Radiotherapy-induced vascular cognitive impairment 20 years after childhood brain tumor
Remes, Tiina Maria; Suo-Palosaari, Maria Helena; Arikoski, Pekka Matti; Harila, Marika; Koskenkorva, Päivi Katri Tuulikki; Lähteenmäki, Päivi Maria; Lönnqvist, Tuula Riitta Irmeli; Ojaniemi, Marja Katariina; Pohjasniemi, Heli; Puosi, Riina; Ritari, Niina; Sirkiä, Kirsti Helena; Sutela, Anna Kaarina; Toiviainen-Salo, Sanna-Maria; Rantala, Heikki Markku Johannes; Harila, Arja Helena (2023-09-27)
Oxford University Press
27.09.2023
Tiina Maria Remes, Maria Helena Suo-Palosaari, Pekka Matti Arikoski, Marika Harila, Päivi Katri Tuulikki Koskenkorva, Päivi Maria Lähteenmäki, Tuula Riitta Irmeli Lönnqvist, Marja Katariina Ojaniemi, Heli Pohjasniemi, Riina Puosi, Niina Ritari, Kirsti Helena Sirkiä, Anna Kaarina Sutela, Sanna-Maria Toiviainen-Salo, Heikki Markku Johannes Rantala, Arja Helena Harila, Radiotherapy-induced vascular cognitive impairment 20 years after childhood brain tumor, Neuro-Oncology, Volume 26, Issue 2, February 2024, Pages 362–373, https://doi.org/10.1093/neuonc/noad186
https://rightsstatements.org/vocab/InC/1.0/
© The Author(s) 2023. This is a pre-copyedited, author-produced version of an article accepted for publication in Neuro-oncology following peer review. The version of record Tiina Maria Remes, Maria Helena Suo-Palosaari, Pekka Matti Arikoski, Marika Harila, Päivi Katri Tuulikki Koskenkorva, Päivi Maria Lähteenmäki, Tuula Riitta Irmeli Lönnqvist, Marja Katariina Ojaniemi, Heli Pohjasniemi, Riina Puosi, Niina Ritari, Kirsti Helena Sirkiä, Anna Kaarina Sutela, Sanna-Maria Toiviainen-Salo, Heikki Markku Johannes Rantala, Arja Helena Harila, Radiotherapy-induced vascular cognitive impairment 20 years after childhood brain tumor, Neuro-Oncology, Volume 26, Issue 2, February 2024, Pages 362–373 is available online at: https://doi.org/10.1093/neuonc/noad186.
https://rightsstatements.org/vocab/InC/1.0/
© The Author(s) 2023. This is a pre-copyedited, author-produced version of an article accepted for publication in Neuro-oncology following peer review. The version of record Tiina Maria Remes, Maria Helena Suo-Palosaari, Pekka Matti Arikoski, Marika Harila, Päivi Katri Tuulikki Koskenkorva, Päivi Maria Lähteenmäki, Tuula Riitta Irmeli Lönnqvist, Marja Katariina Ojaniemi, Heli Pohjasniemi, Riina Puosi, Niina Ritari, Kirsti Helena Sirkiä, Anna Kaarina Sutela, Sanna-Maria Toiviainen-Salo, Heikki Markku Johannes Rantala, Arja Helena Harila, Radiotherapy-induced vascular cognitive impairment 20 years after childhood brain tumor, Neuro-Oncology, Volume 26, Issue 2, February 2024, Pages 362–373 is available online at: https://doi.org/10.1093/neuonc/noad186.
https://rightsstatements.org/vocab/InC/1.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202505263928
https://urn.fi/URN:NBN:fi:oulu-202505263928
Tiivistelmä
Abstract
Background:
Studies have established that radiotherapy for childhood brain tumors (BTs) increases the risk of cerebrovascular disease (CVD); however, it is unclear how this will affect cognitive function. This study aimed to investigate the associations between radiotherapy-induced CVD, white matter hyperintensities (WMHs), and neurocognitive outcomes in adult survivors of childhood BTs.
Methods:
In a cross-sectional setting, we conducted a national cohort that included 68 radiotherapy-treated survivors of childhood BTs after a median follow-up of 20 years. Markers of CVD and WMHs were evaluated using brain MRI, and the sum of CVD-related findings was calculated. Additionally, the associations among CVD findings, WMHs, and neuropsychological test results were analyzed.
Results:
Of the 68 childhood BT survivors, 54 (79%) were diagnosed with CVD and/or WMHs at a median age of 27 years. CVD and/or WMHs were associated with lower scores for verbal intelligence quotient, performance intelligence quotient (PIQ), executive function, memory, and visuospatial ability (P < .05). Additionally, survivors with microbleeds had greater impairments in the PIQ, processing speed, executive function, and visuospatial ability (P < .05). WMHs and CVD burden were associated with greater difficulties in memory function and visuospatial ability (P < .05). Small-vessel disease burden was associated with PIQ scores, processing speed, working memory, and visuospatial ability.
Conclusions:
The study results suggest that markers of radiotherapy-induced CVD, the additive effect of CVD markers, and risk factors of dementia are associated with cognitive impairment, which may suggest that the survivors are at a high risk of developing early-onset dementia.
Background:
Studies have established that radiotherapy for childhood brain tumors (BTs) increases the risk of cerebrovascular disease (CVD); however, it is unclear how this will affect cognitive function. This study aimed to investigate the associations between radiotherapy-induced CVD, white matter hyperintensities (WMHs), and neurocognitive outcomes in adult survivors of childhood BTs.
Methods:
In a cross-sectional setting, we conducted a national cohort that included 68 radiotherapy-treated survivors of childhood BTs after a median follow-up of 20 years. Markers of CVD and WMHs were evaluated using brain MRI, and the sum of CVD-related findings was calculated. Additionally, the associations among CVD findings, WMHs, and neuropsychological test results were analyzed.
Results:
Of the 68 childhood BT survivors, 54 (79%) were diagnosed with CVD and/or WMHs at a median age of 27 years. CVD and/or WMHs were associated with lower scores for verbal intelligence quotient, performance intelligence quotient (PIQ), executive function, memory, and visuospatial ability (P < .05). Additionally, survivors with microbleeds had greater impairments in the PIQ, processing speed, executive function, and visuospatial ability (P < .05). WMHs and CVD burden were associated with greater difficulties in memory function and visuospatial ability (P < .05). Small-vessel disease burden was associated with PIQ scores, processing speed, working memory, and visuospatial ability.
Conclusions:
The study results suggest that markers of radiotherapy-induced CVD, the additive effect of CVD markers, and risk factors of dementia are associated with cognitive impairment, which may suggest that the survivors are at a high risk of developing early-onset dementia.
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