Neurocognitive deficits in medulloblastoma survivors and white matter loss.

Although previous studies have documented a significant risk of intellectual loss after treatment for childhood medulloblastoma (MED), the pathophysiology underlying this process is poorly understood. The purpose of this study was to test the hypotheses that (1) patients treated for MED in childhood...

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Publicado en:Annals of Neurology Vol. 46; no. 6; pp. 834 - 842
Autores principales: Mulhern RK, Reddick WE, Palmer SL, Glass JO, Elkin TD, Kun LE, Taylor J, Langston J, Gajjar A, Mulhern, R K, Reddick, W E, Palmer, S L, Glass, J O, Elkin, T D, Kun, L E, Taylor, J, Langston, J, Gajjar, A
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell 1999
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 1999
      vid: 46
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Neurocognitive deficits in medulloblastoma survivors and white matter loss.
      aug:
        au:
          Mulhern RK
          Reddick WE
          Palmer SL
          Glass JO
          Elkin TD
          Kun LE
          Taylor J
          Langston J
          Gajjar A
          Mulhern, R K
          Reddick, W E
          Palmer, S L
          Glass, J O
          Elkin, T D
          Kun, L E
          Taylor, J
          Langston, J
          Gajjar, A
        affil: Department of Diagnostic Imaging, St Jude Children's Research Hopital, Memphis, TN 38105-2794, USA
      sug:
        subj:
          Cancer Survivors
          Brain Neoplasms Therapy
          Cognition Disorders Etiology
          Child
          Neuropsychological Tests
          Intelligence Tests
          Radiotherapy Adverse Effects
          Magnetic Resonance Imaging
          Brain Neoplasms Radiotherapy
          Brain Neoplasms Drug Therapy
          Antineoplastic Agents, Combined Adverse Effects
          Wechsler Adult Intelligence Scale-Revised
          Age of Onset
          Comparative Studies
          Regression
          Female
          Male
          Funding Source
          Human
          Child: 6-12 years
          Female
          Male
      ab: Although previous studies have documented a significant risk of intellectual loss after treatment for childhood medulloblastoma (MED), the pathophysiology underlying this process is poorly understood. The purpose of this study was to test the hypotheses that (1) patients treated for MED in childhood have reduced volumes of normal white matter (NWM) related to their treatment with craniospinal irradiation with or without chemotherapy, and (2) deficits in NWM among patients surviving MED can at least partially explain deficits in their intellectual performance. Eighteen pediatric patients previously treated for MED were matched on the basis of age at the time of evaluation to 18 patients previously treated for low-grade posterior fossa tumors with surgery alone (mean difference, 3.7 months). Evaluations were conducted with age-appropriate neurocognitive testing and quantitative magnetic resonance imaging by using a novel automated segmentation and classification algorithm constructed from a hybrid neural network. Patients treated for MED had significantly less NWM (p < 0.01) and significantly lower Full-Scale IQ values than those treated for low-grade tumors (mean, 82.1 vs 92.9). In addition, NWM had a positive and statistically significant association with Full-Scale IQ among the patients treated for MED. We conclude that irradiation- or chemotherapy-induced destruction of NWM can at least partially explain intellectual and academic achievement deficits among MED survivors.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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