ArticleQuantitative imaging in medicine and surgery2025
Cortical morphological alterations and structural covariant network topology changes in children with acute lymphoblastic leukemia.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The mechanisms underlying chemotherapy-induced cognitive impairment (CICI) and structural brain changes in children with acute lymphoblastic leukemia (ALL) remain unclear. This study investigated early chemotherapy-induced alterations in cortical morphology and structural covariance network (SCN) reorganization in children with ALL. Methods: In total, 26 children (7.07±3.09 years old) with ALL were included in the study. A surface-based morphometry (SBM) analysis was carried out to estimate changes in cortex morphology in the children with ALL. A statistical analysis of cortical morphological changes using the paired Results: On days 46-52 of chemotherapy, the cortical thickness of multiple brain regions in children with ALL became extensively thinner (cluster size ≥50, P<0.05, FWE corrected). The gyrification index was reduced in the bilateral frontal lobe and right insula. A fractal dimension reduction was observed in the left inferior medial frontal gyrus. The degree (Deg) in the left supplementary motor area (LSMA; P=0.029) increased, and the betweenness (Bet) in the left precuneus (LPCUN) decreased (P=0.034). However, no statistically significant differences were found between the other parameters, including the clustering coefficient (Cp; P=0.159), local efficiency (Eloc; P=0.325), characteristic path length (P=0.522), global efficiency (Eg; P=0.702), assortativity (P=0.956), transitivity (P=0.753), and modularity (P=0.628). The absence of contemporaneous neurocognitive assessments precluded the exploration of relationships between cortical morphological alterations/SCN changes and neurocognition. Conclusions: On days 46-52 of chemotherapy, changes in the morphology of the cerebral cortex, and changes in the Deg, Bet, and hub values in the SCN were already present in children with ALL. The bilateral frontal lobe may be the most susceptible brain region for CICI among children with ALL. These results appear to suggest that the topological properties in the brains of these children were reorganized as a compensatory mechanism after chemotherapy.
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