Functional Imaging of Cerebellar Mutism Syndrome

Memorial Sloan Kettering Cancer Center4 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Brain Mass

Interventions

MRI with DTI and fMRIPROCEDURE

When possible, the subject will undergo a post operative fMRI/ DTI scan as well as clinical language testing. If the subject develops CMS, the second fMRI will be performed as soon as possible. Some subjects may be severely impaired or have difficulty performing fMRI and clinical language testing tasks. In these instances, the fMRI and language testing may not be performed, or we may choose to perform resting state or passive fMRI tasks instead.

Eligibility

Sex: ALLMin age: 3 YearsMax age: 21 Years

Medical Language ↔ Plain English

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)

Locations (1)

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Outcomes

Primary Outcomes

investigate the feasibility of performing preoperative fMRI

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.

Time frame: 1 year

Secondary Outcomes

To investigate potential changes in Diffusion Tensor Imaging (DTI) and tractography

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

Time frame: 1 year

To investigate potential changes in DTI after posterior fossa surgery

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.

Time frame: 1 year

Data from ClinicalTrials.gov

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