title: Cognitive disorders in pediatric medulloblastoma: what neuroimaging has to offer.
abstract: Medulloblastomas are the most common malignant childhood brain tumors arising in the posterior fossa. Treatment improvements for these tumors have meant that there are a greater number of survivors, but this long-term patient survival has increased the awareness of resulting neurocognitive deficits. Impairments in attention, memory, executive functions, and intelligence quotient demonstrate that the cerebellum likely plays a significant role in numerous higher cognitive functions such as language, cognitive, and emotional functions. In addition, children with medulloblastoma not only have cerebellar lesions but also brain white matter damages due to radiation and chemotherapy. Functional neuroimaging, a noninvasive method with many advantages, has become the standard tool in clinical and cognitive neuroscience research. By reviewing functional neuroimaging studies, this review aims to clarify the role of the cerebellum in cognitive function and explain more clearly cognitive sequelae due to polytherapy in children with medulloblastoma. This review suggests that the posterior cerebellar lobes are crucial to maintaining cognitive performance. Clinical investigations could help to better assess the involvement of these lobes in cognitive functions.
authors.affiliation: Department of Radiology, University Hospital Viettiep, Haiphong, Vietnam;
authors.forename: Duc Ha
authors.initials: DH
authors.lastname: Hoang
authors.forename: Anne
authors.initials: A
authors.lastname: Pagnier
authors.forename: Karine
authors.initials: K
authors.lastname: Guichardet
authors.forename: Fanny
authors.initials: F
authors.lastname: Dubois-Teklali
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schiff
authors.forename: Geneviève
authors.initials: G
authors.lastname: Lyard
authors.forename: Emilie
authors.initials: E
authors.lastname: Cousin
authors.forename: Alexandre
authors.initials: A
authors.lastname: Krainik
mesh_terms: D001288:Attention; D001921:Brain / Q000473:pathology; D002528:Cerebellar Neoplasms / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D002531:Cerebellum / Q000187:drug effects / Q000473:pathology* / Q000528:radiation effects; D002648:Child; D003071:Cognition / Q000187:drug effects / Q000528:radiation effects; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology*; D056344:Executive Function; D006801:Humans; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008527:Medulloblastoma / Q000188:drug therapy / Q000523:psychology* / Q000532:radiotherapy; D008568:Memory; D008569:Memory Disorders / Q000209:etiology / Q000473:pathology; D059906:Neuroimaging / Q000379:methods; D017741:Survivors
keywords: ADC = apparent diffusion coefficient; BOLD = blood oxygen–level dependent; DTI = diffusion tensor imaging; FA = fractional anisotropy; cerebellum; children; cognitive disorder; fMRI = functional MRI; function neuroimaging; medulloblastoma; oncology