Spatiotemporal changes in along-tract profilometry of cerebellar peduncles in cerebellar mutism syndrome
•Damage to cerebellar outflow pathway is implicated in cerebellar mutism syndrome.•We indicate a site-specific alteration in distal superior cerebellar peduncle in CMS.•Important implications on surgical resection of paediatric posterior fossa tumours. Cerebellar mutism syndrome, characterised by mu...
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Published in | NeuroImage clinical Vol. 35; p. 103000 |
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01.01.2022
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Abstract | •Damage to cerebellar outflow pathway is implicated in cerebellar mutism syndrome.•We indicate a site-specific alteration in distal superior cerebellar peduncle in CMS.•Important implications on surgical resection of paediatric posterior fossa tumours.
Cerebellar mutism syndrome, characterised by mutism, emotional lability and cerebellar motor signs, occurs in up to 39% of children following resection of medulloblastoma, the most common malignant posterior fossa tumour of childhood. Its pathophysiology remains unclear, but prior studies have implicated damage to the superior cerebellar peduncles. In this study, the objective was to conduct high-resolution spatial profilometry of the cerebellar peduncles and identify anatomic biomarkers of cerebellar mutism syndrome.
In this retrospective study, twenty-eight children with medulloblastoma (mean age 8.8 ± 3.8 years) underwent diffusion MRI at four timepoints over one year. Forty-nine healthy children (9.0 ± 4.2 years), scanned at a single timepoint, served as age- and sex-matched controls. Automated Fibre Quantification was used to segment cerebellar peduncles and compute fractional anisotropy (FA) at 30 nodes along each tract.
Thirteen patients developed cerebellar mutism syndrome. FA was significantly lower in the distal third of the left superior cerebellar peduncle pre-operatively in all patients compared to controls (FA in proximal third 0.228, middle and distal thirds 0.270, p = 0.01, Cohen’s d = 0.927). Pre-operative differences in FA did not predict cerebellar mutism syndrome. However, post-operative reductions in FA were highly specific to the distal left superior cerebellar peduncle, and were most pronounced in children with cerebellar mutism syndrome compared to those without at the 1–4 month follow up (0.325 vs 0.512, p = 0.042, d = 1.36) and at the 1-year follow up (0.342, vs 0.484, p = 0.038, d = 1.12).
High spatial resolution cerebellar profilometry indicated a site-specific alteration of the distal segment of the superior cerebellar peduncle seen in cerebellar mutism syndrome which may have important surgical implications in the treatment of these devastating tumours of childhood. |
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AbstractList | Cerebellar mutism syndrome, characterised by mutism, emotional lability and cerebellar motor signs, occurs in up to 39% of children following resection of medulloblastoma, the most common malignant posterior fossa tumour of childhood. Its pathophysiology remains unclear, but prior studies have implicated damage to the superior cerebellar peduncles. In this study, the objective was to conduct high-resolution spatial profilometry of the cerebellar peduncles and identify anatomic biomarkers of cerebellar mutism syndrome. In this retrospective study, twenty-eight children with medulloblastoma (mean age 8.8 ± 3.8 years) underwent diffusion MRI at four timepoints over one year. Forty-nine healthy children (9.0 ± 4.2 years), scanned at a single timepoint, served as age- and sex-matched controls. Automated Fibre Quantification was used to segment cerebellar peduncles and compute fractional anisotropy (FA) at 30 nodes along each tract. Thirteen patients developed cerebellar mutism syndrome. FA was significantly lower in the distal third of the left superior cerebellar peduncle pre-operatively in all patients compared to controls (FA in proximal third 0.228, middle and distal thirds 0.270, p = 0.01, Cohen's d = 0.927). Pre-operative differences in FA did not predict cerebellar mutism syndrome. However, post-operative reductions in FA were highly specific to the distal left superior cerebellar peduncle, and were most pronounced in children with cerebellar mutism