Radiation-Induced Changes in Structural Network in Patients with Nasopharyngeal Carcinoma
Radiation therapy (RT) is the standard radical treatment for nasopharyngeal carcinoma (NPC), and has produced excellent effects in terms of survival rate [1, 2]. However, one of the serious complications gave rise by the RT is brain injury. Previous studies have found that RT could cause brain structural abnormalities on gray matter and white matter. Nevertheless, the RT effects on the network level should be further investigated. Herein, we explored changes on the structural network for patients with NPC induced by RT. The structural magnetic resonance data (sMRI) were used to investigate the structural network in 20 NPC patients after and before radiotherapy. After constructing the structural network, we examined the radiation-induced changes in topology properties of small world network using graph theoretical analysis. Our results found that both the before and after radiotherapy groups showed small world properties. Compared with the before radiotherapy (pre-RT) group, the after radiotherapy (post-RT) group had lower global and local efficiency, longer shortest path length, and less clustering coefficient. In addition, the hub regions in the post-RT group were significantly different from the pre-RT group. Our findings exhibited the architecture of network topology and information transfer efficiency became poor in post-RT group. We speculated radiation therapy might induce the differences. The results can provide a new perspective to explore and diagnose radiation-induced brain injury and evaluate the effect of radiotherapy.
Radiation-Induced Changes in Structural Network in Patients with Nasopharyngeal Carcinoma, American Journal of Clinical and Experimental Medicine.
Vol. 5, No. 6,
2017, pp. 224-233.
Li Y. Neurosurgery and prognosis in patients with radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy: a follow-up study. Radiation Oncology. 2013; 8(1):1-6.
Wu X, Gu M, Zhou G, Xue X, Wu M and Huang H. Cognitive and neuropsychiatric impairment in cerebral radionecrosis patients after radiotherapy of nasopharyngeal carcinoma. Bmc Neurology. 2014; 14(1):10.
Tang LL, Guo R, Zhou G, Sun Y, Liu LZ, Lin AH, Mai H, Shao J, Li L and Ma J. Prognostic value and staging classification of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy. Plos One. 2014; 9(10):e108375.
Chan AT. Nasopharyngeal carcinoma. Annals of Oncology Official Journal of the European Society for Medical Oncology. 2010; 21 Suppl 7(7):vii308.
Ying S, Zhou GQ, Qi ZY, Li Z, Huang SM, Liu LZ, Li L, Lin AH and Ma J. Radiation-induced temporal lobe injury after intensity modulated radiotherapy in nasopharyngeal carcinoma patients: a dose-volume-outcome analysis. BMC Cancer, 13, 1(2013-08-27). 2013; 13(1):397-397.
Chan YL, Leung SF, King AD, Choi PH and Metreweli C. Late radiation injury to the temporal lobes: morphologic evaluation at MR imaging. Radiology. 1999; 213(3):800-807.
Chen W, Qiu S, Li J, Hong L, Wang F, Xing Z and Li C. Diffusion tensor imaging study on radiation-induced brain injury in nasopharyngeal carcinoma during and after radiotherapy. Tumori. 2015; 101(5):487.
Shen Q, Lin F, Rong X, Yang W, Li Y, Cai Z, Xu P, Xu Y and Tang Y. Temporal Cerebral Microbleeds Are Associated With Radiation Necrosis and Cognitive Dysfunction in Patients Treated for Nasopharyngeal Carcinoma. International Journal of Radiation Oncology Biology Physics. 2016; 94(5):1113.
Peterson K, Clark HB, Hall WA and Truwit CL. Multifocal enhancing magnetic resonance imaging lesions following cranial irradiation. Annals of Neurology. 1995; 38(2):237-244.
Lv XF, Zheng XL, Zhang WD, Liu LZ, Zhang YM, Chen MY and Li L. Radiation-induced changes in normal-appearing gray matter in patients with nasopharyngeal carcinoma: a magnetic resonance imaging voxel-based morphometry study. Neuroradiology. 2014; 56(5):423-430.
