Brain Tumor, Primary
Conditions
Keywords
Proton therapy, Radiation, Brain tumor
Brief summary
With modern therapy, the survival rate for pediatric brain tumor patients has significantly improved, with over 70% of patients surviving their disease. However, this progress often comes at the cost of substantial morbidity, with cognitive deficits being the primary obstacle to independent living. Robust predictors of cognitive decline and a comprehensive understanding of the underlying mechanisms of cognitive injury remain elusive. This study will prospectively investigate alterations in brain resting state networks following radiation therapy using functional imaging. The hypothesis is that radiation therapy leads to dose-dependent alterations in functional connectivity in the networks associated with higher level cognition, ultimately leading to cognitive decline.
Interventions
OTHERCognitive testing
NIH Toolbox Cognitive Battery and the Novel Cognitive Measure (NCM)
DEVICEResting State MRI/Precision functional mapping
At baseline (before the end of radiation therapy) and approximately 12 months after the completion of radiation therapy.
Sponsors
Washington University School of Medicine
United States Department of Defense
The Foundation for Barnes-Jewish Hospital
Children's Cancer Research Fund
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
8 Years to 21 Years
Healthy volunteers
No
Inclusion criteria
* Between 8 and 21 years of age, inclusive * Newly diagnosed primary brain tumor of any location and any histology that will be treated with proton radiation therapy * Life expectancy of at least one year * Able to understand and willing to consent or assent to the research proposed (or that of a legally authorized representative, if applicable), along with consent of legal guardian(s) if applicable
Exclusion criteria
* Presence of visual impairment to an extent that the patient is unable to complete the computer testing * Contraindication to MRI scan (i.e. due to cardiac pacemaker) * Presence of programmable shunt or dental braces * Requires sedation for MRI scans
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Radiation induced effects on functional brain resting state connectivity | Through 1 year follow-up | The investigators will compare resting state maps of each patient pre- and post-radiation therapy. The investigators will evaluate changes in the resting state architecture and compare to the average results that would be expected from a patient in the same age and sex. |
| Baseline characteristics of functional network architecture | At baseline (day 1) | The investigators will assess the unique architecture of brain networks at diagnosis and how significantly this architecture diverges from average healthy controls. |
| Change in characteristics of functional network architecture | Baseline and 1 year follow-up | The investigators will assess brain system segregation which is measure of the connection and disconnection between different brain networks. These will be compared within individuals and compared to healthy controls. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation of radiation dose to changes in cognitive performance and resting state network connectivity | At 1 year follow-up | In an exploratory fashion, the investigators will evaluate the dose of radiation received to each resting state network to determine if functional connectivity changes in a dose dependent manner at 1 year. |
Countries
United States
Contacts
CONTACTStephanie Perkins, M.D.
PRINCIPAL_INVESTIGATORStephanie Perkins, M.D.
Washington University School of Medicine
Outcome results
None listed