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Baudou E, Peran P, Tensaouti F, Arribarat G, Pariente J, Courbieres N, Pollidoro L, Bertozzi AI, Gambart M, Sevely A, Roques M, Ducassou A, Danna J, Tallet J, Dufour C, Chaix Y, Laprie A. The long-term impact of irradiation on functional connectivity in brain circuits involved in memory processes after pediatric posterior fossa tumor. Radiother Oncol 2024; 191:110073. [PMID: 38145791 DOI: 10.1016/j.radonc.2023.110073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/26/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
PURPOSE Memory is one of the main specific cognitive domains impaired with attention and processing speed after a pediatric brain tumor. This work explored the long-term impact of radiotherapy in children with posterior fossa tumor (PFT) on brain connectivity in neural circuits involved in memory using resting-state functional magnetic resonance imaging (rs-fMRI). METHODS A total of 20 irradiated and 15 non-irradiated PFT survivors, and 21 healthy controls, prospectively included in the IMPALA study (NCT04324450), performed memory tests assessing episodic, procedural, and working memories and were subjected to an rs-fMRI. We manually contoured main structures involved in memory to explore connectivity at rest in a seed-to-voxel analysis. The groups were compared and differences in connectivity were correlated with behavioral scores and irradiation doses. RESULTS The performance of all mnesic tasks was lower in PFT survivors with a greater alteration in working and episodic memory in irradiated patients. Irradiated survivors had atypical connectivities in all memory circuits compared to controls and in cortico-caudate and cortico-cerebellar circuits compared to non-irradiated survivors. Non-irradiated survivors had only atypical connectivities in the cortico-cerebellar circuits compared to controls. In irradiated survivors, atypical connectivities in cortico-hippocampal circuits were linked with episodic memory scores and dose of irradiation to the left hippocampus and in cortico-striatal circuits with procedural memory scores and dose of irradiation to the striatum. CONCLUSION The results of this study highlight that irradiation has a long-term impact on brain connectivity in brain circuits involved in memory after pediatric PFT with a specific radiation-dose effect in supratentorial structures.
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Affiliation(s)
- Eloïse Baudou
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France.
| | - Patrice Peran
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France
| | - Fatima Tensaouti
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Radiation Oncology Department, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Germain Arribarat
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France
| | - Jérémie Pariente
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Neurology Department, Toulouse University Hospital, Toulouse, France
| | - Nicolas Courbieres
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France
| | - Lisa Pollidoro
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Anne-Isabelle Bertozzi
- Pediatric Oncology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Marion Gambart
- Pediatric Oncology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Annick Sevely
- Radiology Department, Toulouse University Hospital, Toulouse, France
| | - Margaux Roques
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Radiology Department, Toulouse University Hospital, Toulouse, France
| | - Anne Ducassou
- Radiation Oncology Department, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Jérémy Danna
- CLLE, Université de Toulouse, CNRS, Toulouse, France
| | - Jessica Tallet
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France
| | - Christelle Dufour
- Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Yves Chaix
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Anne Laprie
- Toulouse NeuroImaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Radiation Oncology Department, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
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Baudou E, Danna J, Tallet J, Pollidoro L, Tensaouti F, Bertozzi AI, Pariente J, Courbieres N, Dufour C, Grill J, Chaix Y, Laprie A. Impact of a pediatric posterior fossa tumor and its treatments on motor procedural learning. Eur J Paediatr Neurol 2023; 44:37-45. [PMID: 37060708 DOI: 10.1016/j.ejpn.2023.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/17/2023]
Abstract
INTRODUCTION Posterior fossa tumor (PFT) survivors have difficulty learning new skills. Procedural memory is a skill learning system that allows, through training, the automatization of procedures and progressive improvement of performance. It underlies most of the motor procedures in everyday life that we perform automatically, such as riding a bike or writing. Motor procedural memory is divided into two components: motor sequence learning involving mainly cortico-striatal networks, and motor adaptation involving mainly cortico-cerebellar networks. The aim of this work was to explore the impact of a tumor and its treatment during childhood on procedural learning hypothesizing that sequence learning would be impaired in PFT survivors who have been treated with radiotherapy, whereas motor adaptation would be impaired in all PFT survivors. METHOD 22 irradiated survivors of PFT, 17 non-irradiated survivors and 21 healthy controls from the IMPALA study (NCT04324450) performed a motor sequence learning task and a motor adaptation task. Doses received by striatal and cerebellar structures were reported from the initial dosimetry plans. RESULTS Sequence learning was preserved in both tumor groups, but at the individual level 7/22 irradiated, and 4/17 non-irradiated participants failed to learn the motor sequence. Motor adaptation was impaired in both tumor groups, predominantly in the irradiated group. CONCLUSION This study sheds new light on the long-term impact of PFT treatments in childhood on a rarely-studied part of memory, which is perceptual-motor procedural learning. Our results suggest that the cerebellum and striatum could be considered as organs at risk with regard to procedural learning.
