Brain Imaging in Pediatric Cancer Survivors: Correlates of Cognitive Impairment
Authors: Shelli R. Kesler, Charlotte Sleurs, Brenna C. McDonald, Sabine Deprez, Ellen van der Plas, Brian J. Nieman
Journal: Journal of Clinical Oncology (2021)

Article Tools REVIEW ARTICLES Neurocognitive Outcomes in Survivors of Pediatric Cancer Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.20.02315 Journal of Clinical Oncology - published online before print April 22, 2021 PMID: 33886371 Brain Imaging in Pediatric Cancer Survivors: Correlates of Cognitive Impairment Shelli R. Kesler, PhD1xShelli R. KeslerSearch for articles by this author; Charlotte Sleurs , PhD2,3xCharlotte SleursSearch for articles by this author; Brenna C. McDonald , PhD4xBrenna C. McDonaldSearch for articles by this author; Sabine Deprez , PhD3,5xSabine DeprezSearch for articles by this author; Ellen van der Plas , PhD6xEllen van der PlasSearch for articles by this author; and Brian J. Nieman, PhD7,8,9xBrian J. NiemanSearch for articles by this author Show More 1School of Nursing, Department of Diagnostic Medicine, Dell School of Medicine, Livestrong Cancer Institutes, Austin, TX2Department of Oncology, Catholic University of Leuven, Leuven, Belgium3Leuven Cancer Institute, Leuven, Belgium4Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Center for Neuroimaging, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN5Department of Imaging and Pathology, Catholic University of Leuven, Leuven, Belgium6Department of Psychiatry, University of Iowa Hospital and Clinics, Iowa City, Iowa7Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada8Ontario Institute for Cancer Research, Toronto, ON, Canada9Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada https://doi.org/10.1200/JCO.20.02315 First Page Full Text PDF Figures and Tables © 2021 by American Society of Clinical OncologyCONTEXTKey ObjectivePediatric cancers, including brain tumors and non-CNS cancers, are associated with increased risk for acute and chronic cognitive impairment but specific causative factors remain unclear. We conducted a review of the neuroimaging literature to provide a better understanding regarding the etiology of cognitive impairment in these patients.Knowledge GeneratedStudies consistently demonstrate changes in indices of brain structure and function that are associated with cognitive dysfunction. Effects tend to be diffuse, affecting gray matter structure and associated functional activation and connectivity of cortical and subcortical areas, as well as white matter fiber bundles.RelevanceWe propose that larger samples, multimodal neuroimaging, and human and animal transcriptome studies are needed to determine molecular mechanistic pathways underlying brain changes and guide clinical care. These studies could provide unique early markers of effectiveness for and guide optimal dosing of interventions aimed at preventing or treating cognitive impairments in patients with cancer.SUPPORTSupported in part by the National Institutes of Health: National Cancer Institute grants R01CA226080 and R01CA172145 (S.R.K.), the Kinderkankerfonds Leuven (C.S.), the National Institutes of Health: National Cancer Institute grants R35CA197289, R01CA129769, and R01CA244673 and National Institute on Aging grants P30AG010133 and R01AG019771 (B.C.M.), the Ontario Institute for Cancer Research through funding provided by the Government of Ontario (IA-024) and by the Canadian Institutes of Health Research (156250, 158622, and 168925) (B.J.N.).AUTHOR CONTRIBUTIONSConception and Design: All authorsAdministrative support: All authorsCollection and assembly of data: All authorsData analysis and interpretation: All authorsManuscript writing: All authorsFinal approval of manuscript: All authorsAccountable for all aspects of the work: All authorsAUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTERESTBrain Imaging in Pediatric Cancer Survivors: Correlates of Cognitive ImpairmentThe following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/authors/author-center.Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).No potential conflicts of interest were reported.