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Brain alterations detected by Multiplex MR imaging in nasopharyngeal carcinoma patients after induction chemotherapy : a longitudinal MRI study

cognitive-disorders
neurology
radiology-and-medical-imaging

Abstract

Background.

The alterations in brain regions and cognitive changes in patients with nasopharyngeal carcinoma (NPC) after induction chemotherapy (ICT) remain overlooked. This study aimed to investigate brain alterations and their correlation with clinical cognitive scores by using a novel Multiplex (MTP) MR imaging sequence.

Methods.

Thirty-nine patients underwent MTP imaging and the Montreal Cognitive Assessment (MoCA) test before (pre-ICT) and after (post-ICT) ICT. The MTP data were analyzed using the BrainTool software. A single-group paired t -test was used to determine the differences in properties before and after ICT. Pearson’s correlations were computed to examine the relationship between altered longitudinal regional values and MoCA scores. A two-sample t -test was used to compare the properties of longitudinally altered brain regions between the MoCA-reduction (MoCA˗) and MoCA-no reduction (MoCA ＋ =) groups. Receiver operating characteristic curve analyses were used to assess the performance of brain region properties in predicting cognitive impairment.

Results.

Compared with the pre-ICT group, patients in the post-ICT group showed decreased volume and R2Star and increased T2Star and quantitative susceptibility mapping in multiple brain regions, mostly located in the default mode network (DMN), occipital lobe, temporal lobe, and subcortical lobe. The volume of the left middle temporal gyrus, the T2star value of the right lateral occipital gyrus in the pre-ICT group were found to have a significant correlation with the change of MoCA scores in the post-ICT group, respectively. Compared with the MoCA ＋ = group, the MoCA˗ group still exhibits a decrease in DMN and middle temporal gyrus. The altered brain region properties and the combined model of those altered values were proven to be effective in predicting cognitive decline in patients with NPC after ICT.

Conclusions.

The MTP MR sequence can effectively evaluate brain alterations and cognitive impairment in NPC patients following ICT.
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