King AD, Ahuja AT, Yeung DK, Wong JK, Lee YY, Lam WW, Ho SS, Yu SC and Leung SF. Delayed complications of radiotherapy treatment for nasopharyngeal carcinoma: imaging findings. Clinical Radiology. 2007; 62(3):195-203.
Lin J, Lv X, Niu M, Liu L, Chen J, Fei X, Miao Z, Qiu S, Li L and Huang R. Radiation-induced abnormal cortical thickness in patients with nasopharyngeal carcinoma after radiotherapy. Neuroimage Clinical. 2017; 14(C):610-621.
Ma Q, Wu D, Zeng LL, Shen H, Hu D and Qiu S. Radiation-induced functional connectivity alterations in nasopharyngeal carcinoma patients with radiotherapy. Medicine. 2016; 95(29):e4275.
Duan F, Cheng J, Jiang J, Chang J, Zhang Y and Qiu S. Whole-brain changes in white matter microstructure after radiotherapy for nasopharyngeal carcinoma: a diffusion tensor imaging study. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 2016; 273(12):4453.
Wang HZ, Qiu SJ, Lv XF, Wang YY, Liang Y, Xiong WF and Ouyang ZB. Diffusion tensor imaging and 1 H-MRS study on radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy. Clinical Radiology. 2012; 67(4):340-345.
Xiong WF, Qiu SJ, Wang HZ and Lv XF. 1H-MR spectroscopy and diffusion tensor imaging of normal-appearing temporal white matter in patients with nasopharyngeal carcinoma after irradiation: initial experience. Journal of Magnetic Resonance Imaging Jmri. 2013; 37(1):101–108.
Matthews PM, Filippini N and Douaud G. Brain structural and functional connectivity and the progression of neuropathology in Alzheimer's disease. Journal of Alzheimers Disease Jad. 2013; 33(Suppl 1):S163-S172.
Yao Z, Zhang Y, Lin L, Zhou Y and Xu C. Abnormal cortical networks in mild cognitive impairment and alzheimer's disease. PLoS Computation Biology. 2010.
Mechelli A, Friston KJ, Frackowiak RS and Price CJ. Structural covariance in the human cortex. Journal of Neuroscience the Official Journal of the Society for Neuroscience. 2005; 25(36):8303.
Montembeault M, Rouleau I, Provost JS and Brambati SM. Altered Gray Matter Structural Covariance Networks in Early Stages of Alzheimer's Disease. Cerebral Cortex. 2015; 26(6):2650.
Zhu W, Wei W, Yong H, Xia A, Anstey KJ and Sachdev P. Changing topological patterns in normal aging using large-scale structural networks. Neurobiology of Aging. 2012; 33(5):899.
DJ W and SH S. (1998). Collectivedynamics of ’small-world’ networks. Nature, pp. 440-442.
Strogatz SH. Exploring complex networks. Nature. 2001; 410(6825):268.
Bullmore E and Sporns O. The economy of brain network organization. Nature Reviews Neuroscience. 2012; 13(13):336-349.
Achard S and Bullmore E. Efficiency and Cost of Economical Brain Functional Networks. Plos Computational Biology. 2007; 3(2):e17.
Hsiao KY, Yeh SA, Chang CC, Tsai PC, Wu JM and Gau JS. Cognitive function before and after intensity-modulated radiation therapy in patients with nasopharyngeal carcinoma: a prospective study. International Journal of Radiation Oncology Biology Physics. 2010; 77(3):722-726.
Lam LC, Leung SF and Chow LY. Functional experiential hallucinosis after radiotherapy for nasopharyngeal carcinoma. Journal of Neurology Neurosurgery & Psychiatry. 1998; 64(2):259.
Cheung M, Chan AS, Law SC, Chan JH and Tse VK. Cognitive function of patients with nasopharyngeal carcinoma with and without temporal lobe radionecrosis. Archives of Neurology. 2000; 57(9):1347-1352.
Ho NF, Chong JSX, Hui LK, Koukouna E, Lee TS, Fung D, Lim CG and Zhou J. Intrinsic Affective Network Is Impaired in Children with Attention-Deficit/Hyperactivity Disorder. Plos One. 2015; 10(9):e0139018.
