背景:后颅窝肿瘤占儿童脑肿瘤的三分之二。尽管在过去几年中,治疗的进展提高了生存率,幸存者的长期记忆障碍很常见,对学业成绩有影响.海马,小脑和小脑-皮层网络在几种记忆系统中起作用。它们不仅受到肿瘤本身的位置和手术切除的影响,还有补充治疗的幕上效应,特别是放疗。IMPALA研究将调查辐射剂量对参与记忆的大脑结构的影响,尤其是海马和小脑.
方法:在这项单中心前瞻性行为和神经影像学研究中,90名参与者将被分为三组。前两组将包括儿童时期接受后颅窝脑瘤手术的患者,被认为是可以治愈的,至少5年前完成治疗,放疗(侵袭性脑肿瘤;第1组)或不放疗(低度脑肿瘤;第2组)。第3组将包括与第1组年龄相匹配的对照参与者,性别,和惯用手。所有参与者将进行一系列广泛的神经心理学测试,包括对主存储器系统的评估,并接受多模态3TMRI检查。将从初始放射治疗剂量测定中收集对记忆中涉及的不同大脑结构的照射剂量。
结论:这项研究将提供有关四种不同记忆系统(工作记忆,情景记忆,语义记忆,和程序记忆)和认知功能(注意力,语言,执行功能)可能会干扰它们,为了更好地描述脑肿瘤幸存者的记忆缺陷。我们将研究结构(3DT1)的神经心理学和神经影像学数据之间的相关性,微观结构(DTI),功能(rs-fMRI),血管(ASL)和代谢(光谱学)对肿瘤和辐射剂量的影响。因此,这项研究将为与认知和记忆功能发展相关的备用区域提供剂量限制的设置。
背景:ClinicalTrials.gov:NCT04324450,于2020年3月27日注册,于1月25日更新,2021年。追溯登记,https://www.clinicaltrials.gov/ct2/show/NCT04324450.
BACKGROUND: Posterior fossa tumors represent two thirds of brain tumors in children. Although progress in treatment has improved survival rates over the past few years, long-term memory impairments in survivors are frequent and have an impact on academic achievement. The hippocampi, cerebellum and cerebellar-cortical networks play a role in several memory systems. They are affected not only by the location of the tumor itself and its surgical removal, but also by the supratentorial effects of complementary treatments, particularly radiotherapy. The IMPALA study will investigate the impact of irradiation doses on brain structures involved in memory, especially the hippocampi and cerebellum.
METHODS: In this single-center prospective behavioral and neuro-imaging study, 90 participants will be enrolled in three groups. The first two groups will include patients who underwent surgery for a posterior fossa brain tumor in childhood, who are considered to be cured, and who completed treatment at least 5 years earlier, either with radiotherapy (aggressive brain tumor; Group 1) or without (low-grade brain tumor; Group 2). Group 3 will include control participants matched with Group 1 for age, sex, and handedness. All participants will perform an extensive battery of neuropsychological tests, including an assessment of the main memory systems, and undergo multimodal 3 T MRI. The irradiation dose to the different brain structures involved in memory will be collected from the initial radiotherapy dosimetry.
CONCLUSIONS: This study will provide long-term neuropsychological data about four different memory systems (working memory, episodic memory, semantic memory, and procedural memory) and the cognitive functions (attention, language, executive functions) that can interfere with them, in order to better characterize memory deficits among the survivors of brain tumors. We will investigate the correlations between neuropsychological and neuroimaging data on the structural (3DT1), microstructural (DTI), functional (rs-fMRI), vascular (ASL) and metabolic (spectroscopy) impact of the tumor and irradiation dose. This study will thus inform the setting of dose constraints to spare regions linked to the development of cognitive and memory functions.
BACKGROUND: ClinicalTrials.gov: NCT04324450, registered March 27, 2020, updated January 25th, 2021. Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/NCT04324450.