Possible association between the integrity of cerebellar pathways and neurocognitive performance in children with posterior fossa tumors
- 1 September 2020
- journal article
- research article
- Published by Wiley in Pediatric Blood & Cancer
- Vol. 67 (9), e28538
- https://doi.org/10.1002/pbc.28538
Abstract
Background Cerebellar tumor survivors often exhibit neuropsychological deficits that could be related to alterations in cerebro-cerebellar networks. This is a pilot study designed to understand if diffusion tensor imaging (DTI)-based tractography is able to identify possible correlations between cerebellar white matter structure and cognitive outcome in children on long-term follow-up for posterior fossa (PF) tumors who were thoroughly assessed for neuropsychological functioning. Methods DTI-based tractography was performed in pediatric patients with PF tumors. Fractional anisotropy (FA) and volumetric measurements of spinocerebellar, dentorubrothalamocortical and corticopontocerebellar tracts were analyzed. Cognitive and neuropsychological functioning was assessed by the Wechsler Intelligence Scale for Children-IV Edition (WISC-IV) and the Developmental Neuropsychological Assessment (NEPSY II). The associations between Full-Scale Intelligence Quotient (FSIQ), NEPSY-II scores, and fiber tracts were tested by the Spearman rank correlation coefficient. Results Seven patients (median age at diagnosis five years, range, 3-13) treated for medulloblastoma (2/7; 29%) and pilocytic astrocytoma (5/7; 71%) were retrospectively evaluated. All children had complete surgery. The median FSIQ was 84 (range, 67-93). Patients presented with several deficits on many NEPSY-II tasks; in particular, memory was impaired in nearly half of them. FSIQ and neurocognitive tasks significantly correlated with specific corticopontocerebellar tracts. Conclusion Children on follow-up for PF tumor showed scattered cognitive impairments, including deficits in long-term and immediate memory. Tractography allowed us to describe a possible association between the integrity of cerebellar pathways and neurocognitive performance, suggesting that the myelinization of these fibers may represent an indicator for the development of long-term cognitive sequelae.This publication has 52 references indexed in Scilit:
- A meta-analysis of the effects of chemotherapy on cognition in patients with cancerCancer Treatment Reviews, 2013
- Hyperfractionated Versus Conventional Radiotherapy Followed by Chemotherapy in Standard-Risk Medulloblastoma: Results From the Randomized Multicenter HIT-SIOP PNET 4 TrialJournal of Clinical Oncology, 2012
- Effects of Hydrocephalus After Cerebellar Tumor: A Case-By-Case ApproachPediatric Neurology, 2011
- Neurocognitive outcome 12 months following cerebellar mutism syndrome in pediatric patients with medulloblastomaNeuro-Oncology, 2010
- Visuospatial contextual processing in the parietal cortex: An fMRI investigation of the induced Roelofs effectNeuroImage, 2008
- Radiation-Induced Changes in Normal-Appearing White Matter in Patients With Cerebral Tumors: A Diffusion Tensor Imaging StudyInternational Journal of Radiation Oncology*Biology*Physics, 2008
- White Matter Anisotropy in Post-Treatment Childhood Cancer Survivors: Preliminary Evidence of Association With Neurocognitive FunctionJournal of Clinical Oncology, 2006
- Orthogonal tensor invariants and the analysis of diffusion tensor magnetic resonance imagesMagnetic Resonance in Medicine, 2005
- Cognitive and Adaptive Outcome in Low-Grade Pediatric Cerebellar Astrocytomas: Evidence of Diminished Cognitive and Adaptive Functioning in National Collaborative Research Studies (CCG 9891/POG 9130)Journal of Clinical Oncology, 2005
- Diffusion tensor imaging: Concepts and applicationsJournal of Magnetic Resonance Imaging, 2001