syndrome compared to those without at the 1-4 month follow up (0.325 vs 0.512, p = 0.042, d = 1.36) and at the 1-year follow up (0.342, vs 0.484, p = 0.038, d = 1.12). High spatial resolution cerebellar profilometry indicated a site-specific alteration of the distal segment of the superior cerebellar peduncle seen in cerebellar mutism syndrome which may have important surgical implications in the treatment of these devastating tumours of childhood. • Damage to cerebellar outflow pathway is implicated in cerebellar mutism syndrome. • We indicate a site-specific alteration in distal superior cerebellar peduncle in CMS. • Important implications on surgical resection of paediatric posterior fossa tumours. Cerebellar mutism syndrome, characterised by mutism, emotional lability and cerebellar motor signs, occurs in up to 39% of children following resection of medulloblastoma, the most common malignant posterior fossa tumour of childhood. Its pathophysiology remains unclear, but prior studies have implicated damage to the superior cerebellar peduncles. In this study, the objective was to conduct high-resolution spatial profilometry of the cerebellar peduncles and identify anatomic biomarkers of cerebellar mutism syndrome. In this retrospective study, twenty-eight children with medulloblastoma (mean age 8.8 ± 3.8 years) underwent diffusion MRI at four timepoints over one year. Forty-nine healthy children (9.0 ± 4.2 years), scanned at a single timepoint, served as age- and sex-matched controls. Automated Fibre Quantification was used to segment cerebellar peduncles and compute fractional anisotropy (FA) at 30 nodes along each tract. Thirteen patients developed cerebellar mutism syndrome. FA was significantly lower in the distal third of the left superior cerebellar peduncle pre-operatively in all patients compared to controls (FA in proximal third 0.228, middle and distal thirds 0.270, p = 0.01, Cohen’s d = 0.927). Pre-operative differences in FA did not predict cerebellar mutism syndrome. However, post-operative reductions in FA were highly specific to the distal left superior cerebellar peduncle, and were most pronounced in children with cerebellar mutism syndrome compared to those without at the 1–4 month follow up (0.325 vs 0.512, p = 0.042, d = 1.36) and at the 1-year follow up (0.342, vs 0.484, p = 0.038, d = 1.12). High spatial resolution cerebellar profilometry indicated a site-specific alteration of the distal segment of the superior cerebellar peduncle seen in cerebellar mutism syndrome which may have important surgical implications in the treatment of these devastating tumours of childhood. •Damage to cerebellar outflow pathway is implicated in cerebellar mutism syndrome.•We indicate a site-specific alteration in distal superior cerebellar peduncle in CMS.•Important implications on surgical resection of paediatric posterior fossa tumours. Cerebellar mutism syndrome, characterised by mutism, emotional lability and cerebellar motor signs, occurs in up to 39% of children following resection of medulloblastoma, the most common malignant posterior fossa tumour of childhood. Its pathophysiology remains unclear, but prior studies have implicated damage to the superior cerebellar peduncles. In this study, the objective was to conduct high-resolution spatial profilometry of the cerebellar peduncles and identify anatomic biomarkers of cerebellar mutism syndrome. In this retrospective study, twenty-eight children with medulloblastoma (mean age 8.8 ± 3.8 years) underwent diffusion MRI at four timepoints over one year. Forty-nine healthy children (9.0 ± 4.2 years), scanned at a single timepoint, served as age- and sex-matched controls. Automated Fibre Quantification was used to segment cerebellar peduncles and compute fractional anisotropy (FA) at 30 nodes along each tract. Thirteen patients developed cerebellar mutism syndrome. FA was significantly lower in the distal third of the left superior cerebellar peduncle pre-operatively in all patients compared to controls (FA in proximal third 0.228, middle and distal thirds 0.270, p = 0.01, Cohen’s d = 0.927). Pre-operative differences in FA did not predict cerebellar mutism syndrome. However, post-operative reductions in FA were highly specific to the distal left superior cerebellar peduncle, and were most pronounced in children with cerebellar mutism syndrome compared to those without at the 1–4 month follow up (0.325 vs 0.512, p = 0.042, d = 1.36) and at the 1-year follow up (0.342, vs 0.484, p = 0.038, d = 1.12). High spatial resolution cerebellar profilometry indicated a site-specific alteration of the distal segment of the superior cerebellar peduncle seen in cerebellar mutism syndrome which may have important surgical implications in the treatment of these devastating tumours of childhood. |
