Grenoble institute of neurosciences, Inserm U836, 38000 Grenoble, France; University Grenoble Alps, 38000 Grenoble, France; Department of radiology, Viettiep university hospital, Haiphong, Viet Nam.
Department of pediatrics, Grenoble university hospital, 38000 Grenoble, France.
J Neuroradiol. 2019 May;46(3):207-213. doi: 10.1016/j.neurad.2019.01.093. Epub 2019 Feb 5.
Medulloblastoma is the most common malignant cerebral tumor during childhood, arising in the posterior fossa. Children treated for medulloblastoma often experience working memory (WM) deficits, affecting their quality of life and school performance. The aim of the present study undertaken to describe the cerebellar involvement in WM deficits observed in these children.
23 healthy children and 11 children treated for medulloblastoma were included into study. All subjects performed a detailed neuropsychological examination, an anatomical and functional MRI. Stimuli were presented to the participants with alternating sensory modality and nature of communication in a block design during functional magnetic resonance imaging acquisitions. Non-parametric tests were used for analyzing neuropsychological and behavioral data. SPM8 and SUIT (Spatially Unbiased Atlas Template) were used for anatomical and functional MRI data analyses.
Patients had cerebellar resections mainly located in the left posterior lobe. Patients had significantly reduced intelligence quotient, central executive and visuospatial WM. In healthy children group, fMRI showed activations for non-verbal and visuospatial WM in the left posterior cerebellar lobe.
This study provides further evidence that left posterior cerebellar lobe plays a critical role in WM. Indeed, lesions of left posterior cerebellar lobe were associated with WM impairment in children treated for cerebellar medulloblastoma. Additionally, fMRI using WM tasks showed activation in the left posterior cerebellar lobe in healthy children. Taken together, these findings may help for improving treatment and rehabilitation of children referred for cerebellar tumor.
成神经管细胞瘤是儿童时期最常见的脑恶性肿瘤，起源于后颅窝。接受成神经管细胞瘤治疗的儿童常出现工作记忆（WM）缺陷，影响其生活质量和学业表现。本研究旨在描述这些儿童观察到的 WM 缺陷与小脑之间的关系。
本研究纳入了 23 名健康儿童和 11 名接受成神经管细胞瘤治疗的儿童。所有受试者均进行了详细的神经心理学检查、解剖学和功能磁共振成像。在功能磁共振成像采集过程中，以块设计呈现刺激，交替使用感觉模态和通信性质。使用非参数检验分析神经心理学和行为数据。使用 SPM8 和 SUIT（空间无偏模板）进行解剖学和功能磁共振成像数据分析。
患者的小脑切除术主要位于左后叶。患者的智商、中央执行和视空间 WM 明显降低。在健康儿童组中，fMRI 显示左后小脑叶在非言语和视空间 WM 任务中激活。
本研究进一步证明左后小脑叶在 WM 中起着关键作用。事实上，左后小脑叶的病变与接受小脑成神经管细胞瘤治疗的儿童的 WM 损害有关。此外，使用 WM 任务的 fMRI 在健康儿童的左后小脑叶中显示出激活。总之，这些发现可能有助于改善接受小脑肿瘤治疗的儿童的治疗和康复。
