Objective: To examine the impact of malignancy and location of the cerebellar tumor on motor, cognitive, and psychologic outcome.
Background: Although many studies focus on long-term outcome after cerebellar tumor treatment in childhood, the impact of its precise location remains unclear.
Patients and Methods: Children, aged from 6 to 13 years, with a cerebellar malignant tumor (MT; MT group, n=20) or a cerebellar benign tumor (BT; BT group, n=19) were examined at least 6 months after the end of treatment using the international cooperative ataxia rating scale, the Purdue pegboard for manual skill assessment and the age-adapted Weschler scale. Structural changes in brain anatomy were evaluated and parents and teachers answered 2 independent questionnaires.
Results: Parents and teachers reported high rate of learning and academic difficulties, but without any difference with respect to the type of tumor. However, children with cerebellar MT showed increased cognitive and motor difficulties compared with children with cerebellar BT. Cerebellar signs at clinical examination and manual skill impairment were strongly associated with cognitive difficulties. Both motor and cognitive impairments were found to be associated with extension of the lesion to the dentate nuclei.
Conclusions: Dentate nuclei lesions are major risk factors of motor and cognitive impairments in both cerebellar BT and MT.
*Laboratory of Psychology and Cognitive Neurosciences, University Paris Descartes, CNRS UMR 8189, Boulogne-Billancourt
†Hôpital Necker-Enfants Malades, Paris
§Hôpital National de Saint-Maurice, Saint-Maurice
‡Institut Gustave Roussy
∥Inserm U780, Villejuif, France
Reprints: Delphine Callu, PhD, Laboratoire de psychologie et de neurosciences cognitives, Institut de Psychologie, Université Paris Descartes, CNRS UMR 8189, 71 avenue Edouard Vaillant, 92100 Boulogne-Billancourt, France (e-mail: firstname.lastname@example.org).
DC was supported by grants from Fondation de France and Fondation pour la Recherche Médicale. This study was supported by a grant from Fondation de France and in part by a grant from Fondation Roche.
Received for publication February 5, 2009
accepted August 30, 2009