Mccarthy H, Skokauskas N, Mulligan A, Donohoe G, Mullins D, Kelly J, Johnson K, Fagan A, Gill M and Meaney J. Attention Network Hypoconnectivity With Default and Affective Network Hyperconnectivity in Adults Diagnosed With Attention-Deficit/Hyperactivity Disorder in Childhood. Jama Psychiatry. 2013; 70(12):1329.
Murty VP, Ritchey M, Adcock RA and Labar KS. Reprint of: fMRI studies of successful emotional memory encoding: a quantitative meta-analysis. Neuropsychologia. 2011; 49(4):695-705.
Zielinski BA, Gennatas ED, Zhou J and Seeley WW. Network-level structural covariance in the developing brain. Proceedings of the National Academy of Sciences of the United States of America. 2010; 107(42):18191.
Mesulam MM. From sensation to cognition. Brain A Journal of Neurology. 1998; 121 (Pt 6) (6):1013.
Liao W, Mantini D, Zhang Z, Pan Z, Ding J, Gong Q, Yang Y and Chen H. Evaluating the effective connectivity of resting state networks using conditional Granger causality. Biological Cybernetics. 2010; 102(1):57-69.
Jann K, Kottlow M, Dierks T, Boesch C and Koenig T. Topographic electrophysiological s ignatures of FMRI Resting State Networks. Plos One. 2010; 5(9):e12945.
Oncology DO, Hospital QV, Candos and Quatre Bornes. Báo cáo khoa học: "Radiation Induced Temporal Lobe Necrosis in Patients with Nasopharyngeal Carcinoma: a Review of New Avenues in Its Management" doc. Gastrointestinal Endoscopy. 2007; 65(5):AB155.
Parkin AJ and Hunkin NM. Memory loss following radiotherapy for nasal pharyngeal carcinoma — An unusual presentation of amnesia. British Journal of Clinical Psychology. 2011; 30(4):349-357.
Hua MS, Chen ST, Tang LM and Leung WM. Neuropsychological function in patients with nasopharyngeal carcinoma after radiotherapy. Journal of Clinical & Experimental Neuropsychology. 1998; 20(5):684-693.
Phua SY, Leow LP and Chan MFL. Delayed onset of swallowing impairment following radiotherapy for nasopharyngeal carcinoma (NPC). Asia Pacific Journal of Speech Language & Hearing. 2013; 9(1):33-39.
Hua MS, Chen ST, Tang LM and Leung WM. Olfactory function in patients with nasopharyngeal carcinoma following radiotherapy. Brain injury: [BI]. 1999; 13(11):905-915.
Zhang S and Li CS. Functional clustering of the human inferior parietal lobule by whole-brain connectivity mapping of resting-state functional magnetic resonance imaging signals. Brain Connect. 2014; 4(1):53-69.
Latora V and Marchiori M. Efficient Behavior of Small-World Networks. Physical Review Letters. 2001; 87(19):198701.
Wang J, Wang X, Xia M, Liao X, Evans A and He Y. GRETNA: a graph theoretical network analysis toolbox for imaging connectomics. Frontiers in Human Neuroscience. 2015; 9(386):386.
Bernhardt BC, Bonilha L and Gross DW. Network analysis for a network disorder: The emerging role of graph theory in the study of epilepsy. Epilepsy & Behavior E & B. 2015; 50:162-170.
Physical RE. Intensity and coherence of motifs in weighted complex networks. Physical Review E Statistical Nonlinear & Soft Matter Physics. 2005; 71(2):065103.
Humphries MD, Gurney K and Prescott TJ. The brainstem reticular formation is a small-world, not scale-free, network. Proceedings of the Royal Society B Biological Sciences. 2006; 273(1585):503-511.
Liu Y, Liang M, Zhou Y, He Y, Hao Y, Song M, Yu C, Liu H, Liu Z and Jiang T. Disrupted small-world networks in schizophrenia. Brain. 2008; 131(4):945-961.
Sporns O, Honey CJ and Kötter R. Identification and Classification of Hubs in Brain Networks. Plos One. 2007; 2(10):e1049.