title: Evidence for cerebellar-frontal subsystem changes in children treated with intrathecal chemotherapy for leukemia: enhanced data analysis using an effect size model.
abstract: BACKGROUND
  Following brain insult in early childhood, the later maturing neocerebellum and frontal lobes frequently show abnormalities.
  
  
  OBJECTIVE
  To investigate the morphologic characteristics and function of a proposed cerebellar-frontal subsystem in children treated for acute lymphoblastic leukemia (ALL) with intrathecal methotrexate using quantitative magnetic resonance imaging, neuropsychological measures, nonlinear multiple regression analysis, and a statistical effect size model that augments interpretive validity of nonsignificant statistical findings, particularly from small sample size studies.
  
  
  METHODS
  Comparison and relationship of magnetic resonance imaging morphometry of cerebellar lobuli I-V and VI-VII and prefrontal cortices, and performance on 5 neuropsychological tests assessing visual-spatial attention, short-term memory, and visuomotor organization and coordination between childhood survivors of ALL and a matched control group.
  
  
  METHODS
  Ten childhood survivors of ALL treated between 1982 and 1989 with standard 3-year intrathecal chemotherapy, and matched control subjects.
  
  
  METHODS
  Morphometric results of cerebellar lobuli I-V and VI-VII and prefrontal cortices, and results of Trail-Making Tests, Rey-Osterreith Complex Figure Test, WISC-III Coding.
  
  
  RESULTS
  Significant effect size model values for outcome measures in the ALL group support deficits in lobuli VI-VII and prefrontal cortices, and neuropsychological performance. Multiple regression analysis results were consistent with hypothesized involvement of a cerebellar-frontal brain subsystem.
  
  
  CONCLUSIONS
  Treatment of children with ALL with intrathecal methotrexate before 5 years of age has structural and functional effects on the developing neocerebellar-frontal subsystem.
authors.affiliation: Department of Psychology, The University of New Mexico, Albuquerque 87131, USA. lesnik@unm.edu
authors.forename: P G
authors.initials: PG
authors.lastname: Lesnik
authors.forename: K T
authors.initials: KT
authors.lastname: Ciesielski
authors.forename: B L
authors.initials: BL
authors.lastname: Hart
authors.forename: E C
authors.initials: EC
authors.lastname: Benzel
authors.forename: J A
authors.initials: JA
authors.lastname: Sanders
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D002531:Cerebellum / Q000002:abnormalities / Q000187:drug effects / Q000254:growth & development*; D002648:Child; D003071:Cognition / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000002:abnormalities / Q000187:drug effects / Q000254:growth & development*; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D009483:Neuropsychological Tests; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D000964:Antimetabolites, Antineoplastic; D008727:Methotrexate