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Establishing reproducible predictors of cerebellar mutism syndrome based on pre-operative imaging

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Abstract

Purpose

To establish some explicit, feasible, and reproducible predictors for CMS.

Materials and methods

This study was a retrospective case study. Data were obtained from 82 patients with medulloblastoma at a single center, Beijing Tiantan Hospital. Based on medical records, we created two independent samples: the CMS group comprising 23 patients and the non-CMS group comprising 23 patients. Pre-operative imaging was studied by performing quantitative assessments of specific indicators.

Results

The CMS group showed greater differences in pre-operative imaging data with the non-CMS group. The Aaxi/daxi ratio in pre-operative MR imaging captured in the axial plane was used to quantify the compression of the cerebellum and brainstem, and significant differences were observed between the CMS group and non-CMS group (p = 0.0002). In the sagittal plane, Dsag*dsag was used to quantify the area of the tumor that invaded the brainstem, and significant differences were observed between the two groups (p = 0.0003). In the coronal plane, Acor/dcor was used to quantify the compression of the upper functional brain region, and significant differences were noted between the two groups (p = 0.0219). Additionally, Evans’ index was introduced to quantify the degree of hydrocephalus. The CMS group tended to show an increased Evans’ index (p = 0.0027).

Conclusion

Based on pre-operative imaging data, some reproducible predictors, such as Aaxi/daxi, Dsag*dsag, Acor/dcor, and Evans’ index, were established.

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References

  1. Robertson PL, Muraszko KM, Holmes EJ, Sposto R, Packer RJ, Gajjar A, Dias MS, Allen JC (2006) Incidence and severity of post-operative cerebellar mutism syndrome in children with medulloblastoma: a prospective study by the Children’s Oncology Group. J Neurosurg 105:444–451. https://doi.org/10.3171/ped.2006.105.6.444

    Article  PubMed  Google Scholar 

  2. Beckwitt TS, Krieger MD, O'Neil S, Jubran R, Tavare CJ (2012) Symptoms before and after posterior fossa surgery in pediatric patients. Pediatr Neurosurg 48:21–25. https://doi.org/10.1159/000337730

    Article  Google Scholar 

  3. Wells EM, Khademian ZP, Walsh KS, Vezina G, Sposto R, Keating RF, Packer RJ (2010) Post-operative cerebellar mutism syndrome following treatment of medulloblastoma: neuroratiographic features and origin. J Neurosurg Pediatr 5:329–334. https://doi.org/10.3171/2009.11.PEDS09131

    Article  PubMed  Google Scholar 

  4. Koh S, Turkel SB, Baram TZ (1997) Cerebellar mutism in children: report of six cases and potential mechanisms. Pediatr Neurol 16:218–219. https://doi.org/10.1016/S0887-8994(97)00018-0

  5. Morris EB, Phillips NS, Laningham FH, Patay Z, Gajjar A, Wallace D, Boop F, Sanford R, Ness KK, Ogg RJ (2009) Proximal dentatothalamocortical tract involvement in posterior fossa syndrome. BRAIN 132:3087–3095. https://doi.org/10.1093/brain/awp241

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ellis DL, Kanter J, Walsh JW, Drury SS (2011) Posterior fossa syndrome after surgical removal of a pineal gland tumor. Pediatr Neurol 45:417–419. https://doi.org/10.1016/j.pediatrneurol.2011.09.011

    Article  PubMed  Google Scholar 

  7. Chua F, Thien A, Ng LP, Seow WT, Low D, Chang K, Lian D, Loh E, Low S (2017) Post-operative diffusion weighted imaging as a predictor of posterior fossa syndrome permanence in paediatric medulloblastoma. Childs Nerv Syst 33:457–465. https://doi.org/10.1007/s00381-017-3356-7

    Article  PubMed  Google Scholar 

  8. Catsman-Berrevoets C, Patay Z (2018) Cerebellar mutism syndrome. Handb Clin Neurol 155:273–288. https://doi.org/10.1016/B978-0-444-64189-2.00018-4

    Article  PubMed  Google Scholar 

  9. Doxey D, Bruce D, Sklar F, Swift D, Shapiro K (1999) Posterior fossa syndrome: identifiable risk factors and irreversible complications. Pediatr Neurosurg 31:131–136. https://doi.org/10.1159/000028848

    Article  CAS  PubMed  Google Scholar 

  10. McMillan HJ, Keene DL, Matzinger MA, Vassilyadi M, Nzau M, Ventureyra EC (2009) Brainstem compression: a predictor of post-operative cerebellar mutism. Childs Nerv Syst 25:677–681. https://doi.org/10.1007/s00381-008-0777-3

    Article  CAS  PubMed  Google Scholar 

  11. Charalambides C, Dinopoulos A, Sgouros S (2009) Neuropsychological sequelae and quality of life following treatment of posterior fossa ependymomas in children. Childs Nerv Syst 25:1313–1320. https://doi.org/10.1007/s00381-009-0927-2

    Article  PubMed  Google Scholar 

  12. Law N, Greenberg M, Bouffet E, Taylor MD, Laughlin S, Strother D, Fryer C, McConnell D, Hukin J, Kaise C, Wang F, Mabbott DJ (2012) Clinical and neuroanatomical predictors of cerebellar mutism syndrome. Neuro-Oncology 14:1294–1303. https://doi.org/10.1093/neuonc/nos160

    Article  PubMed  PubMed Central  Google Scholar 

  13. Sergeant A, Kameda-Smith MM, Manoranjan B, Karmur B, Duckworth J, Petrelli T, Savage K, Ajani O, Yarascavitch B, Samaan MC, Scheinemann K, Alyman C, Almenawer S, Farrokhyar F, Fleming AJ, Singh SK, Stein N (2017) Analysis of surgical and MRI factors associated with cerebellar mutism. J Neuro-Oncol 133:539–552. https://doi.org/10.1007/s11060-017-2462-4

    Article  Google Scholar 

  14. Ding Y, McAllister JN, Yao B, Yan N, Canady AI (2001) Axonal damage associated with enlargement of ventricles during hydrocephalus: a silver impregnation study. Neurol Res 23:581–587. https://doi.org/10.1179/016164101101199045

    Article  CAS  PubMed  Google Scholar 

  15. Del BM, Zhang YW (1998) Cell death, axonal damage, and cell birth in the immature rat brain following induction of hydrocephalus. Exp Neurol 154:157–169. https://doi.org/10.1006/exnr.1998.6922

    Article  Google Scholar 

  16. Di Rocco C et al (2011) Heralding cerebellar mutism: evidence for pre-surgical language impairment as primary risk factor in posterior fossa surgery. Cerebellum 10(3):551–562. https://doi.org/10.1007/s12311-011-0273-2

    Article  PubMed  Google Scholar 

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Funding

This study was funded by the Beijing Natural Science Foundation (7172041).

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Correspondence to Yongji Tian.

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Before the investigation, we received the approval of the Ethics Review Committee of the Beijing Tiantan Hospital

Conflict of interest

The authors declare that they have no conflict of interest.

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Zhang, H., Liao, Z., Hao, X. et al. Establishing reproducible predictors of cerebellar mutism syndrome based on pre-operative imaging. Childs Nerv Syst 35, 795–800 (2019). https://doi.org/10.1007/s00381-019-04075-6

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  • DOI: https://doi.org/10.1007/s00381-019-04075-6

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