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Anatomo-functional study of the cerebellum in working memory in children treated for medulloblastoma

SUMMARY

Introduction and Purpose: Medulloblastoma is the most common malignant cerebral tumor during childhood, arising in the posterior fossa. Children treated for medulloblastoma often experience working memory (WM) deficits, affecting their quality of life and school performance. The aim of the present study undertaken to describe the cerebellar involvement in WM deficits observed in these children.

Method: Healthy children and children treated for medulloblastoma were included into study. All subjects performed a detailed neuropsychological examination, an anatomical and functional MRI. Stimuli were presented to the participants with alternating sensory modality and nature of communication in a block design during functional magnetic resonance imaging acquisitions. A Mann- Whitney U test was used for analyzing neuropsychological and behavioral data. The SPM8 and the SUIT (Spatially Unbiased Atlas Template) were utilized for anatomical and functional MRI data.

Results: The patients had cerebellar lesions locating principally in the left posterior lobe. These patients were significantly reduced intelligence quotient, central executive and visuospatial WM. In healthy children group, fMRI showed robust activations for nonverbal or visuospatial WM in the left posterior cerebellar lobe.

Conclusion: This study provides further evidence that the cerebellum plays a role in WM. Lesions of the left posterior cerebellar lobe may lead to nonverbal WM impairment in children. These finding contribute to treatment planning and to rehabilitation for improving the quality of life of children treated for cerebellar medulloblastoma.

Keywords: Medulloblastoma, cerebellum function