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

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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.

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Authors and Affiliations

  1. Arbeitsbereich Pädiatrische Neurochirurgie, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Verena Soelva, Alexander Abbushi & Ulrich-Wilhelm Thomale

  2. Klinik für Pädiatrie mit Schwerpunkt Onkologie und Hämatologie, Berlin, Germany

    Pablo Hernáiz Driever & Stefan Rueckriegel

  3. Radiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany

    Harald Bruhn

  4. Neurochirurgische Klinik, Medizinischen Universität Innsbruck, Innsbruck, Austria

    Wilhelm Eisner

Authors
  1. Verena Soelva
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  2. Pablo Hernáiz Driever
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  3. Alexander Abbushi
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  4. Stefan Rueckriegel
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  5. Harald Bruhn
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  6. Wilhelm Eisner
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  7. Ulrich-Wilhelm Thomale
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Correspondence to Ulrich-Wilhelm Thomale.

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Soelva, V., Hernáiz Driever, P., Abbushi, A. et al. Fronto-cerebellar fiber tractography in pediatric patients following posterior fossa tumor surgery. Childs Nerv Syst 29, 597–607 (2013). https://doi.org/10.1007/s00381-012-1973-8

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  • DOI: https://doi.org/10.1007/s00381-012-1973-8

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