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Child's Nervous System

, Volume 29, Issue 4, pp 597–607 | Cite as

Fronto-cerebellar fiber tractography in pediatric patients following posterior fossa tumor surgery

  • Verena Soelva
  • Pablo Hernáiz Driever
  • Alexander Abbushi
  • Stefan Rueckriegel
  • Harald Bruhn
  • Wilhelm Eisner
  • Ulrich-Wilhelm ThomaleEmail author
Original Paper

Abstract

Objective

Fronto-cerebellar association fibers (FCF) are involved in neurocognitive regulatory circuitry. This may also be relevant for cerebellar mutism syndrome (CMS) as a complication following posterior fossa tumor removal in children. In the present study, we investigated FCF by diffusion tensor imaging in affected children and controls.

Methods

Diffusion-weighted MR imaging at 3 T (GE) allowed tractography of FCF using a fiber tracking algorithm software (Brainlab 2.6) in 29 patients after posterior fossa tumor removal and in 10 healthy peers. Fiber tract volumes were assessed and fiber signals were evaluated in a semiquantitative manner along the anatomical course.

Results

Volumes of FCF revealed significant diminished values in pediatric patients with symptoms of CMS (19.3 ± 11.7 cm3) when compared with patients without symptoms of CMS (26.9 ± 11.9 cm3) and with healthy peers (36.5 ± 13.82 cm3). In medulloblastoma patients, the volume of FCF was also significantly reduced in patients with symptoms of CMS despite having the same antitumor therapy. In semiquantitative analysis of the fiber tract signals, differences were observed in the superior cerebellar peduncles and midline cerebellar structures in patients with symptoms of CMS.

Conclusion

Using DTI, which allows the visualization of fronto-cerebellar fiber tracts, lower FCF tract volumes and diminished fiber signal intensities at the level of the superior cerebellar peduncles and in midline cerebellar structures were identified in patients with postoperative symptoms of CMS. Our study refers to the role of a neural circuitry between frontal lobes and the cerebellum being involved in neurocognitive impairment after posterior fossa tumor treatment in children.

Keywords

Diffusion tensor imaging Tractography Pediatric brain tumor Posterior fossa surgery Cerebellar mutism 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Verena Soelva
    • 1
  • Pablo Hernáiz Driever
    • 2
  • Alexander Abbushi
    • 1
  • Stefan Rueckriegel
    • 2
  • Harald Bruhn
    • 3
  • Wilhelm Eisner
    • 4
  • Ulrich-Wilhelm Thomale
    • 1
    Email author
  1. 1.Arbeitsbereich Pädiatrische NeurochirurgieCharité-Universitätsmedizin BerlinBerlinGermany
  2. 2.Klinik für Pädiatrie mit Schwerpunkt Onkologie und HämatologieBerlinGermany
  3. 3.RadiologieCharité-Universitätsmedizin BerlinBerlinGermany
  4. 4.Neurochirurgische KlinikMedizinischen Universität InnsbruckInnsbruckAustria

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