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Affiliation(s)
- Eloïse Baudou
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France.
| | - Jérémy Danna
- Aix Marseille Univ, CNRS, LNC, Marseille, France
| | - Jessica Tallet
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France
| | - Lisa Pollidoro
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Fatima Tensaouti
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Radiation Oncology Department, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
| | - Anne-Isabelle Bertozzi
- Pediatric Oncology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Jérémie Pariente
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Neurology Department, Toulouse University Hospital, Toulouse, France
| | - Nicolas Courbieres
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France
| | - Christelle Dufour
- Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology, Institut Gustave Roussy, University Paris-Saclay, Villejuif, France; CNRS Unit 8203, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Yves Chaix
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Pediatric Neurology Department, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | - Anne Laprie
- Toulouse Neuro-imaging Center (ToNIC), INSERM University of Toulouse Paul Sabatier, Toulouse, France; Radiation Oncology Department, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France
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Mohamad J, Simgen A. [Acoustic neuromas : Differential diagnoses]. Radiologe 2021; 60:1018-1025. [PMID: 32995935 DOI: 10.1007/s00117-020-00751-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CLINICAL ISSUE Acoustic neuromas in adults are the most common infratentorial tumors that originate from the Schwann's cells of the vestibular part of the eighth cranial nerve and are clinically noticeable through neurological deficits, such as unilateral hypoacusis, tinnitus, dizziness and unilateral facial nerve palsy. Due to the widespread use of computed tomography (CT) and magnetic resonance imaging (MRI), acoustic neuromas can now be diagnosed with a high rate of sensitivity and specificity; however, there are a number of possible differential diagnoses, such as meningioma, epidermoid and metastases as well as a number of less common diagnoses, such as peripheral nerve sheath tumors, sarcoidosis/neuritis and lipomas, which are sometimes difficult to distinguish from acoustic neuromas. Particularly smaller findings can often only be differentiated with the aid of a histopathological investigation. PRACTICAL RECOMMENDATIONS Small intrameatal and asymptomatic acoustic neuromas, some of which are discovered as incidental findings, do not require immediate treatment and should instead be monitored by MRI. Larger findings that are symptomatic and thus cause a number of severe neurological symptoms that are stressful for the patient, should be surgically removed. In cases where surgical treatment is not possible or for smaller symptomatic findings, radiotherapy can also be considered as an alternative.
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Affiliation(s)
- J Mohamad
- Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Kirrberger Straße 1, 66424, Homburg/Saar, Deutschland.
