Evidence map›Paper›PMID 30825966›Full record

Observational studyRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2019

Identifying early diffusion imaging biomarkers of regional white matter injury as indicators of executive function decline following brain radiotherapy: A prospective clinical trial in primary brain tumor patients.

Kathryn R Tringale, Tanya Nguyen, Naeim Bahrami, Deborah C Marshall, Kelly M Leyden, Roshan Karunamuni, Tyler M Seibert, Mary Kay Gorman, Michael Connor, Jeff Burkeen and 4 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
  4. Article
  5. Consolidation Regimen and Cerebral Atrophy in Patients With Primary Central Nervous System Lymphoma.International journal of radiation oncology, biology, physics · 2025
    Article
  6. Evaluation of the potential of diffusion tensor imaging biomarkers in prediction of white matter changes after brain radiation therapy: A systematic review.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2025
    Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Brain diffusion MRI biomarkers after oncology treatments.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2023
    Review
  12. Review
  13. Article
  14. Article
  15. Neurological side effects of radiation therapy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022
    Review
  16. Review
  17. Article
  18. Article
  19. Article
  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Kathryn R TringaleSchool of Medicine, University of California, San Diego, USA.
Tanya NguyenDepartment of Psychiatry, University of California, San Diego, USA.
Naeim BahramiCenter for Multimodal Imaging and Genetics, University of California, San Diego, USA.
Deborah C MarshallDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego, USA.
Kelly M LeydenCenter for Multimodal Imaging and Genetics, University of California, San Diego, USA.
Roshan KarunamuniCenter for Multimodal Imaging and Genetics, University of California, San Diego, USA; Department of Radiation Medicine and Applied Sciences, University of California, San Diego, USA.
Tyler M SeibertCenter for Multimodal Imaging and Genetics, University of California, San Diego, USA; Department of Radiation Medicine and Applied Sciences, University of California, San Diego, USA.
Mary Kay GormanDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego, USA.
Michael ConnorDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego, USA.
Jeff BurkeenDepartment of Radiation Medicine and Applied Sciences, University of California, San Diego, USA.
David E PiccioniDepartment of Neurosciences, University of California, San Diego, USA.
Nikdokht FaridDepartment of Radiology, University of California, San Diego, USA.
Jona A Hattangadi-GluthCenter for Multimodal Imaging and Genetics, University of California, San Diego, USA; Department of Radiation Medicine and Applied Sciences, University of California, San Diego, USA.
Carrie R McDonaldDepartment of Psychiatry, University of California, San Diego, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, USA; Department of Radiation Medicine and Applied Sciences, University of California, San Diego, USA. Electronic address: camcdonald@ucsd.edu.

Funding

San Diego Clinical and Translational Research InstituteUL1TR000100 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S · 2012 to 2015
$19.7M
Multimodal Imaging of Language in the Preoperative Evaluation of EpilepsyR01NS065838 · NINDS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MCDONALD, CARRIE R · 2010 to 2018
$4.4M
UC San Diego Clinical and Translational Research InstituteTL1TR001443 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI DEPP, COLIN A. · 2015 to 2019
$3.4M
San Diego Clinical and Translational Research InstituteKL2TR000099 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S · 2012 to 2014
$1.1M
HSRD VA TPR 15-229NCATS NIH HHS KL2 TR000099NCATS NIH HHS TL1 TR001443NCATS NIH HHS UL1 TR000100NINDS NIH HHS R01 NS065838
6 · The paper itself

Abstract

background and purposeExecutive function (EF) decline is common after brain radiation therapy (RT), yet the etiology is unclear. We analyzed the association between longitudinal changes in frontal lobe white matter microstructure and decline in EF following RT in brain tumor patients on a prospective clinical trial. MATERIALS AND

methodsDiffusion tensor imaging was obtained on 22 patients with brain tumors prior to RT, as well as 3- and 6-months post-RT, in a prospective, observational trial. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated within the superficial white matter (SWM) of the anterior cingulate (AC) and dorsolateral prefrontal cortex. Measures of cognitive flexibility, verbal fluency, and verbal set-shifting were obtained pre- and post-RT. Reliable change indices were calculated to determine significant baseline to 6-month EF changes.

resultsDecreases in FA and increases in MD were observed in the caudal AC (CAC) at 3-months post-RT. CAC changes were characterized by increased RD bilaterally. From baseline to 6-months post-RT, decreased FA and increased MD and RD of the CAC was associated with decline in verbal set-shifting ability, whereas increased MD in the CAC was associated with a decline in cognitive flexibility.

conclusionWhite matter underlying the AC may be particularly vulnerable to radiation effects. Early microstructural loss within AC SWM represents an important biomarker for EF decline, and dose reduction in this region may represent a possibility for cognitive preservation for patients receiving radiotherapy.

Indexed as

BiomarkersBrainBrain NeoplasmsDiffusion Tensor ImagingExecutive FunctionFemaleHumansLongitudinal StudiesMaleMiddle AgedProspective StudiesRadiation InjuriesWhite MatterBiomarkersBrain tumorsExecutive functionNeurocognitionNeuroimagingRadiation therapy

Identifiers

PMID30825966
PMCPMC6400307

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.