研究表明，儿童脑肿瘤 (BT) 的放射治疗会增加患脑血管疾病 (CVD) 的风险；然而，尚不清楚这将如何影响认知功能。本研究旨在调查放疗诱发的 CVD、白质高信号 (WMH) 和儿童 BT 成年幸存者的神经认知结果之间的关联。在横断面设置中，我们进行了一项全国性队列研究，其中包括 68 名接受放疗的儿童 BT 幸存者。中位随访 20 年后的儿童期 BT。使用脑磁共振成像 (MRI) 评估 CVD 和 WMH 标志物，并计算 CVD 相关结果的总和。此外，还分析了 CVD 结果、WMH 和神经心理学测试结果之间的关联。 在 68 名儿童 BT 幸存者中，54 人 (79%) 被诊断患有 CVD 和/或 WMH，中位年龄为 27 岁。 CVD 和/或 WMH 与言语智商、表现智商 (PIQ)、执行功能、记忆力和视觉空间能力得分较低相关 (p < 0.05)。此外，患有微出血的幸存者在 PIQ、处理速度、执行功能和视觉空间能力方面有更大的损伤 (p < 0.05)。 WMH 和 CVD 负担与记忆功能和视觉空间能力的更大困难相关（p < 0.05）。小血管疾病负担与 PIQ 评分、处理速度、工作记忆和视觉空间能力相关。研究结果表明，放疗诱发 CVD 的标志物、CVD 标志物的累加效应以及痴呆的危险因素与认知障碍相关，这可能表明幸存者患早发性痴呆的风险很高。© 作者 2023。由牛津大学出版社代表神经肿瘤学会出版。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Studies have established that radiotherapy for childhood brain tumors (BTs) increases the risk of cerebrovascular disease (CVD); however, it is unclear how this will affect cognitive function. This study aimed to investigate the associations between radiotherapy-induced CVD, white matter hyperintensities (WMHs), and neurocognitive outcomes in adult survivors of childhood BTs.In a cross-sectional setting, we conducted a national cohort that included 68 radiotherapy-treated survivors of childhood BTs after a median follow-up of 20 years. Markers of CVD and WMHs were evaluated using brain magnetic resonance imaging (MRI), and the sum of CVD-related findings was calculated. Additionally, the associations among CVD findings, WMHs, and neuropsychological test results were analyzed.Of the 68 childhood BT survivors, 54 (79%) were diagnosed with CVD and/or WMHs at a median age of 27 years. CVD and/or WMHs were associated with lower scores for verbal intelligence quotient, performance intelligence quotient (PIQ), executive function, memory, and visuospatial ability (p < 0.05). Additionally, survivors with microbleeds had greater impairments in the PIQ, processing speed, executive function, and visuospatial ability (p < 0.05). WMHs and CVD burden were associated with greater difficulties in memory function and visuospatial ability (p < 0.05). Small-vessel disease burden was associated with PIQ scores, processing speed, working memory, and visuospatial ability.The study results suggest that markers of radiotherapy-induced CVD, the additive effect of CVD markers, and risk factors of dementia are associated with cognitive impairment, which may suggest that the survivors are at a high risk of developing early-onset dementia.© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.