Neural correlates of working memory function in pediatric cancer survivors treated with chemotherapy: an fMRI study

NMR Biomed. 2020 Jun;33(6):e4296. doi: 10.1002/nbm.4296. Epub 2020 Mar 25.


The goal of this study is to investigate the neural correlates of working memory function associated with chemotherapy in pediatric cancer survivors using event-related functional MRI (fMRI) analysis. Fifteen pediatric cancer survivors treated with chemotherapy and 15 healthy controls were studied. Blood oxygenation level dependent (BOLD) fMRI was acquired. A visual n-back task was used to test working memory function during the fMRI scan. Responses were recorded via an MRI compatible button box for analysis. fMRI scans were analyzed using statistical parametric mapping software. All statistics were corrected for multiple comparisons by false discovery rate, with p < 0.05 as significance. Patients however gave more incorrect responses (p < 0.05), more no responses (p < 0.05), and longer response times (p < 0.05) compared with healthy controls. Correct responses generated significantly lower BOLD responses in the posterior cingulate for pediatric cancer survivors compared with controls (p < 0.05). Incorrect responses generated significantly greater BOLD responses in the angular gyrus in survivors (p < 0.05), and no response trials generated greater BOLD responses within the superior parietal lobule (p < 0.05) compared with controls. Working memory impairment appears to be due to an inability to manipulate information and to retrieve information from memory. The ability to delineate the affected neural circuits associated with chemotherapy-induced cognitive impairment could inform treatment strategies, identify patients at high risk of developing cognitive deficits, and pre-emptively tailor behavioral enrichment to overcome specific cognitive deficits.

Keywords: acute lymphoblastic leukemia; blood oxygenation level dependent (BOLD) fMRI; chemobrain; cognitive impairment; cognitive late effects; functional MRI; n-back tasks.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antineoplastic Agents / therapeutic use*
  • Brain / diagnostic imaging*
  • Brain / physiopathology*
  • Cancer Survivors*
  • Child
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Memory, Short-Term*


  • Antineoplastic Agents