{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T05:47:12Z","timestamp":1762062432819,"version":"build-2065373602"},"reference-count":22,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education","award":["219C000146"],"award-info":[{"award-number":["219C000146"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Three patients who exhibited hemiplegic symptoms on conventional brain magnetic resonance imaging (MRI), during maintenance treatment for acute lymphoblastic leukemia, are reported. All patients exhibited unilateral motor weakness and poor hand function during chemotherapy. Conventional MRI revealed no definite abnormal lesions. However, in diffusion tensor tractography, the affected corticospinal tract on the contralateral side, consistently with clinical dysfunction, revealed disrupted integrity, decreased fractional anisotropy, and increased apparent diffusion coefficient compared to the results of the unaffected side or control participants. Control participants matched for age, sex, and duration from leukemia diagnosis, who underwent chemotherapy but had no motor impairments, exhibited preserved integrity of both corticospinal tracts. Diffusion tensor tractography can help evaluate patients with acute lymphoblastic leukemia and neurological dysfunction.<\/jats:p>","DOI":"10.3390\/children9081223","type":"journal-article","created":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T21:09:06Z","timestamp":1660511346000},"page":"1223","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Disruption of the Corticospinal Tract in Patients with Acute Lymphoblastic Leukemia: A Case Series"],"prefix":"10.3390","volume":"9","author":[{"given":"Jae","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pediatric Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Byun","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su","family":"Son","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 42415, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2730","DOI":"10.1056\/NEJMoa0900386","article-title":"Treating childhood acute lymphoblastic leukemia without cranial irradiation","volume":"360","author":"Pui","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3858","DOI":"10.1200\/JCO.2006.05.9055","article-title":"Comparison of long-term neurocognitive outcomes in young children with acute lymphoblastic leukemia treated with cranial radiation or high-dose or very high-dose intravenous methotrexate","volume":"24","author":"Spiegler","year":"2006","journal-title":"J. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2644","DOI":"10.1200\/JCO.2015.65.4574","article-title":"Chemotherapy pharmacodynamics and neuroimaging and neurocognitive outcomes in long-term survivors of childhood acute lymphoblastic leukemia","volume":"34","author":"Krull","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1002\/pbc.20860","article-title":"A meta-analysis of the neurocognitive sequelae of treatment for childhood acute lymphocytic leukemia","volume":"49","author":"Campbell","year":"2007","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_5","first-page":"1","article-title":"Acute and long-term neurologic complications in children with acute lymphoblastic leukemia","volume":"48","author":"Yetgin","year":"2006","journal-title":"Turk. J. Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"655669","DOI":"10.3389\/fonc.2021.655669","article-title":"Neurocognitive and behavioral outcomes of chinese survivors of childhood lymphoblastic leukemia","volume":"11","author":"Peng","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1093\/jnci\/djs344","article-title":"Cognitive outcomes following contemporary treatment without cranial irradiation for childhood acute lymphoblastic leukemia","volume":"104","author":"Conklin","year":"2012","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.ejpn.2018.12.005","article-title":"Motor function in survivors of pediatric acute lymphoblastic leukemia treated with chemotherapy-only","volume":"23","author":"Goebel","year":"2019","journal-title":"Eur. J. Paediatr. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1080\/09297049.2019.1676406","article-title":"Motor functioning and associated cognitive outcomes in pediatric survivors of acute lymphoblastic leukemia","volume":"26","author":"Oswald","year":"2020","journal-title":"Child Neuropsychol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.critrevonc.2012.04.003","article-title":"Central nervous system chemotoxicity during treatment of pediatric acute lymphoblastic leukemia\/lymphoma","volume":"84","author":"Vagace","year":"2012","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1002\/pbc.24537","article-title":"Motor functioning during and following treatment with chemotherapy for pediatric acute lymphoblastic leukemia","volume":"60","author":"Green","year":"2013","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e28385","DOI":"10.1002\/pbc.28385","article-title":"Investigating fine motor deficits during maintenance therapy in children with acute lymphoblastic leukemia","volume":"67","author":"Hanna","year":"2020","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_13","first-page":"51","article-title":"Simple visualization of the corticospinal pathway using tractography: One-ROI and two-ROI methods","volume":"63","author":"Mori","year":"2003","journal-title":"Nihon Igaku Hoshasen Gakkai Zasshi"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"638","DOI":"10.3389\/fnhum.2016.00638","article-title":"The change of intra-cerebral CST location during childhood and adolescence; diffusion tensor tractography study","volume":"10","author":"Kwon","year":"2016","journal-title":"Front. Hum. Neurosci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.neulet.2007.04.054","article-title":"Diffusion tensor imaging demonstrates focal lesions of the corticospinal tract in hemiparetic patients with cerebral palsy","volume":"420","author":"Son","year":"2007","journal-title":"Neurosci. Lett."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.neulet.2012.06.006","article-title":"Usefulness of diffusion tensor imaging in patients who showed sustained unexplainable clinical symptom of torticollis","volume":"522","author":"Kim","year":"2012","journal-title":"Neurosci. Lett."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"650","DOI":"10.3174\/ajnr.A3272","article-title":"Diffusion tensor imaging-demonstrated differences between hemiplegic and diplegic cerebral palsy with symmetric periventricular leukomalacia","volume":"34","author":"Cho","year":"2013","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.neulet.2014.04.044","article-title":"The relation between motor function of stroke patients and diffusion tensor imaging findings for the corticospinal tract","volume":"572","author":"Jang","year":"2014","journal-title":"Neurosci. Lett."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1001\/archneurol.2011.1930","article-title":"Classification of cause of motor weakness in traumatic brain injury using diffusion tensor imaging","volume":"69","author":"Choi","year":"2012","journal-title":"Arch. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.brainres.2017.01.017","article-title":"Structural brain alteration in survivors of acute lymphoblastic leukemia with chemotherapy treatment: A voxel-based morphometry and diffusion tensor imaging study","volume":"1658","author":"Zou","year":"2017","journal-title":"Brain Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/j.ijrobp.2008.08.060","article-title":"White matter fractional anisotropy correlates with speed of processing and motor speed in young childhood cancer survivors","volume":"74","author":"Aukema","year":"2009","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2973","DOI":"10.1093\/brain\/awu230","article-title":"Diffusion tensor imaging and neurocognition in survivors of childhood acute lymphoblastic leukaemia","volume":"137","author":"Edelmann","year":"2014","journal-title":"Brain"}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/8\/1223\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:08:06Z","timestamp":1760141286000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/8\/1223"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,12]]},"references-count":22,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["children9081223"],"URL":"https:\/\/doi.org\/10.3390\/children9081223","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,8,12]]}}}