{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:15:46Z","timestamp":1791969346400,"version":"4.3.4"},"reference-count":79,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T00:00:00Z","timestamp":1746316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cranial irradiation is a key component of neuro-oncological treatment but can result in cognitive side effects. Preserving cognition from radiotherapy-(RT)-induced toxicity remains an ongoing debate. To spatially map radiotoxic effects in patients who underwent cranial RT, this study applied a voxel-based approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cognitive assessments (Controlled Word Association (COWA), Hopkins Verbal Learning (HVLT-R), and Trail Making Tests (TMT A,B)) were conducted prospectively before, 6 months and 1 year post-RT in 111 intracranial tumor patients (18\u201380 years). Reliable change indices indicated cognitive changes across timepoints. CT and T1-weighted MRI scans acquired at diagnosis were co-registered, normalized to standard space, and smoothed. Voxel-wise permutation-based regression analyses examined the relationship between RT dose and cognitive decline (\u03b1\u2005&amp;lt;\u20050.05 at cluster level).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Images of 111 patients (Mdn age\u2005=\u200555.39 years; 47% male; lesions were gliomas (61%), meningiomas (18%), other (21%); in frontal (33%), temporal (25%), other location (42%)) were analyzed. Reliable decline was most pronounced at 6 months, particularly on the TMT A (25.77%), TMT B (24.21%), and HVLT immediate recall (21%). At 1 year, 20% of patients continued to show a decline in TMT B. Higher RT doses to frontal gyri, temporal, occipital, and para-central regions were associated with declines in verbal fluency, memory, processing speed, and flexibility at both peak- and cluster-level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Differential voxel-wise RT dose effects at peak versus cluster level suggest local and network-based recruitment of diverse functional regions and vulnerability to cranial RT. These insights may help re-define key regions at risk from a network-based perspective, preserving cognition in future RT planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuonc\/noaf114","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T07:53:24Z","timestamp":1745567604000},"page":"2634-2646","source":"Crossref","is-referenced-by-count":6,"title":["Radiotherapy-induced neurocognitive decline among adult intracranial tumor patients: A voxel-based approach"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-8330","authenticated-orcid":false,"given":"Charlotte","family":"Sleurs","sequence":"first","affiliation":[{"name":"Department of Oncology, KU Leuven , Leuven ,","place":["Belgium"]},{"name":"Department of Cognitive Neuropsychology, Tilburg University , Tilburg ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina M L","family":"Zegers","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marvin F","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Mental Health and Neuroscience research institute , Maastricht ,","place":["The Netherlands"]},{"name":"Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter","family":"van Elmpt","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette","family":"Dijkstra","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alida A","family":"Postma","sequence":"additional","affiliation":[{"name":"Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, Mental Health and Neuroscience research institute , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2571-1816","authenticated-orcid":false,"given":"Laurien","family":"De Roeck","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, UZ Leuven , Leuven 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