Weaknesses in cognitive proficiency have been attributed to white matter compromise in neurodevelopmental conditions, such as attention-deficit/hyperactivity disorder and preterm birth, as well as acquired conditions, such as traumatic brain injury and multiple sclerosis. White matter maturation supports the development of these abilities, which depend on coordinated activity across distributed brain networks. This is thought to reflect a plateau in new skill development and has been strongly associated with deficits in underlying cognitive proficiency skills, such as attention, psychomotor speed, and working memory. This exploratory study is the first to directly support for white matter integrity as a mechanism of cognitive sparing in PRT.Ĭonventional radiotherapy places pediatric brain tumor survivors at risk for intellectual decline, with an estimated 1-point loss in full-scale IQ per year following treatment. These findings support improved long-term outcomes in PRT versus XRT.

Overall, both white matter integrity (FA) and neuropsychological performance were lower in XRT patients while PRT patients were similar to healthy control participants with respect to both FA and cognitive functioning.

Fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) were extracted from 12 tracts of interest. Tractography was conducted using automated fiber quantification (AFQ). Participants completed age-appropriate measures of intellectual functioning, visual-motor integration, and motor coordination. A healthy comparison group ( n = 23) was also recruited. Pediatric brain tumor survivors treated with XRT ( n = 10) or PRT ( n = 12) underwent neuropsychological testing and diffusion weighted imaging >7 years post-radiotherapy. This exploratory study examined the relationship between white matter change and late cognitive effects in pediatric brain tumor survivors treated with XRT versus PRT. Superior cognitive outcomes have been reported following proton radiotherapy (PRT) compared to photon radiotherapy (XRT), presumably due to improved sparing of normal brain tissue. Radiotherapy for pediatric brain tumors is associated with reduced white matter structural integrity and neurocognitive decline.

Proton free