Sex-Based Differences in Functional Brain Activity During Working Memory in Survivors of Pediatric Acute Lymphoblastic Leukemia

• Published in: JNCI cancer spectrum 2022-03, Vol.6 (2)
• Main Authors: Gandy, Kellen, Scoggins, Matthew A, Phillips, Nicholas, van der Plas, Ellen, Fellah, Slim, Jacola, Lisa M, Pui, Ching-Hon, Hudson, Melissa M, Reddick, Wilburn E, Sitaram, Ranganatha, Krull, Kevin R
• Format: Article
• Language: English
• ISSN: 2515-5091; 2515-5091
• DOI: 10.1093/jncics/pkac026

Background Long-term survivors of pediatric acute lymphoblastic leukemia are at elevated risk for neurocognitive deficits and corresponding brain dysfunction. This study examined sex-based differences in functional neuroimaging outcomes in acute lymphoblastic leukemia survivors treated with chemotherapy alone. Methods Functional magnetic resonance imaging (fMRI) and neurocognitive testing were obtained in 123 survivors (46% male; median [min-max] age = 14.2 years [8.3-26.5 years]; time since diagnosis = 7.7 years [5.1-12.5 years]) treated on the St. Jude Total XV treatment protocol. Participants performed the n-back working memory task in a 3 T scanner. Functional neuroimaging data were processed (realigned, slice time corrected, normalized, smoothed) and analyzed using statistical parametric mapping with contrasts for 1-back and 2-back conditions, which reflect varying degrees of working memory and task load. Group-level fMRI contrasts were stratified by sex and adjusted for age and methotrexate exposure. Statistical tests were 2-sided (P