Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-25T10:37:43.764Z Has data issue: false hasContentIssue false
  • English
  • Français

Attentional functioning and white matter integrity among survivors of malignant brain tumors of childhood

Published online by Cambridge University Press:  01 March 2004

RAYMOND K. MULHERN ,
HOLLY A. WHITE ,
JOHN O. GLASS ,
LARRY E. KUN ,
LAURIE LEIGH ,
STEPHEN J. THOMPSON  and
WILBURN E. REDDICK
RAYMOND K. MULHERN
Affiliation:
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee Department of Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee
HOLLY A. WHITE
Affiliation:
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
JOHN O. GLASS
Affiliation:
Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee Departments of Electrical and Computer Engineering and Biomedical Engineering, University of Memphis, Memphis, Tennessee
LARRY E. KUN
Affiliation:
Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee Department of Pediatrics, University of Tennessee College of Medicine, Memphis, Tennessee
LAURIE LEIGH
Affiliation:
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
STEPHEN J. THOMPSON
Affiliation:
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee Division of Neurology, St. Jude Children's Research Hospital, Memphis, Tennessee
WILBURN E. REDDICK
Affiliation:
Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee Departments of Electrical and Computer Engineering and Biomedical Engineering, University of Memphis, Memphis, Tennessee
Get access Rights & Permissions [Opens in a new window]

Abstract

Children surviving treatment for malignant brain tumors commonly have problems maintaining their premorbid levels of intellectual development and academic achievement. Our group has been especially interested in the effects of treatment on normal appearing white matter (NAWM) on MRI and the influence of NAWM volumes on neurocognitive functioning. The present study assessed NAWM and attentional abilities among 37 long-term survivors of malignant brain tumors, ranging in age from 1.7 to 14.8 (Mdn = 6.5) years at diagnosis, who had been treated with cranial radiation therapy with or without chemotherapy 2.6 to 15.3 (Mdn = 5.7) years earlier. On the Conners' Continuous Performance Test, the Overall Index and 7 of the other 10 indices were significantly deficient compared to age- and gender-corrected normative values. After statistically controlling for the effects of age at diagnosis and time elapsed from treatment, 5 of the 8 indices were significantly associated with cerebral white matter volumes and/or specific regional white matter volumes of the prefrontal/frontal lobe and cingulate gyrus. No gender effects were observed. The results of the present study further support the contention that NAWM is an important substrate for treatment-induced neurocognitive problems among survivors of malignant brain tumors of childhood. (JINS, 2004, 10, 180–189.)