ArticleNumber | 103000 |
Author | Clark, Christopher A. Grant, Gerald A. Feldman, Heidi M. Jabarkheel, Rashad Yecies, Derek Mankad, Kshitij Bruckert, Lisa Aquilina, Kristian Toescu, Sebastian M. Zhang, Michael Yeom, Kristen W. Travis, Katherine E. |
Author_xml | – sequence: 1 givenname: Sebastian M. surname: Toescu fullname: Toescu, Sebastian M. email: sebastian.toescu@ucl.ac.uk organization: Division of Developmental-Behavioural Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 2 givenname: Lisa surname: Bruckert fullname: Bruckert, Lisa organization: Division of Developmental-Behavioural Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 3 givenname: Rashad surname: Jabarkheel fullname: Jabarkheel, Rashad organization: Department of Neurosurgery, Lucille Packard Children’s Hospital, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 4 givenname: Derek surname: Yecies fullname: Yecies, Derek organization: Department of Neurosurgery, Lucille Packard Children’s Hospital, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 5 givenname: Michael surname: Zhang fullname: Zhang, Michael organization: Department of Neurosurgery, Lucille Packard Children’s Hospital, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 6 givenname: Christopher A. surname: Clark fullname: Clark, Christopher A. organization: Developmental Imaging and Biophysics Section, UCL-GOS Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK – sequence: 7 givenname: Kshitij surname: Mankad fullname: Mankad, Kshitij organization: Department of Radiology, Great Ormond Street Hospital, London WC1N 3JH, UK – sequence: 8 givenname: Kristian surname: Aquilina fullname: Aquilina, Kristian organization: Department of Neurosurgery, Great Ormond Street Hospital, London WC1N 3JH, UK – sequence: 9 givenname: Gerald A. surname: Grant fullname: Grant, Gerald A. organization: Department of Neurosurgery, Lucille Packard Children’s Hospital, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 10 givenname: Heidi M. surname: Feldman fullname: Feldman, Heidi M. organization: Division of Developmental-Behavioural Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 11 givenname: Katherine E. surname: Travis fullname: Travis, Katherine E. organization: Division of Developmental-Behavioural Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA – sequence: 12 givenname: Kristen W. surname: Yeom fullname: Yeom, Kristen W. organization: Department of Radiology, Lucile Packard Children’s Hospital, Stanford University School of Medicine, Stanford, CA 94305, USA |
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Keywords | Diffusion MRI Tractography Medulloblastoma Cerebellar mutism syndrome Dentato-rubro-thalamo-cortical tract |
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Snippet | •Damage to cerebellar outflow pathway is implicated in cerebellar mutism syndrome.•We indicate a site-specific alteration in distal superior cerebellar... Cerebellar mutism syndrome, characterised by mutism, emotional lability and cerebellar motor signs, occurs in up to 39% of children following resection of... • Damage to cerebellar outflow pathway is implicated in cerebellar mutism syndrome. • We indicate a site-specific alteration in distal superior cerebellar... |
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StartPage | 103000 |
SubjectTerms | Cerebellar mutism syndrome Dentato-rubro-thalamo-cortical tract Diffusion MRI Medulloblastoma Regular Tractography |
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Title | Spatiotemporal changes in along-tract profilometry of cerebellar peduncles in cerebellar mutism syndrome |
URI | https://dx.doi.org/10.1016/j.nicl.2022.103000 https://www.ncbi.nlm.nih.gov/pubmed/35370121 https://search.proquest.com/docview/2646942176 https://pubmed.ncbi.nlm.nih.gov/PMC9421471 https://doaj.org/article/b37fc83ed9a847ccb04bc4f9dcd2496f |
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