Radiation Induced Alterations in Resting State Brain Networks in Pediatric Brain Tumor Patients

Washington University School of Medicine16 enrolled

Overview

With modern therapy, the survival rate for pediatric brain tumor patients has significantly improved, with over 70% of patients surviving their disease. However, this progress often comes at the cost of substantial morbidity, with cognitive deficits being the primary obstacle to independent living. Robust predictors of cognitive decline and a comprehensive understanding of the underlying mechanisms of cognitive injury remain elusive. This study will prospectively investigate alterations in brain resting state networks following radiation therapy using functional imaging. The hypothesis is that radiation therapy leads to dose-dependent alterations in functional connectivity in the networks associated with higher level cognition, ultimately leading to cognitive decline.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Brain Tumor, Primary

Interventions

Cognitive testingOTHER

NIH Toolbox Cognitive Battery and the Novel Cognitive Measure (NCM)

Eligibility

Sex: ALLMin age: 8 YearsMax age: 21 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Between 8 and 21 years of age, inclusive * Newly diagnosed primary brain tumor of any location and any histology that will be treated with proton radiation therapy * Life expectancy of at least one year * Able to understand and willing to consent or assent to the research proposed (or that of a legally authorized representative, if applicable), along with consent of legal guardian(s) if applicable Exclusion Criteria: * Presence of visual impairment to an extent that the patient is unable to complete the computer testing * Contraindication to MRI scan (i.e. due to cardiac pacemaker) * Presence of programmable shunt or dental braces * Requires sedation for MRI scans

Outcomes

Primary Outcomes

Radiation induced effects on functional brain resting state connectivity

The investigators will compare resting state maps of each patient pre- and post-radiation therapy. The investigators will evaluate changes in the resting state architecture and compare to the average results that would be expected from a patient in the same age and sex.

Time frame: Through 1 year follow-up

Baseline characteristics of functional network architecture

The investigators will assess the unique architecture of brain networks at diagnosis and how significantly this architecture diverges from average healthy controls.

Time frame: At baseline (day 1)

Change in characteristics of functional network architecture

The investigators will assess brain system segregation which is measure of the connection and disconnection between different brain networks. These will be compared within individuals and compared to healthy controls.

Time frame: Baseline and 1 year follow-up

Secondary Outcomes

Correlation of radiation dose to changes in cognitive performance and resting state network connectivity

In an exploratory fashion, the investigators will evaluate the dose of radiation received to each resting state network to determine if functional connectivity changes in a dose dependent manner at 1 year.

Time frame: At 1 year follow-up