TY - JOUR
T1 - A CBF decrease in the left supplementary motor areas
T2 - New insight into postoperative pediatric cerebellar mutism syndrome using arterial spin labeling perfusion MRI
AU - Boisgontier, Jennifer
AU - Fillon, Ludovic
AU - Rutten, Caroline
AU - Saitovitch, Ana
AU - Dufour, Christelle
AU - Lemaître, Hervé
AU - Beccaria, Kévin
AU - Blauwblomme, Thomas
AU - Levy, Raphaël
AU - Dangouloff-Ros, Volodia
AU - Grévent, David
AU - Roux, Charles Joris
AU - Grill, Jacques
AU - Vinçon-Leite, Alice
AU - Saidoun, Lila
AU - Bourdeaut, Franck
AU - Zilbovicius, Monica
AU - Boddaert, Nathalie
AU - Puget, Stéphanie
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Postoperative pediatric cerebellar mutism syndrome (pCMS), characterized mainly by delayed onset transient mutism is a poorly understood complication that may occur after pediatric medulloblastoma (MB) resection. Our aim was to investigate postoperative changes in whole-brain cerebral blood flow (CBF) at rest in pCMS patients using arterial spin labeling (ASL) perfusion imaging. This study compared preoperative and postoperative T2-weighted signal abnormalities and CBF using a voxel-wise, whole-brain analysis in 27 children undergoing MB resection, including 11 patients who developed mutism and 16 who did not. Comparison of postoperative T2 signal abnormalities between patients who developed pCMS (mean age 7.0 years) and those who did not showed that pCMS (mean age 8.9 years) patients were significantly more likely to present with T2-weighted hyperintensities in the right dentate nucleus (DN) (p = 0.02). Comparison of preoperative and postoperative CBF in patients with pCMS showed a significant postoperative CBF decrease in the left pre-supplementary motor area (pre-SMA) (p = 0.007) and SMA (p = 0.009). In patients who did not develop pCMS, no significant differences were observed. Findings provide evidence of an association between pCMS, injury to the right DN, and left pre-SMA/SMA hypoperfusion, areas responsible for speech. This supports the relevance of CBF investigations in pCMS.
AB - Postoperative pediatric cerebellar mutism syndrome (pCMS), characterized mainly by delayed onset transient mutism is a poorly understood complication that may occur after pediatric medulloblastoma (MB) resection. Our aim was to investigate postoperative changes in whole-brain cerebral blood flow (CBF) at rest in pCMS patients using arterial spin labeling (ASL) perfusion imaging. This study compared preoperative and postoperative T2-weighted signal abnormalities and CBF using a voxel-wise, whole-brain analysis in 27 children undergoing MB resection, including 11 patients who developed mutism and 16 who did not. Comparison of postoperative T2 signal abnormalities between patients who developed pCMS (mean age 7.0 years) and those who did not showed that pCMS (mean age 8.9 years) patients were significantly more likely to present with T2-weighted hyperintensities in the right dentate nucleus (DN) (p = 0.02). Comparison of preoperative and postoperative CBF in patients with pCMS showed a significant postoperative CBF decrease in the left pre-supplementary motor area (pre-SMA) (p = 0.007) and SMA (p = 0.009). In patients who did not develop pCMS, no significant differences were observed. Findings provide evidence of an association between pCMS, injury to the right DN, and left pre-SMA/SMA hypoperfusion, areas responsible for speech. This supports the relevance of CBF investigations in pCMS.
KW - Arterial spin labeling
KW - cerebral blood flow
KW - mutism
KW - pediatric
KW - supplementary motor areas
UR - http://www.scopus.com/inward/record.url?scp=85110250441&partnerID=8YFLogxK
U2 - 10.1177/0271678X211031321
DO - 10.1177/0271678X211031321
M3 - Article
C2 - 34259072
AN - SCOPUS:85110250441
SN - 0271-678X
VL - 41
SP - 3339
EP - 3349
JO - Journal of Cerebral Blood Flow and Metabolism
JF - Journal of Cerebral Blood Flow and Metabolism
IS - 12
ER -