Working memory in survivors of childhood acute lymphocytic leukemia: functional neuroimaging analyses.
BACKGROUND
Research on the physical and psychological late effects of treatment of childhood cancer has led to the identification of significant long-term neurocognitive deficits experienced by some survivors, particularly in the areas of memory and executive functioning. Despite indications of deficits based on cognitive assessment, the identification of specific mechanisms of neurocognitive deficits using neuroimaging techniques has yet to be adequately considered.


METHODS
This study used functional neuroimaging techniques to examine working memory and executive functioning deficits of survivors of childhood acute lymphocytic leukemia (ALL), as compared to age- and gender-matched healthy controls.


RESULTS
There was a trend for ALL survivors to perform more poorly on a working memory task in terms of overall accuracy. Additionally, survivors displayed significantly greater activation in areas underlying working memory (dorsolateral and ventrolateral prefrontal cortex) and error monitoring (dorsal and ventral anterior cingulate cortex).


CONCLUSIONS
These results support the theory of compensatory activation in necessary brain regions in order to complete tasks in pediatric ALL survivors, similar to that observed in multiple sclerosis patients. Concurrent examination of testing and brain imaging enables the connection of behavioral observations with underlying neurological characteristics of deficits in survivors and may help provide insight into mechanisms through which deficits appear.
Robinson
Kristen E
KE
Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee 37203, USA. kristen.e.robinson@vanderbilt.edu
Livesay
Katherine L
KL
Campbell
Laura K
LK
Scaduto
Mary
M
Cannistraci
Christopher J
CJ
Anderson
Adam W
AW
Whitlock
James A
JA
Compas
Bruce E
BE
D000293:Adolescent; D017668:Age of Onset; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects*; D001931:Brain Mapping; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000009:adverse effects; D005260:Female; D006801:Humans; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000139:chemically induced*; D008570:Memory, Short-Term / Q000187:drug effects*; D008727:Methotrexate / Q000009:adverse effects; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma; D017741:Survivors
D000970:Antineoplastic Agents; D003561:Cytarabine; D008727:Methotrexate