long-term survivors of childhood leukemia[J]. Eur Radiol, 2008, 18(11): 2691-2700. DOI: 10.1007/s00330-008-1038-2.
ZOU L W, SU L Z, XU J J, et al. Structural brain alteration in survivors of acute lymphoblastic leukemia with chemotherapy treatment: a voxel-based morphometry and diffusion tensor imaging study[J]. Brain Res, 2017, 1658: 68-72. DOI: 10.1016/j.brainres.2017.01.017.
MORITA T, ASADA M, NAITO E. Right-hemispheric dominance in self-body recognition is altered in left-handed individuals[J]. Neuroscience, 2020, 425: 68-89. DOI: 10.1016/j.neuroscience.2019.10.056.
HAN Y, YANG Q L, ZHAO Y J, et al. Diffusion kurtosis imaging study on changes of brain microstructure and cognitive function in breast cancer survivors with chemotherapy[J]. Chin J Magn Reson Imaging, 2022, 13(4): 111-114. DOI: 10.12015/issn.1674-8034.2022.04.021.
SZCZEPANSKI S M, KNIGHT R T. Insights into human behavior from lesions to the prefrontal cortex[J]. Neuron, 2014, 83(5): 1002-1018. DOI: 10.1016/j.neuron.2014.08.011.
DIXON M L, THIRUCHSELVAM R, TODD R, et al. Emotion and the prefrontal cortex: an integrative review[J]. Psychol Bull, 2017, 143(10): 1033-1081. DOI: 10.1037/bul0000096.
KRULL K R, CHEUNG Y T, LIU W, et al. Chemotherapy pharmacodynamics and neuroimaging and neurocognitive outcomes in long-term survivors of childhood acute lymphoblastic leukemia[J]. J Clin Oncol, 2016, 34(22): 2644-2653. DOI: 10.1200/JCO.2015.65.4574.
ZHOU L, WANG M R, GENG Z J, et al. Differences in the FA value between precentral gyrus and postcentral gyrus during normal brain aging[J]. Hebei Med J, 2018, 40(15): 2309-2312.
XU J P. Functional parcellation of human middle temporal gyrus and its applications to autism spectrum disorders[D]. Shenzhen: Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 2020. DOI: 10.27822/d.cnki.gszxj.2020.000001.
SATO W, TOICHI M, UONO S, et al. Impaired social brain network for processing dynamic facial expressions in autism spectrum disorders[J/OL]. BMC Neurosci, 2012, 13: 99 [2022-09-16]. DOI: 10.1186/1471-2202-13-99.
XU J P, LYU H Q, LI T, et al. Delineating functional segregations of the human middle temporal gyrus with resting-state functional connectivity and coactivation patterns[J]. Hum Brain Mapp, 2019, 40(18): 5159-5171. DOI: 10.1002/hbm.24763.
MONJE M, THOMASON M E, RIGOLO L, et al. Functional and structural differences in the hippocampus associated with memory deficits in adult survivors of acute lymphoblastic leukemia[J]. Pediatr Blood Cancer, 2013, 60(2): 293-300. DOI: 10.1002/pbc.24263.
SHEREMATA S L, SOMERS D C, SHOMSTEIN S. Visual short-term memory activity in parietal lobe reflects cognitive processes beyond attentional selection[J]. J Neurosci, 2018, 38(6): 1511-1519. DOI: 10.1523/JNEUROSCI.1716-17.2017.
ALEXANDER T C, SIMECKA C M, KIFFER F, et al. Changes in cognition and dendritic complexity following intrathecal methotrexate and cytarabine treatment in a juvenile murine model[J]. Behav Brain Res, 2018, 346: 21-28. DOI: 10.1016/j.bbr.2017.12.008.
PALEJWALA A H, DADARIO N B, YOUNG I M, et al. Anatomy and white matter connections of the lingual gyrus and Cuneus[J/OL]. World Neurosurg, 2021, 151: e426-e437 [2022-09-16]. DOI: 10.1016/j.wneu.2021.04.050.
MAVREA K, EFTHYMIOU V, KATSIBARDI K, et al. Cognitive function of children and adolescent survivors of acute lymphoblastic leukemia: a meta-analysis[J/OL]. Oncol Lett, 2021, 21(4): 262 [2022-09-16]. DOI: 10.3892/ol.2021.12523.

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