Keywords

Childhood cancerAttentionWhite matter
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 10 , Issue 2 , March 2004 , pp. 180 - 189
Copyright
© 2004 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Andreason, N.C., Flaum, M., Swayze, V., O'Leary, D.S., Alliger, R., Cohen, G., Ehrhardt, J., & Yuh, W.T.C. (1993). Intelligence and brain structure in normal individuals. American Journal of Psychiatry, 15, 130–134.Google Scholar
Baddeley, A.D. (1996). Exploring the central executive. Quarterly Journal of Experimental Psychology, 49, 5–28.Google Scholar
Banich, M.T., Milham, M.P., Atchley, R.A., Cohen, N.J., Webb, W., Wszalek, T., Kramer, A.F., Liang, Z., Barad, V., Gullett, D., Shah, C., & Brown, C. (2000). Prefrontal regions play a predominant role in imposing an attentional ‘set’: Evidence from fMRI. Cognitive Brain Research, 10, 1–9.Google Scholar
Brouwers, P., Riccardi, R., Poplack, D., & Fedio, P. (1984). Attentional deficits in long-term survivors of childhood acute lymphoblastic leukemia (ALL). Journal of Clinical Neuropsychology, 6, 325–336.Google Scholar
Butler, R.W. & Copeland, D.R. (2002). Attentional processes and their remediation in children treated for cancer: A literature review and the development of a therapeutic approach. Journal of the International Neuropsychological Society, 8, 115–124.CrossRefGoogle Scholar
Cabeza, R. & Nyberg, L. (2000). Imaging Cognition II: An empirical review of 275 PET and fMRI studies. Journal of Cognitive Neuroscience, 12, 1–47.Google Scholar
Carlson, C.L. & Mann, M. (2002). Sluggish cognitive tempo predicts a different pattern of impairment in the attention deficit hyperactivity disorder, predominately inattentive type. Journal of Clinical Child and Adolescent Psychology, 31, 123–129.CrossRefGoogle Scholar
Casey, B.J., Giedd, J.N., & Thomas, K.M. (2000). Structural and functional brain development and its relation to cognitive development. Biological Psychology, 54, 241–257.Google Scholar
Casey, B.J., Trainor, R.J., Orendi, J.L., Shubert, A.B., Nystrom, L.E., Giedd, J.N., Castellanos, F.X., Haxby, J.V., Noll, D.C., Cohen, J.D., Forman, S.D., Dahl, R.E., & Rapoport, J.L. (1997). A developmental functional MRI study of prefrontal activation during performance of a go-no-go tasks. Journal of Cognitive Neuroscience, 9, 835–847.CrossRefGoogle Scholar
Castellanos, F.X., Giedd, J.M.N., Marsh, W.L., Hamburger, S.D., Vaituzis, A.C., Dickstein, D.P., Sarfatti, S.E., Vauss, Y.C., Snell, J.W., Lange, N., Kaysen, D., Krain, A.L., Ritchie, G.F., Rajapakse, J.C., & Rapoport, J.L. (1996). Quantitative brain magnetic resonance imaging in attention deficit hyperactivity disorder. Archives of General Psychiatry, 53, 607–616.Google Scholar
Castellanos, F.X., Lee, P.L., Sharp, W., Jeffries, N.O., Greenstein, D.K., Clasen, L.S., Blumenthal, J.D., James, R.S., Ebens, C.L., Walter, J.M., Zijdenbos, A., Evans, A.C., Giedd, J.N., & Rapoport, J.L. (2002). Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Medical Association, 288, 1740–1748.CrossRefGoogle Scholar
Conners, C.K. (1995). The Conners' Continuous Performance Test. Toronto, Canada: Multi-Health Systems.
Delis, D., Kramer, J., Kaplan, E., & Ober, B.A. (1994). California Verbal Learning Test for Children. New York: Harcourt, Brace, Jovanovich, Inc.
Espy, K., Moore, K.M., Kaufman, P.M., Kramer, J.H., Matthay, K., & Hutter, J.J. (2001). Chemotherapeutic CNS prophylaxis and neuropsychologic change in children with acute lymphoblastic leukemia: A prospective study. Journal of Pediatric Psychology, 26, 1–9.Google Scholar
Filley, C.M. & Kleinschmidt-DeMasters, B.K. (2001). Toxic leukoencephalopathy. New England Journal of Medicine, 345, 425–432.CrossRefGoogle Scholar
Filipek, P.A., Semrud-Clikeman, M., Steingard, R.J., Renshaw, P.F., Kennedy, D.N., & Biederman, J. (1997). Volumetric MRI analysis comparing subjects having attention deficit hyperactivity disorder with normal controls. Neurology, 48, 589–601.Google Scholar
Fletcher, J.M. (1998). Attention in children: Conceptual and methodological issues. Child Neuropsychology, 4, 81–86.Google Scholar
Glass, J.O., Ji, Q., & Glas, L.S., & Reddick, W.E. (in press). Prediction of total cerebral tissue volumes in normal appearing brain from sub-sampled segmentation volumes. Magnetic Resonance Imaging.
Gunning-Dixon, F.M. & Raz, N. (2000). The cognitive correlates of white matter abnormalities in normal aging: A quantitative review. Neuropsychology, 14, 224–232.CrossRefGoogle Scholar
Guttmann, C.R.G., Jolesz, F.A., Kikinis, R., Killiany, R.J., Moss, M.B., Sandor, T., & Albert, M.S. (1998). White matter changes with normal aging. Neurology, 50, 972–978.CrossRefGoogle Scholar
Hager, F., Volz, H., Gaser, C., Mentzel, H., Kaiser, W.A., & Sauer, H. (1998). Challenging the anterior attentional system with a continuous performance task: A functional magnetic resonance imaging approach. European Archives of Psychiatry and Clinical Neuroscience, 248, 161–170.Google Scholar
Hopewell, J.W. & van der Kogel, A.J. (1999). Pathophysiological mechanisms leading to the development of late radiation-induced damage to the central nervous system. Frontiers of Radiation Therapy in Oncology, 33, 265–275.Google Scholar
Inzitari, D. (2000). Age-related white matter changes and cognitive impairment. Annals of Neurology, 47, 141–143.Google Scholar
