Assessing regional homogeneity and cognitive function alterations in pediatric brain tumor patients: a resting-state functional magnetic resonance imaging study.

Background: Cognitive impairment mechanisms in children with preoperative brain tumors are not well understood. This study aimed to determine the correlation between the changes of resting-state functional magnetic resonance imaging (rs-fMRI) and the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in patients with brain tumors before surgery and in healthy controls (HCs).

Methods: rs-fMRI data were acquired using 3-T magnetic resonance imaging (MRI) scanners for 21 patients with pediatric brain tumor and 19 age- and gender-matched HCs. The data of WISC-IV were collected by psychiatrists. We used chi-square tests and two-sample -tests to identify clinical features with significant associations before surgery. A two-sample t-tests was used to identify brain regions with significant changes in regional homogeneity (ReHo) before surgery in patients. Pearson correlation coefficients were used to assess the relationship between changes in ReHo and the five measures in the WISC-IV.

Results: The ReHo values were significantly decreased in the left anterior cingulate (T=-4.391) and right middle frontal gyrus (MFG) (T=-5.130) in patients compared to controls. Notably, ReHo values in the right MFG showed a positive correlation with the Perceptual Reasoning Index (R=0.471; P=0.031) and Working Memory Index (R=0.531; P=0.013) of the WISC-IV.

Conclusions: The study identified significant ReHo alterations in patients with pediatric brain tumor, primarily in brain regions associated with cognitive processing, and revealed a positive correlation between these alterations and specific cognitive functions. These findings contribute to understanding cognitive impairments in this patient group and suggest potential areas for targeted intervention.