{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:15:47Z","timestamp":1778001347760,"version":"3.51.4"},"reference-count":62,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"the Radiological Society of North America (RSNA) Resident Research","award":["2021 RSNA Grant RR2157, PI K.R.T."],"award-info":[{"award-number":["2021 RSNA Grant RR2157, PI K.R.T."]}]},{"name":"UC San Diego Moores Cancer Center Cancer Center Support Grant Early-Stage Clinical Investigator Award partially supported time for analysis and manuscript development"},{"name":"NIH\/NCI Cancer Center Support","award":["P30 CA008748 (PI Vickers)"],"award-info":[{"award-number":["P30 CA008748 (PI Vickers)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proton beam radiotherapy (PBRT) is a mainstay in treatment of pediatric brain tumors and may reduce risk of neurotoxicity. We hypothesized that dose-dependent effects on resting-state networks (RSNs) would manifest as impaired neurocognition and quality of life (QoL) in pediatric patients undergoing PBRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients and age- and sex-matched healthy controls (HCs) were prospectively enrolled and underwent resting-state functional connectivity (FC) MRI and neurocognitive tests (NIH Toolbox, PROMIS QoL Questionnaire) at 3-5 months post-PBRT. Functional connectivity within and between RSNs (default mode network [DMN], dorsal attention network [DAN], executive central network [ECN], salience network [SN]) was compared. One-sample t-tests assessed average RSN-specific FC. Group-level analysis used paired t-tests (q\u2009=\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-eight participants (14 patients, 14 HCs; median age 14 years) were analyzed. Compared to HCs, patients displayed worse attention\/executive function (P\u2009=\u2009.018), working memory (P\u2009=\u2009.011), and processing speed (P\u2009=\u2009.047). Patients had lower within-network FC in DMN (P\u2009=\u2009.013) and SN (P\u2009=\u2009.026). Patients had disrupted anticorrelation between DMN and SN, and less local efficiency of RSNs (corrected P\u2009&amp;lt;\u2009.05). Higher brain volume receiving \u226520\u00a0Gy, left hippocampus mean dose, and left temporal lobe mean dose were associated with RSN disruption in DMN and SN (|r|\u22650.70). Lower SN FC was associated with poorer processing speed (P\u2009=\u2009.049). On multivariable analysis, ECN FC was associated with working memory (P\u2009=\u2009.016) and patients had worse working memory vs HCs (P\u2009=\u2009.009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared to HCs, pediatric patients after PBRT displayed significant disruption in several RSNs, notably between SN and DMN critical in neurocognitive control. Dose-dependent neurocognition and QoL impairment warrant further investigation for mitigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuonc\/noag072","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:47:26Z","timestamp":1774529246000},"source":"Crossref","is-referenced-by-count":0,"title":["Functional neuroimaging biomarkers of impaired neurocognition after proton beam radiotherapy for brain tumors in pediatric patients: A prospective trial"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1506-4870","authenticated-orcid":false,"given":"Kathryn R","family":"Tringale","sequence":"first","affiliation":[{"name":"Department of Radiation Medicine and Applied Science, University of California San Diego , La Jolla, CA,","place":["USA"]},{"name":"Rady Children\u2019s Hospital , San Diego, 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NY,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8222-606X","authenticated-orcid":false,"given":"Jona A","family":"Hattangadi-Gluth","sequence":"additional","affiliation":[{"name":"California Protons Cancer Therapy Center , San Diego, CA,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie R","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine and Applied Science, University of California San Diego , La Jolla, CA,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7159-7014","authenticated-orcid":false,"given":"Tara","family":"Fahy","sequence":"additional","affiliation":[{"name":"Department of Radiology, Memorial Sloan Kettering Cancer Center , New York, 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