Abstract
BACKGROUND: Radiation-induced brain injury (RBI) is a common complication in patients with nasopharyngeal carcinoma (NPC) who have undergone radiotherapy (RT), which is characterized by significant cognitive and psychological impairments. Although radiation-induced regional structural abnormalities have been well-reported, the effects of RT on the whole brain structural covariance networks are mostly unknown. Here, we performed a source-based morphometry (SBM) study to solve this issue. METHODS: In this cross-sectional study, 131 NPC patients with pre- and post-RT were stratified into pre-RT (n=47) and post-RT (n=84) groups. The SBM method was adopted to investigate the radiation-induced alterations in structural covariance networks in patients with NPC. RESULTS: Compared to the pre-RT group, our SBM analyses revealed increased z-scores in the independent component 05 (IC05; mainly located in the posterior cingulate, precuneus areas, and superior parietal lobe) (P=0.040) and decreased z-scores in the temporal-occipital network (P=0.015) and cerebellar network (P=0.023) in post-RT NPC patients. Compared to the pre-RT group, voxel-based morphometry (VBM) revealed reduced gray matter volume in the left temporal lobe, cerebellum, bilateral thalamus, left insular, and occipital lobe in the post-RT group. Notably, a significant negative correlation was observed between the mean radiation doses of the right temporal lobe and the z-score of the cerebellar network (r=-0.349, P=0.027). CONCLUSIONS: This present study revealed radiation-induced changes in structural covariance networks and cortical volume in patients with NPC. These findings shed some light on the neural basis of symptom patterns in RBI and may support the development of new intervention strategies to prevent progression to radiation-induced brain necrosis.