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Changes to Memory Structures in Children Treated for Posterior Fossa Tumors

Published online by Cambridge University Press:  24 January 2014

Lily Riggs
Affiliation:
Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario Department of Psychology, Hospital for Sick Children, Toronto, Ontario
Eric Bouffet
Affiliation:
Department of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario Department of Pediatrics, University of Toronto, Toronto, Ontario
Suzanne Laughlin
Affiliation:
Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario
Normand Laperriere
Affiliation:
Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario
Fang Liu
Affiliation:
Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario
Jovanka Skocic
Affiliation:
Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario
Nadia Scantlebury
Affiliation:
Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario
Frank Wang
Affiliation:
Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario
Nicholas J. Schoenhoff
Affiliation:
Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario
Douglas Strother
Affiliation:
Departments of Oncology and Pediatrics, University of Calgary, Calgary, Alberta
Juliette Hukin
Affiliation:
Department of Oncology, British Columbia Children's Hospital, Vancouver, British Columbia
Christopher Fryer
Affiliation:
Department of Oncology, British Columbia Children's Hospital, Vancouver, British Columbia
Dina McConnell
Affiliation:
Department of Psychology, British Columbia Children's Hospital, Vancouver, British Columbia
Donald J. Mabbott*
Affiliation:
Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario Department of Psychology, Hospital for Sick Children, Toronto, Ontario Department of Haematology/Oncology, Hospital for Sick Children, Toronto, Ontario Department of Psychology, University of Toronto, Toronto, Ontario
*
Correspondence and reprint requests to: Donald J. Mabbott, Psychology Department, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8. E-mail: donald.mabbott@sickkids.ca

Abstract

Children treated for medulloblastoma (MB) exhibit long-term impairments in declarative memory, but the pathophysiology underlying this is unclear. Previous studies report declines in global white matter volume, but have failed to link this to declines in memory performance. We examined the effects of treatment on measures of global brain structure (i.e., total white and gray matter volume) and specific memory structures (i.e., hippocampus and uncinate fasciculus). We used volumetric MRI and diffusion tensor imaging in pediatric survivors of MB and one survivor of astrocytoma treated with cranial-spinal radiation (n = 20), and healthy controls (n = 13). Compared to controls, the survivor group exhibited reduced white matter volume, damage to the uncinate fasciculus, and a smaller right hippocampus. Critically, reduced hippocampal volume was not related to differences in brain volume, suggesting that the hippocampus may be especially vulnerable to treatment effects. A subset of the survivors (n = 10) also underwent memory testing using the Children's Memory Scale (CMS). Performance on the general index of the CMS was significantly correlated with measures of hippocampal volume and uncinate fasciculus. The examination of treatment effects on specific brain regions provides a better understanding of long-term cognitive outcome in children with brain tumors, particularly medulloblastoma. (JINS, 2014, 1, 1–13)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2014 

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