White matter fractional anisotropy correlates with speed of processing and motor speed in young childhood cancer survivors.
OBJECTIVE
To determine whether childhood medulloblastoma and acute lymphoblastic leukemia (ALL) survivors have decreased white matter fractional anisotropy (WMFA) and whether WMFA is related to the speed of processing and motor speed.


METHODS
For this study, 17 patients (6 medulloblastoma, 5 ALL treated with high-dose methotrexate (MTX) (4 x 5 g/m(2)) and 6 with low-dose MTX (3 x 2 g/m(2))) and 17 age-matched controls participated. On a 3.0-T magnetic resonance imaging (MRI) scanner, diffusion tensor imaging (DTI) was performed, and WMFA values were calculated, including specific regions of interest (ROIs), and correlated with the speed of processing and motor speed.


RESULTS
Mean WMFA in the patient group, mean age 14 years (range 8.9 - 16.9), was decreased compared with the control group (p = 0.01), as well as WMFA in the right inferior fronto-occipital fasciliculus (IFO) (p = 0.03) and in the genu of the corpus callosum (gCC) (p = 0.01). Based on neurocognitive results, significant positive correlations were present between processing speed and WMFA in the splenium (sCC) (r = 0.53, p = 0.03) and the body of the corpus callosum (bCC) (r = 0.52, p = 0.03), whereas the right IFO WMFA was related to motor speed (r = 0.49, p < 0.05).


CONCLUSIONS
White matter tracts, using a 3.0-T MRI scanner, show impairment in childhood cancer survivors, medulloblastoma survivors, and also those treated with high doses of MTX. In particular, white matter tracts in the sCC, bCC and right IFO are positively correlated with speed of processing and motor speed.
Aukema
Eline J
EJ
Pediatric Psychosocial Department, Emma Children's Hospital/Academic Medical Center, Amsterdam, The Netherlands. e.j.aukema@amc.uva.nl
Caan
Matthan W A
MW
Oudhuis
Nienke
N
Majoie
Charles B L M
CB
Vos
Frans M
FM
Reneman
Liesbeth
L
Last
Bob F
BF
Grootenhuis
Martha A
MA
Schouten-van Meeteren
Antoinette Y N
AY
D000293:Adolescent; D000704:Analysis of Variance; D016880:Anisotropy; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects; D001932:Brain Neoplasms / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D016022:Case-Control Studies; D002648:Child; D003337:Corpus Callosum / Q000187:drug effects / Q000503:physiopathology; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006801:Humans; D007360:Intelligence / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D020772:Internal Capsule / Q000187:drug effects / Q000503:physiopathology / Q000528:radiation effects; D008527:Medulloblastoma / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D008606:Mental Processes / Q000187:drug effects / Q000502:physiology*; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy / Q000503:physiopathology* / Q000532:radiotherapy; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D017741:Survivors
D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate