Abnormalities of structural brain connectivity in pediatric brain tumor survivors

Background Pediatric brain tumor survivors are at an increased risk for white matter (WM) injury. However, damage to whole-brain structural connectivity is unelucidated. The impact of treatment on WM connectivity was investigated. Methods Whole-brain WM networks were derived from diffusion tensor imaging data acquired for 28 irradiated patients (radiotherapy, RT) (mean age = 13.74 3.32 years), 13 patients not irradiated (No RT) (mean age = 12.57 2.87), and 41 typically developing children (TDC) (mean age = 13.32 +/- 2.92 years). Differences in network properties were analyzed using robust regressions. Results Participation coefficient was lower in both patient groups (RT: adj. P = .015; No RT: adj. P = .042). Compared to TDC, RT had greater clustering (adj. P = .015), local efficiency (adj. P = .003), and modularity (adj. P = .000003). WM traced from hubs was damaged in patients: left hemisphere pericallosal sulcus (FA [F = 4.97; q < 0.01]; MD [F = 11.02; q < 0.0001]; AD [F = 10.00; q < 0.0001]; RD [F = 8.53; q < 0.0001]), right hemisphere pericallosal sulcus (FA [F = 8.87; q < 0.0001]; RD [F = 8.27; q < 0.001]), and right hemisphere parietooccipital sulcus (MD [F = 5.78; q < 0.05]; RD [F = 5.12; q < 0.05]). Conclusions Findings indicate greater segregation of WM networks after RT. Intermodular connectivity was lower after treatment with and without RT. No significant network differences were observed between patient groups. Our results are discussed in the context of a network approach that emphasizes interactions between brain regions.