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Mathematical skills in children with pilocytic astrocytoma

  • Original Article - Pediatric Neurosurgery
  • Published:
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Abstract

Background

Pediatric patients with circumscribed cerebellar pilocytic astrocytoma (PA) tumors generally perform within the normal range on neuropsychological tests after a complete tumor resection. The outcome in academically relevant abilities such as mathematics, which in adults involve some cerebellar functions, is however much less understood. The aim of this study is to retrospectively investigate the neuroplasticity of mathematical skills and associated cognitive functions following cerebellar resection of PA in pediatric patients.

Methods

Twenty-two children (mean age = 11.2 + 1.8), including 11 PA patients (females = 6) and 11 healthy controls (females = 6), were administered a battery of mathematical (MaT) and neuropsychological tests. Single-case statistical analyses were carried out (Crawford’s t) as well as between-group comparisons (Wilcoxon test). Spearman correlations between MaT and neuropsychological tests were calculated.

Results

Thirty-six percent of the patients showed difficulties in some mathematical tasks, 50% of them within a broader cognitive deficit. Verbal working memory was associated with MaT performance both in patients and controls while, crucially, visuospatial memory, and visual-motor integration were associated with MaT in patients only. Among patients, MaT correlated negatively with tumor size and positively with the interval surgery test.

Conclusions

The results evince an overall recovery of mathematical abilities despite PA in the majority of patients. This functional reestablishment is supported by visuospatial and visuomotor integration functions that contribute to set up emerging mathematical skills in these patients. Higher levels of compensation are found in more developed tumors as compared to smaller ones.

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Acknowledgments

We wish to thank Laura Milanese for her valuable assistance on the recruitment of patients. Our gratitude also goes to the parents of all the children for their participation.

Funding

This study was funded by the University of Padua (Grant Number: STPD11B88HM). The sponsor had no role in the design or conduct of this research.

Author information

Author notes

  1. Silvia Benavides-Varela and R. Lorusso contributed equally to this work.

Authors and Affiliations

  1. Department of Developmental Psychology and Socialization, University of Padova, Via Venezia 8, 35131, Padova, Italy

    Silvia Benavides-Varela & Daniela Lucangeli

  2. Department of General Psychology, University of Padova, Via Venezia 8, 35131, Padova, Italy

    Silvia Benavides-Varela

  3. IRCCS San Camillo Hospital Foundation, Neuropsychology Unit, Lido, Venice, Italy

    Silvia Benavides-Varela & Carlo Semenza

  4. Department of Neuroscience (Padova Neuroscience Center), University of Padova, Padova, Italy

    Riccardina Lorusso, Valentina Baro, Luca Denaro, Domenico D’Avella & Carlo Semenza

  5. Department of Medicine, University of Padova, Padova, Italy

    Riccardina Lorusso

  6. Brain Development Laboratory, Cuban Neurosciences Centre, Havana, Cuba

    Nancy Estévez-Pérez

Authors
  1. Silvia Benavides-Varela
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  2. Riccardina Lorusso
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  3. Valentina Baro
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  4. Luca Denaro
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  5. Nancy Estévez-Pérez
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  6. Daniela Lucangeli
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  7. Domenico D’Avella
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  8. Carlo Semenza
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Corresponding author

Correspondence to Silvia Benavides-Varela.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Comments

The authors review a cohort of 11 children with pilocytic astrocytoma of the cerebellum and administer a battery of neuropsychological and mathematical tests between 0.6 and 5.5 years after surgical resection. The same tests are also carried out with a group of matched controls. The authors find recovery of mathematical ability in all patients. They also find that visuospatial memory and visual-motor integration were associated with mathematical skills in patients only. Mathematical skills also correlated with time from surgery and, inversely, with size of the tumor. They conclude that the recovery and emergence of mathematical skills in patients are supported by the reorganisation of visuospatial and visual-motor skills, replicating processes that typically occur in younger children.

This is an interesting concept and reflects not just the ability of these children to recover their mathematical skills after surgery but also underlines the importance of the cerebellum in cognitive development.

Kristina Aquilina

London, UK

This article is part of the Topical Collection on Pediatric Neurosurgery

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Benavides-Varela, S., Lorusso, R., Baro, V. et al. Mathematical skills in children with pilocytic astrocytoma. Acta Neurochir 161, 161–169 (2019). https://doi.org/10.1007/s00701-018-3744-0

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  • DOI: https://doi.org/10.1007/s00701-018-3744-0

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