Neuropsychological Profile in Children with Posterior Fossa Tumors with or Without Postoperative Cerebellar Mutism Syndrome (CMS)

Cámara, Silvia; Fournier, Ma Concepción; Cordero, Patricia Madrigal; Melero, Javier; Robles, Fernando; Esteso, Borja; Vara, Ma Teresa; Rodríguez, Serafín; Lassaletta, Álvaro; Budke, Marcelo

doi:10.1007/s12311-019-01088-4

Cited by 43 publications

(55 citation statements)

References 38 publications

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“…The analysis of reading performance revealed a wide range of deficits in patients ( Table 1 ): slow reading, larger total number of fixations and fixations per word, longer fixation duration, increased percentage of saccadic regressions, and larger variability of progressive saccades. Very few studies conducted on patients with similar condition have assessed their reading skills [ 29 , 32 , 33 ], while to our knowledge, there are no studies in which oculomotor parameters changes were described. Oculomotor parameters while reading are thought to reflect reading skills level [ 34 , 35 , 36 ]; therefore, we assume these skills to be impaired in our patients as a result of existing cerebellar dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Reading in Children Who Survived Cerebellar Tumors: Evidence from Eye Movements

Mironets

Shurupova

Dreneva

2022

Vision

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Cerebellar tumors often affect the eye movement centers located in vermis, negatively affecting cognitive development and learning abilities in children. Previous research has established that patients who survived cerebellar tumors tend to demonstrate various saccadic impairments (e.g., hypermetria) and poor gaze stability as compared to healthy controls. The aim of the current study was to evaluate the influence of oculomotor deficits in such patients on reading parameters. A total of 112 children (8–17 y.o.), 65 of whom survived cerebellar tumors, participated in the study. The study design included several oculomotor and reading tasks. Eye movements were recorded every 1/60 s monocularly with an Arrington eye tracker. We observed profound reading impairments in the patients as compared to healthy children, including longer reading time, greater numbers of fixations and regressive saccades, and longer fixation durations. We also found significant correlations between changes in basic oculomotor functions and reading parameters. The patients also demonstrated gaze fixation instability, large number of fixations, and long scanpath reflecting the return of the gaze to the already counted objects. Thus, oculomotor changes caused by cerebellar tumor and its treatment led to disturbances in such neurocognitive activity as reading. Our findings emphasize the necessity of considering these deficits in cerebellar tumor survivors when designing rehabilitation protocols.

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Section: Discussionmentioning

confidence: 99%

Reading in Children Who Survived Cerebellar Tumors: Evidence from Eye Movements

Mironets

Shurupova

Dreneva

2022

Vision

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“…More precisely, children with hydrocephalus often show a high discrepancy between verbal IQ and their performance score, to the advantage of the former. Hydrocephalus severity is thought to negatively affect visuospatial [ 89 ] and fine-motor skills, such as manual speed and visuomotor coordination [ 90 ]. This is probably related to the diffuse white matter damage caused by the increased pressure in the brain [ 88 , 91 ].…”

Section: Discussionmentioning

confidence: 99%

Processing Speed and Time since Diagnosis Predict Adaptive Functioning Measured with WeeFIM in Pediatric Brain Tumor Survivors

Oprandi

Oldrati

Fave

et al. 2021

Cancers

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(1) Background: Brain tumor (BT) survivors show difficulties in the acquisition of developmental milestones, related to academic achievement, vocational employment, social relationships, and autonomy. The skills underlying adaptive functioning (AF) are usually damaged in BT survivors due to the presence of the brain tumor, treatment-related factors, and other neurological sequelae. In this study, we aimed to explore the contribution of different cognitive factors in children with BT to AF, considering diagnosis-related variables. (2) Methods: Standardized cognitive assessment was undertaken and clinical information was collected from a retrospective cohort of 78 children with a BT, aged between 6 and 18 year old at the time of the assessment. Regression models were computed to investigate the influence of the selected variables on daily functional skills as measured by the Functional Independence Measure for Children (WeeFIM). (3) Results: The analyses showed that the main explanatory variables are processing speed and time since diagnosis. Other clinical variables, such as age at diagnosis and hydrocephalus, differentially influence functional skills according to distinct domains (i.e., self-care, mobility, and cognition). (4) Conclusions: The main explanatory variables of AF that emerged in our models point to a potential target of improving AF management in pediatric BT survivors.

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“…Although mutism is always transient and recovers spontaneously, long-term dysarthria or other higher language impairments often persist 3 . Another remarkable feature of this condition is emotional lability, which is characterized by exaggerated changes in mood or affect with a rapid uctuation of emotional expression 4,5 . The overall estimated incidence of the syndrome in children with PFT is between 11% and 30%, depending on the different presentations of tumor types 6 .…”

Section: Introductionmentioning

confidence: 99%

Unmet Needs in Clinical Practice: A Proposal and Application of A Diagnostic and Severity Scale to Grade Cerebellar Mutism Syndrome

Ricci

D’Alessandro

Somà

et al. 2021

Preprint

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BACKGROUND: The post-operative Pediatric Cerebellar Mutism Syndrome (CMS) affects about one-third of children and adolescents following surgical removal of a posterior fossa tumor (PFT). According to the Posterior Fossa Society consensus working definition, CMS is characterized by delayed onset mutism/reduced speech and emotional lability after cerebellar or 4th ventricle tumor surgery in children, with additional common features that include hypotonia and oropharyngeal dysfunction/dysphagia. The main objective of this work was to propose a diagnostic scale to grade CMS duration and severity.METHOD: Thirty consecutive subjects, aged 1-17 years (median 8 years, IQR 7) were evaluated with the proposed Post-Operative Pediatric CMS Survey after surgical resection of a PFT and, in cases of CMS, for the next 30 days after the onset (T0) or until symptom remission. At day 30th (T1), CMS was classified into mild, moderate, or severe according to the proposed Scale.RESULTS: CMS occurred in 13 patients (43.3%, 95% C.I.: 25.5-62.6%), with mild severity in 4 cases (31%), moderate in 4 (31%), and severe in 5 (38%). At T1, longer symptom persistence was associated with greater severity (p=0.01). Greater severity at T0 predicted greater severity at T1 (p=0.0001). Children with a midline tumor location and those aged under 5 years at diagnosis were at higher risk of CMS (p=0.025 and p=0.008, respectively).CONCLUSIONS: The proposed scale is a simple and applicable tool for estimating the severity of CMS at its onset, monitoring its course over time, and providing an early prognostic stratification to guide treatment decisions.

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Neuropsychological Profile in Children with Posterior Fossa Tumors with or Without Postoperative Cerebellar Mutism Syndrome (CMS)

Cited by 43 publications

References 38 publications

Reading in Children Who Survived Cerebellar Tumors: Evidence from Eye Movements

Reading in Children Who Survived Cerebellar Tumors: Evidence from Eye Movements

Processing Speed and Time since Diagnosis Predict Adaptive Functioning Measured with WeeFIM in Pediatric Brain Tumor Survivors

Unmet Needs in Clinical Practice: A Proposal and Application of A Diagnostic and Severity Scale to Grade Cerebellar Mutism Syndrome

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