Cognition and Brain System Segregation in Pediatric Brain Tumor Patients Treated with Proton Therapy

Abstract Purpose Pediatric brain tumor patients often experience significant cognitive sequelae. Resting-state functional MRI (rsfMRI) provides a measure of network organization, and we hypothesize that pediatric treated with proton therapy will demonstrate abnormal architecture related to outcome radiation dosimetry. Participants Methods were enrolled on prospective study assessment using the NIH Toolbox Cognitive Domain. rsfMRI was obtained in participants able complete unsedated MRI. Brain system segregation (BSS), architecture, calculated for whole brain, high-level cognition association systems, sensory-motor systems. Results Twenty-six assessment, 18 completed rsfMRI. There baseline deficits attention inhibition processing speed prior worsening performance over time multiple domains. Average BSS across significantly decreased compared healthy controls (1.089 1.101, respectively; P = 0.001). systems lower than (P < 0.001) while there no difference sensory motor networks 0.70). Right hippocampus dose associated worse 0.05) dorsal 0.05). Conclusion Higher mean right correlated performance. Patients demonstrated alterations organization measured rsfMRI; however, somatosensory different from children. Further work preradiation is needed assess effects surgery presence architecture.