{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T21:47:37Z","timestamp":1780955257506,"version":"3.54.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T00:00:00Z","timestamp":1717545600000},"content-version":"vor","delay-in-days":156,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01 NS114405-03"],"award-info":[{"award-number":["R01 NS114405-03"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01 NS114405-01S2"],"award-info":[{"award-number":["R01 NS114405-01S2"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Approximately 25% of paediatric patients who undergo cerebellar tumour resection develop cerebellar mutism syndrome. Our group recently showed that damage to the cerebellar deep nuclei and superior cerebellar peduncles, which we refer to as the cerebellar outflow pathway, is associated with an increased risk of cerebellar mutism syndrome. Here, we tested whether these findings replicate in an independent cohort. We evaluated the relationship between lesion location and the development of cerebellar mutism syndrome in an observational study of 56 paediatric patients ranging from five months to 14 years of age who underwent cerebellar tumour resection. We hypothesized that individuals who developed cerebellar mutism syndrome after surgery, relative to those who did not, would have lesions that preferentially intersect with: (i) the cerebellar outflow pathway and (ii) a previously generated \u2018lesion-symptom map\u2019 of cerebellar mutism syndrome. Analyses were conducted in accordance with pre-registered hypotheses and analytic methods (https:\/\/osf.io\/r8yjv\/). We found supporting evidence for both hypotheses. Compared to patients who did not develop cerebellar mutism syndrome, patients with cerebellar mutism syndrome (n = 10) had lesions with greater overlap with the cerebellar outflow pathway (Cohen\u2019s d = 0.73, P = 0.05), and the cerebellar mutism syndrome lesion-symptom map (Cohen\u2019s d = 1.1, P = 0.004). These results strengthen the association of lesion location with the risk of developing cerebellar mutism syndrome and demonstrate generalizability across cohorts. These findings may help to inform the optimal surgical approach to paediatric cerebellar tumours.<\/jats:p>","DOI":"10.1093\/braincomms\/fcae197","type":"journal-article","created":{"date-parts":[[2024,6,5]],"date-time":"2024-06-05T02:48:01Z","timestamp":1717555681000},"source":"Crossref","is-referenced-by-count":4,"title":["Neuroanatomy of cerebellar mutism syndrome: the role of lesion location"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7873-1469","authenticated-orcid":false,"given":"Jax","family":"Skye","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"},{"name":"Department of Pediatrics, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"},{"name":"Department of Psychiatry, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"},{"name":"Department of Psychological and Brain Sciences, University of Iowa , Iowa City, IA 52242 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Bruss","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8768-9231","authenticated-orcid":false,"given":"Sebastian","family":"Toescu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Great Ormond Street Hospital , London WC1N 3JH , UK"},{"name":"Developmental Imaging and Biophysics Section, UCL-GOS Institute of Child Health , London WC1N 1EH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-5196","authenticated-orcid":false,"given":"Kristian","family":"Aquilina","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Great Ormond Street Hospital , London WC1N 3JH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Grafft","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Developmental and Behavioral Pediatrics, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gino","family":"Bardi Lola","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Hematology\/Oncology, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7865-9257","authenticated-orcid":false,"given":"Aaron D","family":"Boes","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"},{"name":"Department of Pediatrics, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"},{"name":"Department of Psychiatry, University of Iowa Carver College of Medicine, University of Iowa , Iowa City, IA 52242 , USA"},{"name":"Iowa Neuroscience Institute, University of Iowa , Iowa City, IA 52242 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,5]]},"reference":[{"issue":"16","key":"2024083010174821700_fcae197-B1","doi-asserted-by":"crossref","first-page":"2497","DOI":"10.1002\/cncr.28748","article-title":"Declining childhood and adolescent cancer mortality","volume":"120","author":"Smith","year":"2014","journal-title":"Cancer"},{"issue":"5","key":"2024083010174821700_fcae197-B2","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1227\/00006123-198411000-00014","article-title":"Pseudobulbar palsy after posterior fossa operation in children","volume":"15","author":"Wisoff","year":"1984","journal-title":"Neurosurgery"},{"issue":"7","key":"2024083010174821700_fcae197-B3","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1001\/archneur.1985.04060070091023","article-title":"Muteness of cerebellar