Mapping of long-term cognitive and motor deficits in pediatric cerebellar brain tumor survivors into a cerebellar white matter atlas
Please always quote using this URN: urn:nbn:de:bvb:20-opus-307416
- Purpose Diaschisis of cerebrocerebellar loops contributes to cognitive and motor deficits in pediatric cerebellar brain tumor survivors. We used a cerebellar white matter atlas and hypothesized that lesion symptom mapping may reveal the critical lesions of cerebellar tracts. Methods We examined 31 long-term survivors of pediatric posterior fossa tumors (13 pilocytic astrocytoma, 18 medulloblastoma). Patients underwent neuronal imaging, examination for ataxia, fine motor and cognitive function, planning abilities, and executive function.Purpose Diaschisis of cerebrocerebellar loops contributes to cognitive and motor deficits in pediatric cerebellar brain tumor survivors. We used a cerebellar white matter atlas and hypothesized that lesion symptom mapping may reveal the critical lesions of cerebellar tracts. Methods We examined 31 long-term survivors of pediatric posterior fossa tumors (13 pilocytic astrocytoma, 18 medulloblastoma). Patients underwent neuronal imaging, examination for ataxia, fine motor and cognitive function, planning abilities, and executive function. Individual consolidated cerebellar lesions were drawn manually onto patients’ individual MRI and normalized into Montreal Neurologic Institute (MNI) space for further analysis with voxel-based lesion symptom mapping. Results Lesion symptom mapping linked deficits of motor function to the superior cerebellar peduncle (SCP), deep cerebellar nuclei (interposed nucleus (IN), fastigial nucleus (FN), ventromedial dentate nucleus (DN)), and inferior vermis (VIIIa, VIIIb, IX, X). Statistical maps of deficits of intelligence and executive function mapped with minor variations to the same cerebellar structures. Conclusion We identified lesions to the SCP next to deep cerebellar nuclei as critical for limiting both motor and cognitive function in pediatric cerebellar tumor survivors. Future strategies safeguarding motor and cognitive function will have to identify patients preoperatively at risk for damage to these critical structures and adapt multimodal therapeutic options accordingly.…
Author: | Frederik Grosse, Stefan Mark Rueckriegel, Ulrich-Wilhelm Thomale, Pablo Hernáiz Driever |
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URN: | urn:nbn:de:bvb:20-opus-307416 |
Document Type: | Journal article |
Faculties: | Medizinische Fakultät / Neurochirurgische Klinik und Poliklinik |
Language: | English |
Parent Title (English): | Child's Nervous System |
ISSN: | 0256-7040 |
ISSN: | 1433-0350 |
Year of Completion: | 2021 |
Volume: | 37 |
Issue: | 9 |
Pagenumber: | 2787-2797 |
Source: | Child's Nervous Systemt (2021) 37:2787–2797. https://doi.org/10.1007/s00381-021-05244-2 |
DOI: | https://doi.org/10.1007/s00381-021-05244-2 |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Tag: | VLSM; adolescence; brain tumor; childhood; cognitive function; executive function; lesion symptom mapping |
Release Date: | 2024/04/18 |
Date of first Publication: | 2021/09/01 |
Licence (German): | CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International |