Structural Connectivity Alterations in the Attention Network of Childhood Acute Lymphoblastic Leukemia Survivors

Motivation: Long-term survivors of childhood acute lymphoblastic leukemia (ALL) often experience gradual cognitive decline, including deficits in attention, though the neural mechanisms and brain network changes underlying these deficits remain unclear. Goal(s): This study aims to investigate structural changes associated with attention deficits in ALL survivors using diffusion MRI-based connectome analysis. Approach: Attention related structural connectomes were compared between ALL survivors (n=70) and age- and sex-matched healthy controls (n=70). Results: Significant differences were found primarily in the anterior cingulate and medial prefrontal cortex (ACMPFC) and posterior cingulate cortex (PCC). ALL survivors showed increased connectivity in the ACMPFC and decreased connectivity in the PCC. Impact: Therapy for acute lymphoblastic leukemia is associated with an increased risk of neurocognitive issues in survivors. This study's findings offer evidence of both compromised and compensatory changes in attention network, which may help illuminate the neural basis of attention deficits.