origin","volume":"42","author":"Rekate","year":"1985","journal-title":"Arch Neurol"},{"issue":"4","key":"2024083010174821700_fcae197-B4","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/brain\/121.4.561","article-title":"The cerebellar cognitive affective syndrome","volume":"121","author":"Schmahmann","year":"1998","journal-title":"Brain"},{"issue":"6","key":"2024083010174821700_fcae197-B5","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1037\/a0016106","article-title":"Long-term cognitive deficits following posterior fossa tumor resection: A neuropsychological and functional neuroimaging follow-up study","volume":"23","author":"De Smet","year":"2009","journal-title":"Neuropsychology"},{"issue":"4","key":"2024083010174821700_fcae197-B6","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/cncr.30238","article-title":"Posterior fossa syndrome: Review of the behavioral and emotional aspects in pediatric cancer patients","volume":"123","author":"Lanier","year":"2017","journal-title":"Cancer"},{"issue":"16","key":"2024083010174821700_fcae197-B7","doi-asserted-by":"crossref","first-page":"e1561","DOI":"10.1212\/WNL.0000000000008326","article-title":"Pediatric postoperative cerebellar cognitive affective syndrome follows outflow pathway lesions","volume":"93","author":"Albazron","year":"2019","journal-title":"Neurology"},{"issue":"6","key":"2024083010174821700_fcae197-B8","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1007\/s00381-019-04229-6","article-title":"Post-operative cerebellar mutism syndrome: Rehabilitation issues","volume":"36","author":"Paquier","year":"2020","journal-title":"Child\u2019s Nervous System"},{"issue":"7","key":"2024083010174821700_fcae197-B9","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1007\/s00381-016-3093-3","article-title":"Consensus paper on post-operative pediatric cerebellar mutism syndrome: The Iceland Delphi results","volume":"32","author":"Gudrunardottir","year":"2016","journal-title":"Childs Nerv Syst"},{"issue":"1","key":"2024083010174821700_fcae197-B10","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1007\/s12311-019-01088-4","article-title":"Neuropsychological profile in children with posterior fossa tumors with or without postoperative cerebellar mutism syndrome (CMS)","volume":"19","author":"C\u00e1mara","year":"2020","journal-title":"Cerebellum"},{"issue":"5","key":"2024083010174821700_fcae197-B11","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1007\/s00701-020-04479-3","article-title":"Living with the cerebellar mutism syndrome: Long-term challenges of the diagnosis","volume":"163","author":"Wibroe","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"issue":"3","key":"2024083010174821700_fcae197-B12","doi-asserted-by":"crossref","first-page":"e29536","DOI":"10.1002\/pbc.29536","article-title":"Perioperative risk factors for long-term intelligence in children with postoperative cerebellar mutism syndrome after medulloblastoma surgery","volume":"69","author":"Aarsen","year":"2022","journal-title":"Pediatr Blood Cancer"},{"issue":"2","key":"2024083010174821700_fcae197-B13","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1006\/nimg.2001.0845","article-title":"Spatial normalization of brain images with focal lesions using cost function masking","volume":"14","author":"Brett","year":"2001","journal-title":"Neuroimage"},{"issue":"1","key":"2024083010174821700_fcae197-B14","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.neuroimage.2009.01.045","article-title":"A probabilistic MR atlas of the human cerebellum","volume":"46","author":"Diedrichsen","year":"2009","journal-title":"Neuroimage"},{"issue":"3","key":"2024083010174821700_fcae197-B15","doi-asserted-by":"crossref","first-page":"1786","DOI":"10.1016\/j.neuroimage.2010.10.035","article-title":"Imaging the deep cerebellar nuclei: A probabilistic atlas and normalization procedure","volume":"54","author":"Diedrichsen","year":"2011","journal-title":"Neuroimage"},{"key":"2024083010174821700_fcae197-B16","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.neuroimage.2015.09.014","article-title":"A probabilistic atlas of the cerebellar white matter","volume":"124","author":"van Baarsen","year":"2016","journal-title":"Neuroimage"},{"key":"2024083010174821700_fcae197-B17","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.neuropsychologia.2017.08.027","article-title":"Improved accuracy of lesion to symptom mapping with multivariate sparse canonical correlations","volume":"115","author":"Pustina","year":"2018","journal-title":"Neuropsychologia"},{"issue":"3","key":"2024083010174821700_fcae197-B18","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1016\/j.neuroimage.2007.12.033","article-title":"Thresholding lesion overlap difference maps: Application to category-related naming and recognition deficits","volume":"41","author":"Rudrauf","year":"2008","journal-title":"Neuroimage"},{"issue":"2","key":"2024083010174821700_fcae197-B19","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1093\/neuonc\/noac168","article-title":"Fastigial nuclei surgical damage and focal midbrain disruption implicate PAG survival circuits in cerebellar mutism syndrome","volume":"25","author":"McAfee","year":"2023","journal-title":"Neuro