ArticleNeuro-oncology2023
Fastigial nuclei surgical damage and focal midbrain disruption implicate PAG survival circuits in cerebellar mutism syndrome.
Article in Neuro-oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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21 citing papers in PubMed, 27 citations in OpenAlex.
- Frequency-dependent cerebellar circuits independently gate social vocalizations and movement.iScience · 2026Article
- Neurosurgical practice and its influence on postoperative paediatric cerebellar mutism syndrome-the Alder Hey experience.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Article
- Does the surgical route matter in cerebellar mutism syndrome? Comparing transvermian and telovelar approaches for pediatric posterior fossa tumors.Brain & spine · 2026Review
- Subcortical alterations following pediatric posterior fossa brain tumor treatment: A longitudinal MRI study.Neuroimage. Reports · 2025Article
- Fractal dimension as a predictive biomarker for tumor grade and cerebellar mutism syndrome in pediatric posterior fossa tumors.Quantitative imaging in medicine and surgery · 2025Article
- Neuropsychological function in childhood cancer patients and adult survivors of childhood cancer.Journal of clinical and experimental neuropsychology · 2025Review
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- Secondary cerebro-cerebellar and intra-cerebellar dysfunction in cerebellar mutism syndrome.Neuro-oncology · 2024Article
- Proceedings of the first global meeting of the Posterior Fossa Society: state of the art in cerebellar mutism syndrome.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Postoperative cerebellar mutism syndrome is an acquired autism-like network disturbance.Neuro-oncology · 2024Article
- National multicentered retrospective review of clinical and intraoperative factors associated with the development of cerebellar mutism after pediatric posterior fossa tumor resection.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Cerebellar Mutism Syndrome and Dentato-Thalamo-Cortical Tract Disruption in Diffusion Tractography Following Surgery for Medulloblastoma.Radiology · 2024Article
- Dopamine receptors of the rodent fastigial nucleus support skilled reaching for goal-directed action.Brain structure & function · 2024Article
- Evolution of neurosurgical advances and nuances in medulloblastoma therapy.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Review
- Application of the Rotterdam postoperative cerebellar mutism syndrome prediction model in patients undergoing surgery for medulloblastoma in a single institution.Journal of neurosurgery. Pediatrics · 2024Article
- Neuroanatomy of cerebellar mutism syndrome: the role of lesion location.Brain communications · 2024Article
- Cerebellar mutism is linked to midbrain volatility and desynchronization from speech cortices.Brain : a journal of neurology · 2023Article
- Cerebellar mutism syndrome of non-tumour surgical aetiology-a case report and literature review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023Review
- Neuroimaging of postoperative pediatric cerebellar mutism syndrome: a systematic review.Neuro-oncology advancesArticle
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPediatric postoperative cerebellar mutism syndrome (CMS) is a rare but well-known complication of medulloblastoma (Mb) resection with devastating effects on expressive language, mobility, cognition, and emotional regulation that diminishes quality of life for many Mb survivors. The specific anatomical and neuronal basis of CMS remains obscure. We address this issue by identifying patterns of surgical damage and secondary axonal degeneration in Mb survivors with CMS.
methodsChildren with Mb deemed high risk for CMS based on intraventricular location of the tumor had T1 images analyzed for location(s) of surgical damage using a specially developed algorithm. We used three complementary methods of spatial analysis to identify surgical damage linked to CMS diagnosis. Magnetization transfer ratio (MTR) images were analyzed for evidence of demyelination in anatomic regions downstream of the cerebellum, indicating neuronal dysfunction.
resultsSpatial analyses highlighted damage to the fastigial nuclei and their associated cerebellar cortices as the strongest predictors of CMS. CMS-related MTR decrease was greatest in the ventral periaqueductal gray (PAG) area and highly consistent in the left red nucleus.
conclusionOur evidence points to disruption of output from the fastigial nuclei as a likely causal trigger for CMS. We propose that core CMS symptoms result from a disruption in the triggering of survival behaviors regulated by the PAG, including the gating of vocalization and volitional movement. The fastigial nuclei provide the densest output to the PAG from the cerebellum, thus sparing these structures may provide a greater likelihood of CMS prevention.
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