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Greve T, Beyer F, Szelényi A. Intraoperative Erb's Point-Vertex recording increases brainstem auditory evoked potential wave V amplitude. Clin Neurophysiol 2020; 131:420-4. [PMID: 31881448 DOI: 10.1016/j.clinph.2019.11.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/13/2019] [Accepted: 11/09/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Recording derivations for intraoperative brainstem auditory evoked potential (BAEP) monitoring consist of a preauricular electrode referenced to Cz'. These derivations are prone to unfavorable signal amplitude. This study analyses whether an alternative noncephalic electrode positioned over ipsilateral Erb's point, thereby generating a new Erb's point-vertex recording derivation, improves BAEP recordings. METHODS Electrodes were placed preauricularly (A1/A2) and at left and right Erb's point (EP1/EP2). They were referenced to Cz'. Click sound stimulation (80-95 dB above hearing level) was applied. At intraoperative baseline conditions, latencies and amplitudes of waves I-V of all derivations were analyzed. RESULTS Data of 30 patients (54 ± 15 years/17 females) with normal hearing or mild symmetrical presbycusis undergoing infratentorial surgeries (15 microvascular decompressions) were analyzed. Using EP1-Cz'/EP2-Cz' derivations compared to A1-Cz'/A2-Cz', amplitudes for wave IV (left +65%, p < 0.001; right +43%, p = 0.002) and wave V (left +54%, p < 0.001; right +48%, p < 0.001) were significantly increased. Only in the left (EP1) derivation, there was a tendency towards less reproducibility of wave I, resulting in a decrease of amplitude (-35%, p = 0.005). CONCLUSIONS Adding an Erb's point electrode derivation resulted in larger amplitudes of waves IV to V. whereas conventional preauricular or mastoid derivation is preferential for wave I assessment. SIGNIFICANCE Increased wave amplitudes facilitate detection of pathologically reduced wave forms (wave V in particular) which represents a significant advancement.
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Ben Nsir A, Thai QA, Kassar AZ, Ben Said I, Jemel H. Primary Cerebellar Gliosarcoma with Extracranial Metastases: An Orphan Differential Diagnosis. World Neurosurg 2015; 84:2076.e13-7. [PMID: 26239018 DOI: 10.1016/j.wneu.2015.07.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/18/2015] [Accepted: 07/20/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND Gliosarcomas are rare, malignant primary brain tumors, most commonly located in the temporal lobe, that contain both glial and mesenchymal elements. Gliosarcomas located within the cerebellum are exceedingly rare. The previously unreported finding of a cerebellar gliosarcoma concurrently with an extracranial metastasis to the lungs is discussed here. CASE DESCRIPTION A 57-year-old man presented with a 3-month history of chest pain, weight loss, headaches, and vomiting. Physical examination revealed a left cerebellar dysfunction, and the radiological work-up revealed a 6 × 6-cm right apical pulmonary tumor and a 4 × 3.5 × 3.8-cm peripherally enhancing left cerebellar mass. On the basis of a smoking history in the setting of a lung lesion and cerebellar mass, the presumptive diagnosis was primary lung cancer with metastasis to the cerebellum. Gross total resection of a firm pseudo-encapsulated cerebellar mass was performed. The microscopic features and the immunohistochemical profile confirmed the diagnosis of Gliosarcoma. The thoracic lesion was removed subsequently, and pathology confirmed it as an extracranial metastasis from the cerebellar gliosarcoma. Adjuvant radiation and chemotherapy were then administered. No clinical or radiographic evidence of recurrence was observed during one year of follow-up monitoring. CONCLUSIONS To the best of our knowledge, a primary infratentorial gliosarcoma with extracranial metastases has not been previously described.
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Moon SK, Kim EJ, Choi WS, Ryu CW, Park BJ, Lee J. Gliosarcoma of the cerebellar hemisphere: a case report and review of the literature. Korean J Radiol 2010; 11:566-70. [PMID: 20808702 PMCID: PMC2930167 DOI: 10.3348/kjr.2010.11.5.566] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2009] [Accepted: 02/11/2010] [Indexed: 11/28/2022] Open
Abstract
Gliosarcoma is a rare central nervous system tumor usually located in the supratentorial area. Here we report a rare case of a gliosarcoma that developed in the cerebellar hemisphere in a 70-year-old woman. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain revealed an infratentorial mass of which radiological features were similar to those of glioblastoma. The tumor was diagnosed by pathology as a gliosarcoma. Though rare, gliosarcoma should be considered in the differential diagnosis of infratentorial tumors with radiological features of glioblastoma or metastasis in elderly patients.
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Affiliation(s)
- Sung Kyoung Moon
- Department of Radiology, Kyung Hee University Medical Center, Seoul, Korea
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