Abstract
Objective
To explore differences between executive functioning (EF) and resting-state functional connectivity (rs-FC) of the executive control network (ECN) in survivors of acute lymphoblastic leukemia (ALL) compared to healthy controls.
Method
ALL participants (age 9-18) from Children’s of Alabama Hospital were ≥ 5 years post-diagnosis treated with chemotherapy only. Eleven ALL survivors and twelve controls were administered the Delis-Kaplan Executive Function Scale (D-KEFS) and Behavior Rating Inventory of Executive Function (BRIEF-2) self- and parent report. Using seed-to-voxel rs-FC analyses, we examined ECN regions (e.g., medial and dorsolateral prefrontal cortex [MPFC; dlPFC]). Within group multiple regression analyses were conducted to correlate EF scores to rs-FC z-scores.
Results
No significant differences were found on EF scores between ALL and control groups. rs-FC analyses indicated ECN hyperconnectivity in ALL survivors compared to controls (p < .05, FDR corrected). In ALL survivors, significant positive correlation was found between the average of Inhibit and Shift scores on the BRIEF-2 self-report and the MPFC (r = .926, p = .024), and negative correlation between D-KEFS Verbal Fluency and left dlPFC (r = −.869, p = .012). In controls, significant negative correlation was found between D-KEFS Design Fluency and left dlPFC (r = −.671, p = .012).
Conclusions
ALL survivors show hyperconnectivity of the ECN that is also correlated with both subjective and objective measures of EF. However, EF task performance was not significantly different between the two groups. This may indicate increased utilization of network regions to overcome network disruption specific to the ALL group in order to perform similarly to peers.
Altered resting state functional connectivity in young survivors of acute lymphoblastic leukemia