title: Executive function in paediatric medulloblastoma: The role of cerebrocerebellar connections.
abstract: Executive functions (EFs) are involved in the attainment, maintenance, and integration of information; these functions may play a key role in cognitive and behavioural outcomes in children treated for medulloblastoma (MB). At present, it remains unclear which EFs are most sensitive to the treatment effects for MB and whether damage to cerebrocerebellar circuitry is associated with EF. We completed a comprehensive evaluation of EF in 24 children treated for MB and 20 age-matched healthy children (HC) and distilled these measures into components. Six components (C1-C6) were extracted from our model, reflecting dissociable constructs of EF: C1 = cognitive efficiency; C2 = planning/problem-solving; C3 = positive cognitive emotion regulation; C4 = working memory; C5 = negative cognitive emotion regulation; and C6 = mixed cognitive emotion regulation. Group differences were found for C1, C2, C3, and C4; the MB group showed poorer performance on EF tasks and made less use of positive cognitive emotion regulation strategies relative to HC. Compromise to cerebrocerebellar microstructure - cerebro-ponto-cerebellar and cerebello-thalamo-cerebral pathways - was evident in children treated for MB compared to HC. We found that cerebrocerebellar circuitry has a mediating effect on one component of EF following treatment for MB - working memory.
authors.affiliation: Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Psychology, Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Law
authors.affiliation: Department of Psychology, Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada.|Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Smith
authors.affiliation: Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada.|Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Greenberg
authors.affiliation: Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Bouffet
authors.affiliation: Division of Neurosurgery, Arthur and Sonia Labatt Brain Tumor Research Centre, Hospital for Sick Children, Toronto, Ontario, Canada.|Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Taylor
authors.affiliation: Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Laughlin
authors.affiliation: Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada.|Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.|Genetics and Genome Biology Program, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Pediatrics, University of Toronto, Ontario, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Malkin
authors.affiliation: Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.affiliation: Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Psychology, Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada.|Pediatric Oncology Group of Ontario, Toronto, Ontario, Canada.
authors.forename: Iska
authors.initials: I
authors.lastname: Moxon-Emre
authors.affiliation: Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Nadia
authors.initials: N
authors.lastname: Scantlebury
authors.affiliation: Program in Neuroscience and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.|Department of Psychology, Collaborative Program in Neuroscience, University of Toronto, Ontario, Canada.|Division of Hematology/Oncology, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Donald
authors.initials: D
authors.lastname: Mabbott
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002528:Cerebellar Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002648:Child; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D004644:Emotions / Q000502:physiology; D056344:Executive Function / Q000502:physiology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D008570:Memory, Short-Term / Q000502:physiology; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009483:Neuropsychological Tests; D011340:Problem Solving / Q000502:physiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: cerebrocerebellar pathways; diffusion tensor imaging; emotion regulation; executive function; medulloblastoma; white matter