Cortical morphological alterations and structural covariant network topology changes in children with acute lymphoblastic leukemia
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: The mechanisms underlying chemotherapy-induced cognitive impairment (CICI) and structural brain changes in children with acute lymphoblastic leukemia (ALL) remain unclear. This study investigated early chemotherapy-induced alterations in cortical morphology and structural covariance network (SCN) reorganization in children with ALL. Methods: -test (P<0.05) with family-wise error (FWE) correction was conducted. The global and local SCN parameters of the brain covariance network were calculated. A statistical analysis was performed using the 1,000-permutation test (P<0.05) with a false discovery rate to correct the attributes of the local network. Results: On days 46-52 of chemotherapy, the cortical thickness of multiple brain regions in children with ALL became extensively thinner (cluster size ≥50, P<0.05, FWE corrected). The gyrification index was reduced in the bilateral frontal lobe and right insula. A fractal dimension reduction was observed in the left inferior medial frontal gyrus. The degree (Deg) in the left supplementary motor area (LSMA; P=0.029) increased, and the betweenness (Bet) in the left precuneus (LPCUN) decreased (P=0.034). However, no statistically significant differences were found between the other parameters, including the clustering coefficient (Cp; P=0.159), local efficiency (Eloc; P=0.325), characteristic path length (P=0.522), global efficiency (Eg; P=0.702), assortativity (P=0.956), transitivity (P=0.753), and modularity (P=0.628). The absence of contemporaneous neurocognitive assessments precluded the exploration of relationships between cortical morphological alterations/SCN changes and neurocognition. Conclusions: On days 46-52 of chemotherapy, changes in the morphology of the cerebral cortex, and changes in the Deg, Bet, and hub values in the SCN were already present in children with ALL. The bilateral frontal lobe may be the most susceptible brain region for CICI among children with ALL. These results appear to suggest that the topological properties in the brains of these children were reorganized as a compensatory mechanism after chemotherapy.
Authors: Ke Wei, Ruiyuan Chen, Zhixin Gao, Huirong Mai, Longping Liu, Weiguo Cao
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415656011
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