Evaluating Structural and Functional Changes of Brain by fMRI and DTI in Patients With Intracranial Germ Cell Tumors

Study Overview
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Brief Summary
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BOLD-fMRI and DTI scans are performed to patients with germ cell tumors in the basal ganglia before and after treatments. The changes of the MRI and muscle strength of patients during treatments are evaluated, and the association between these two are investigated.

Detailed Description
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Primary intracranial germ cell tumors are a specific entity of brain tumors with a variety of histological types and different degrees of malignancy. Intracranial GCTs make up 11.2% - 15.3% of primary intracranial tumors in Asian children compared with 3.6% in the US. And tumors located at the basal ganglia is much rarer. The investigators realize that most of patients with tumors at this location are involved with motor disfunction. And after treatments, some patients get relieved dramatically, but some others failed to get similar outcomes. To better understand the mechanism causing this difference of treatment outcomes, the investigators perform BOLD-fMRI and DTI scans to patients with germ cell tumors in the basal ganglia before and after treatments. The changes of the fMRI and muscle strength of patients during treatments are evaluated, and the association between these two are investigated.

Official Title
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Evaluating Changes of Brain Networks and White Matter Fibers by fMRI and DTI After Treatments in Patients With Germ Cell Tumors in the Basal Ganglia

Conditions
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Intracranial Germ Cell Tumor

Intervention / Treatment
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* Radiation: radiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age ≥3 years; no history of brain radiotherapy; no other known cause of movement and cognitive impairment; no contraindications to the magnetic resonance imaging (MRI) scan; Exclusion Criteria: patients can not tolerate MR scan; head motion is greater than 3 mm during functional MRI scanning.

Ages Eligible for Study
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Minimum Age: 3 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| single-group studies<br>All the patients received chemotherapy and radiotherapy. | Radiation: radiotherapy<br>* whole brain with/without spinal cord<br>* Other names: chemotherapy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes of brain networks measured by BOLD-fMRI after treatments. | The brain networks during treatments are compared by functional connectivity. | The fMRI scans are performed: (1) before treatments in one week, (2) before radiotherapy in one week, (3) after radiotherapy in one week, (4) one year after radiotherapy. | 
| Changes of white matter fibers measured by DTI after treatments. | The white matter fibers damaged by tumor are evaluated by FA and MD value. | The DTI scans are performed along with the fMRI scans. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes of muscle strength after treatments. | The limb muscle strength of patients are evaluated with the Medical Research Council (MRC) scale for muscle strength (grade 0-5). | The muscle strength evaluation are performed at the same day before the fMRI scans. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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fMRI, DTI, Intracranial Germ cell tumor, Basal ganglia