Oncol"},{"issue":"2","key":"2024083010174821700_fcae197-B20","doi-asserted-by":"crossref","first-page":"288","DOI":"10.3174\/ajnr.A1821","article-title":"Cerebellocerebral diaschisis is the likely mechanism of postsurgical posterior fossa syndrome in pediatric patients with midline cerebellar tumors","volume":"31","author":"Miller","year":"2010","journal-title":"Am J Neuroradiol"},{"issue":"2","key":"2024083010174821700_fcae197-B21","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3171\/jns.2006.104.2.329","article-title":"Transient cerebellar mutism caused by bilateral damage to the dentate nuclei after the second posterior fossa surgery","volume":"104","author":"Kusano","year":"2006","journal-title":"J Neurosurg"},{"issue":"11","key":"2024083010174821700_fcae197-B22","doi-asserted-by":"crossref","first-page":"3087","DOI":"10.1093\/brain\/awp241","article-title":"Proximal dentatothalamocortical tract involvement in posterior fossa syndrome","volume":"132","author":"Morris","year":"2009","journal-title":"Brain"},{"issue":"4","key":"2024083010174821700_fcae197-B23","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00381-012-1973-8","article-title":"Fronto-cerebellar fiber tractography in pediatric patients following posterior fossa tumor surgery","volume":"29","author":"Soelva","year":"2013","journal-title":"Childs Nerv Syst"},{"issue":"4","key":"2024083010174821700_fcae197-B24","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1093\/neuonc\/nou299","article-title":"Diffusion abnormalities on intraoperative magnetic resonance imaging as an early predictor for the risk of posterior fossa syndrome","volume":"17","author":"Avula","year":"2015","journal-title":"Neuro Oncol"},{"issue":"11","key":"2024083010174821700_fcae197-B25","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1007\/s00381-013-2205-6","article-title":"Diffusion tensor imaging of the superior cerebellar peduncle identifies patients with posterior fossa syndrome","volume":"29","author":"Ojemann","year":"2013","journal-title":"Childs Nerv Syst"},{"key":"2024083010174821700_fcae197-B26","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.neuroimage.2018.01.082","article-title":"Triple representation of language, working memory, social and emotion processing in the cerebellum: Convergent evidence from task and seed-based resting-state fMRI analyses in a single large cohort","volume":"172","author":"Guell","year":"2018","journal-title":"Neuroimage"},{"key":"2024083010174821700_fcae197-B27","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1007\/978-3-030-23810-0","volume-title":"Handbook of the cerebellum and cerebellar disorders","author":"Manto","year":"2022","edition":"2nd ed"},{"key":"2024083010174821700_fcae197-B28","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1007\/978-1-4614-1997-6_38","volume-title":"Neuroscience in the 21st century","author":"Miall","year":"2013"},{"issue":"1","key":"2024083010174821700_fcae197-B29","doi-asserted-by":"crossref","first-page":"83","DOI":"10.3390\/children10010083","article-title":"The entity of cerebellar mutism syndrome: A narrative review centered on the etiology, diagnostics, prevention, and therapeutic options","volume":"10","author":"Panagopoulos","year":"2022","journal-title":"Children"},{"issue":"3","key":"2024083010174821700_fcae197-B30","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.neuron.2014.07.016","article-title":"The cerebellum, sensitive periods, and autism","volume":"83","author":"Wang","year":"2014","journal-title":"Neuron"},{"key":"2024083010174821700_fcae197-B31","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.wneu.2021.06.065","article-title":"Cerebellar mutism syndrome: An overview of the pathophysiology in relation to the cerebrocerebellar anatomy, risk factors, potential treatments, and outcomes","volume":"153","author":"Ashida","year":"2021","journal-title":"World Neurosurg"},{"issue":"1","key":"2024083010174821700_fcae197-B32","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1093\/brain\/awx317","article-title":"The cerebellar cognitive affective\/schmahmann syndrome scale","volume":"141","author":"Hoche","year":"2018","journal-title":"Brain"}],"container-title":["Brain Communications"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/braincomms\/advance-article-pdf\/doi\/10.1093\/braincomms\/fcae197\/58104368\/fcae197.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/braincomms\/article-pdf\/6\/4\/fcae197\/58888348\/fcae197.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/braincomms\/article-pdf\/6\/4\/fcae197\/58888348\/fcae197.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T09:30:44Z","timestamp":1725010244000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/braincomms\/article\/doi\/10.1093\/braincomms\/fcae197\/7688125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":32,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,7,2]]}},"URL":"https:\/\/doi.org\/10.1093\/braincomms\/fcae197","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2972206\/v1","asserted-by":"object"}]},"ISSN":["2632-1297"],"issn-type":[{"value":"2632-1297","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024]]},"published":{"date-parts":[[2024]]},"article-number":"fcae197"}}