Hoang Duc Ha, Pagnier Anne, Guichardet Karine, Dubois-Teklali Fanny, Schiff Isabelle, Lyard Geneviève, Cousin Emilie, Krainik Alexandre
Department of Radiology, University Hospital Viettiep, Haiphong, Vietnam;
J Neurosurg Pediatr. 2014 Aug;14(2):136-44. doi: 10.3171/2014.5.PEDS13571. Epub 2014 Jun 20.
Medulloblastomas are the most common malignant childhood brain tumors arising in the posterior fossa. Treatment improvements for these tumors have meant that there are a greater number of survivors, but this long-term patient survival has increased the awareness of resulting neurocognitive deficits. Impairments in attention, memory, executive functions, and intelligence quotient demonstrate that the cerebellum likely plays a significant role in numerous higher cognitive functions such as language, cognitive, and emotional functions. In addition, children with medulloblastoma not only have cerebellar lesions but also brain white matter damages due to radiation and chemotherapy. Functional neuroimaging, a noninvasive method with many advantages, has become the standard tool in clinical and cognitive neuroscience research. By reviewing functional neuroimaging studies, this review aims to clarify the role of the cerebellum in cognitive function and explain more clearly cognitive sequelae due to polytherapy in children with medulloblastoma. This review suggests that the posterior cerebellar lobes are crucial to maintaining cognitive performance. Clinical investigations could help to better assess the involvement of these lobes in cognitive functions.
髓母细胞瘤是后颅窝最常见的儿童恶性脑肿瘤。这些肿瘤治疗方法的改进意味着有更多的幸存者，但患者的长期存活增加了对由此产生的神经认知缺陷的认识。注意力、记忆力、执行功能和智商方面的损害表明，小脑可能在众多高级认知功能（如语言、认知和情感功能）中发挥重要作用。此外，髓母细胞瘤患儿不仅有小脑病变，还因放疗和化疗导致脑白质损伤。功能神经影像学作为一种具有诸多优势的非侵入性方法，已成为临床和认知神经科学研究的标准工具。通过回顾功能神经影像学研究，本综述旨在阐明小脑在认知功能中的作用，并更清楚地解释髓母细胞瘤患儿多模式治疗所致的认知后遗症。本综述表明，小脑后叶对维持认知表现至关重要。临床研究有助于更好地评估这些脑叶在认知功能中的参与情况。
