Kirschen Matthew P, Davis-Ratner Mathew S, Milner Marnee W, Chen S H Annabel, Schraedley-Desmond Pam, Fisher Paul G, Desmond John E
Department of Radiology, Stanford University, Stanford, CA, USA.
Behav Neurol. 2008;20(1-2):39-53. doi: 10.3233/BEN-2008-0216.
This study was designed to investigate cerebellar lobular contributions to specific cognitive deficits observed after cerebellar tumor resection. Verbal working memory (VWM) tasks were administered to children following surgical resection of cerebellar pilocytic astrocytomas and age-matched controls. Anatomical MRI scans were used to quantify the extent of cerebellar lobular damage from each patient's resection. Patients exhibited significantly reduced digit span for auditory but not visual stimuli, relative to controls, and damage to left hemispheral lobule VIII was significantly correlated with this deficit. Patients also showed reduced effects of articulatory suppression and this was correlated with damage to the vermis and hemispheral lobule IV/V bilaterally. Phonological similarity and recency effects did not differ overall between patients and controls, but outlier patients with abnormal phonological similarity effects to either auditory or visual stimuli were found to have damage to hemispheral lobule VIII/VIIB on the left and right, respectively. We postulate that damage to left hemispheral lobule VIII may interfere with encoding of auditory stimuli into the phonological store. These data corroborate neuroimaging studies showing focal cerebellar activation during VWM paradigms, and thereby allow us to predict with greater accuracy which specific neurocognitive processes will be affected by a cerebellar tumor resection.
本研究旨在调查小脑小叶切除术后观察到的特定认知缺陷中,小脑小叶所起的作用。对小脑毛细胞型星形细胞瘤手术切除后的儿童以及年龄匹配的对照组进行言语工作记忆(VWM)任务测试。利用解剖学磁共振成像扫描来量化每位患者切除术后小脑小叶损伤的程度。与对照组相比,患者对听觉刺激的数字广度显著降低,而对视觉刺激则不然,并且左侧半球小叶VIII的损伤与这一缺陷显著相关。患者还表现出言语抑制效应减弱,这与双侧蚓部和半球小叶IV/V的损伤相关。患者和对照组在语音相似性和近因效应方面总体上没有差异,但对听觉或视觉刺激的语音相似性效应异常的异常值患者,分别在左侧和右侧半球小叶VIII/VIIB有损伤。我们推测左侧半球小叶VIII的损伤可能会干扰听觉刺激在语音存储中的编码。这些数据证实了神经影像学研究的结果,即在VWM范式期间小脑有局灶性激活,从而使我们能够更准确地预测小脑肿瘤切除会影响哪些特定的神经认知过程。