Lockwood, K.A., Bell, T.S., & Colegrove, R.W. (1999). Long-term effects of cranial radiation therapy on attention functioning in survivors of childhood leukemia. Journal of Pediatric Psychology, 24, 55–66.CrossRefGoogle Scholar
Mostow, E.N., Byrne, J., Connelly, R.R., & Mulvihill, J.J. (1991). Quality of life in long-term survivors of CNS tumors of childhood and adolescence. Journal of Clinical Oncology, 9, 592–599.Google Scholar
Mulhern, R.K., Hancock, J., Fairclough, D.L., & Kun, L.E. (1992). Neuropsychological status of children treated for brain tumors: A critical review and integrative analysis. Medical and Pediatric Oncology, 20, 181–191.CrossRefGoogle Scholar
Mulhern, R.K., Kepner, J.L., Thomas, P.R., Armstrong, F.D., Friedman, H.S., & Kun, L.E. (1998). Neuropsychologic functioning of survivors of childhood medulloblastoma randomized to receive conventional or reduced-dose craniospinal irradiation: a pediatric oncology group study. Journal of Clinical Oncology, 16, 1723–1728.Google Scholar
Mulhern, R.K., Reddick, W.E., Palmer, S.L., Glass, J., Elkin, D., Kun, L.E., Taylor, J., Langston, J., & Gajjar, A. (1999). Neurocognitive deficits in medulloblastoma survivors and white matter loss. Annals of Neurology, 46, 834–841.Google Scholar
Mulhern, R.K., Palmer, S.L., Reddick, W.E., Glass, J.O., Kun, L.E., Taylor, J., Langston, J., & Gajjar, A. (2001). Risks of young age for selected neurocognitive deficits in medulloblastoma are associated with white matter loss. Journal of Clinical Oncology, 19, 472–479.Google Scholar
Palmer, S.L., Goloubeva, O., Reddick, W.E., Glass, J.O., Gajjar, A., Kun, L.E., Merchant, T.E., & Mulhern, R.K. (2001). Patterns of intellectual development among survivors of pediatric medulloblastoma: A longitudinal analysis. Journal of Clinical Oncology, 19, 2302–2308.Google Scholar
Posner, M.I. & DiGirolamo, G.J. (1998). Executive attention: Conflict, target detection, and cognitive control. In R. Parasuraman (Ed.), The attentive brain (pp. 401–423). Cambridge, MA: MIT Press.
Posner, M.I. & Peterson, S.E. (1990). The attention system of the human brain. Annual Review of Neuroscience, 13, 25–42.Google Scholar
Reddick, W.E., Glass, J.O., Cook, E.N., Elkin, T.D., & Deaton, R. (1997). Automated segmentation and classification of multispectral magnetic resonance images of brain using artifical neural networks. IEEE Transactions in Medical Imaging, 16, 911–918.CrossRefGoogle Scholar
Reddick, W.E., Mulhern, R.K., Elkin, T.D., Glass, J.O., Merchant, T.E., & Langston, J.W. (1998). A hybrid neural network analysis of subtle brain volume differences in children surviving brain tumors. Magnetic Resonance Imaging, 16, 413–421.CrossRefGoogle Scholar
Reddick, W.E., Russell, J.M., Glass, J.O., Xiong, X., Mulhern, R.K., Langston, J.W., Merchant, T.E., Kun, L.E., & Gajjar, A. (2000). Subtle white matter volume differences in children treated for medulloblastoma with conventional or reduced-dose cranial-spinal irradiation. Magnetic Resonance Imaging, 18, 787–793.CrossRefGoogle Scholar
Reddick, W.E., White, H.A., Glass, J.O., Wheeler, G.C., Thompson, S.J., Gajjar, A., Leigh, L., & Mulhern, R.K. (2003). Developmental model relating white matter volume with neurocognitive deficits in pediatric brain tumor survivors. Cancer, 97, 2512–2519.Google Scholar
Reiss, A.L., Abrams, M.T., Singer, H.S., Ross, J.L., & Denckla, M.B. (1996). Brain development, gender and IQ in children: A volumetric imaging study. Brain, 119, 1763–1774.Google Scholar
Ris, M.D. & Noll, R.B. (1994). Long-term neurobehavioral outcome in pediatric brain tumor patients: Review and methodological critique. Journal of Clinical and Experimental Neuropsychology, 16, 21–42.Google Scholar
Ris, M.D., Packer, R., Goldwein, J., Jones-Wallace, D., & Boyett, J. (2001). Intellectual outcome after reduced-dose radiation therapy plus adjuvant chemotherapy for medulloblastoma: A Children's Cancer Group Study. Journal of Clinical Oncology, 19, 3470–3476.Google Scholar
Rodgers, J., Horrocks, J., Britton, P.G., & Kernathan, J. (1999). Attentional ability among survivors of leukaemia. Archive of Disease in Childhood, 80, 318–323.Google Scholar
Roman, D.D. & Sperduto, P.W. (1995). Neuropsychological effects of cranial radiation: current knowledge and future directions. International Journal of Radiation Oncology and Biological Physics, 31, 983–998.CrossRefGoogle Scholar
Schatz, F., Kramer, J.H., Ablin, A., & Matthay, K.K. (2000). Processing speed, working memory and IQ: A developmental model of cognitive deficits following cranial radiation therapy. Neuropsychology, 14, 189–200.CrossRefGoogle Scholar
Thompson, S., Leigh, L., Christensen, R., Xiong, X., Kun, L.E., Heideman, R., Reddick, W.E., Gajjar, A., Merchant, T., Pui, C.H., Hudson, M.M., & Mulhern, R.K. (2001). Immediate neurocognitive effects of methylphenidate on learning-impaired survivors of childhood cancer. Journal of Clinical Oncology, 19, 1802–1808.Google Scholar
Walter, A., Mulhern, R.K., Gajjar, A., Heideman, R., Reardon, D., Sanford, R.A., Xiong, X., & Kun, L.E. (1999). Survival and neurodevelopmental outcome of young children with medulloblastoma at St. Jude Children's Research Hospital. Journal of Clinical Oncology, 17, 3720–3728.Google Scholar
Wechsler, D. (1997). Wechsler Intelligence Test for Children Third Edition. New York: The Psychological Corporation.