title: Cortical surface area and thickness in adult survivors of pediatric acute lymphoblastic leukemia.
abstract: BACKGROUND
  Advances in the treatment of acute lymphoblastic leukemia (ALL) have led to great improvements in survival rates and outcomes, but there is concern about cognitive late effects. We aimed to determine whether ALL survivors have smaller cortical surface area and/or thickness, and test whether this is related to disease and treatment variables and self-reported executive functioning in everyday life.
  
  
  METHODS
  Magnetic resonance imaging (MRI) scans from 130 adult long-term survivors of childhood ALL (age: 18-46 years; age at diagnosis: 0-16 years; years since diagnosis: 7-40) and 130 healthy controls were assessed to estimate and compare regional cortical surface area and thickness. Information on disease and treatment factors were obtained from patients' records, and executive functioning in survivors was measured using a validated questionnaire (BRIEF-A).
  
  
  RESULTS
  Smaller cortical surface area was observed in several regions in both cerebral hemispheres in ALL survivors. In these regions, mean surface area was 4.1-5.5% smaller in ALL survivors compared to healthy controls. In contrast, only one region showed lower cortical thickness in ALL survivors. There were no significant associations between cortical surface area/thickness in these regions and disease or treatment variables. In ALL survivors, smaller surface area in prefrontal regions, encompassing parts of the superior frontal gyri and the left anterior cingulate cortex, was associated with problems in executive functioning, specifically with emotional control and self-monitoring.
  
  
  CONCLUSIONS
  ALL survivors had smaller surface area in several cortical regions and smaller surface area in prefrontal regions was associated with reported problems in executive functioning.
authors.affiliation: Research Group for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Norway.
authors.forename: Christian K
authors.initials: CK
authors.lastname: Tamnes
authors.forename: Bernward
authors.initials: B
authors.lastname: Zeller
authors.forename: Inge K
authors.initials: IK
authors.lastname: Amlien
authors.forename: Adriani
authors.initials: A
authors.lastname: Kanellopoulos
authors.forename: Stein
authors.initials: S
authors.lastname: Andersson
authors.forename: Paulina
authors.initials: P
authors.lastname: Due-Tønnessen
authors.forename: Ellen
authors.initials: E
authors.lastname: Ruud
authors.forename: Kristine B
authors.initials: KB
authors.lastname: Walhovd
authors.forename: Anders M
authors.initials: AM
authors.lastname: Fjell
mesh_terms: D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D056344:Executive Function; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000401:mortality / Q000473:pathology*; D017741:Survivors
keywords: MRI; cancer; cerebral cortex; chemotherapy; executive function; late effects