Functional Imaging of Cerebellar Mutism Syndrome

Completed

Brief Summary: The purpose of this study is to better understand why some children with cancer have difficulty speaking after brain surgery. Difficulty speaking may be due to known complications to the language centers in the brain. These language centers may be located in slightly different places in different people. This study will study which areas may be damaged.

Recruitment & Eligibility

Inclusion Criteria

Subject and/or guardian is able to provide written informed consent prior to study registration
Age ≥3 years and ≤21 years
Newly diagnosed, untreated mass in posterior fossa, either benign or malignant
Is being evaluated for surgical resection of the mass
Able to perform clinical language testing in English

Exclusion Criteria

Claustrophobia
Any contraindication to MRI (e.g., pacemaker, aneurysm clip, tissue expander).
Pregnant or nursing female
Does not speak English as a primary language (as determined by the P.I. or treating physician after discussion with a potential subject and his/her family)
Preexisting language or developmental disorder that would limit ability to cooperate with testing (as determined by the P.I. or treating physician after interviewing potential subject and his/her family; for example, a child may be excluded if he/she has confirmed or suspected autism spectrum disorder, dysarthria, dyslexia, lisp, hypotonia, or other age inappropriate speech development)

Arm && Interventions

Group	Intervention	Description
mass in posterior fossa, either benign or malignant	MRI with DTI and fMRI	A pilot study will be performed. We will perform fMRI and DTI in children before and after surgery for posterior fossa brain tumors. Each subject will receive the standard of care for their brain tumors in terms of surgical resection, radiation therapy and/or chemotherapy.

Primary Outcome Measures

Name	Time	Method
investigate the feasibility of performing preoperative fMRI	1 year	in young children at risk for developing CMS after posterior fossa brain tumor resection. Age appropriate language functional MRI tasks targeting the cerebellar language centers will be performed in children before surgery and correlated with formal neuropsychological and language testing. The fMRI will be repeated after surgery. If ≥5 of the 7 subjects successfully complete ≥60% of the functional imaging tests, we will determine the pilot study to be successful and then pursue further study.

Secondary Outcome Measures

Name	Time	Method
To investigate potential changes in DTI after posterior fossa surgery	1 year	that may correlate with the development of CMS. We hypothesize that measurements of water diffusion by DTI and tractography will be altered in subjects who develop CMS, even without striking anatomical changes after surgery. DTI: Measurements of DTI parameters (e.g., fractional anisotropy, apparent diffusion coefficient) of cerebellar and cerebro-cerebellar white matter tracts on the postoperative scan. The preoperative and postoperative DTI results will be compared.
To investigate potential changes in Diffusion Tensor Imaging (DTI) and tractography	1 year	in subjects who develop CMS after brain tumor resection. Injury to cerebro-cerebellar tracts such as the dentatothalamocortical tracts has been implicated in the development of CMS. We propose studying the proximity between important language white matter paths and the surgical intervention before surgery. DTI: Measurements of DTI parameters (e.g., fractional anisotropy, apparent diffusion coefficient) of cerebellar and cerebro-cerebellar white matter tracts on the preoperative scan

Locations (1): Memorial Sloan Kettering Cancer Center
🇺🇸
New York, New York, United States

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