{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:44:35Z","timestamp":1790181875725,"version":"4.1.0"},"reference-count":95,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cerebellar mutism syndrome (CMS) is a common and debilitating complication of posterior fossa tumor surgery in children. Affected children exhibit communication and social impairments that overlap phenomenologically with subsets of deficits exhibited by children with Autism spectrum disorder (ASD). Although both CMS and ASD are thought to involve disrupted cerebro-cerebellar circuitry, they are considered independent conditions due to an incomplete understanding of their shared neural substrates.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this study, we analyzed postoperative cerebellar lesions from 90 children undergoing posterior fossa resection of medulloblastoma, 30 of whom developed CMS. Lesion locations were mapped to a standard atlas, and the networks functionally connected to each lesion were computed in normative adult and pediatric datasets. Generalizability to ASD was assessed using an independent cohort of children with ASD and matched controls (n\u2005=\u2005427).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Lesions in children who developed CMS involved the vermis and inferomedial cerebellar lobules. They engaged large-scale cerebellothalamocortical circuits with a preponderance for the prefrontal and parietal cortices in the pediatric and adult connectomes, respectively. Moreover, with increasing connectomic age, CMS-associated lesions demonstrated stronger connectivity to the midbrain\/red nuclei, thalami and inferior parietal lobules and weaker connectivity to the prefrontal cortex. Importantly, the CMS-associated lesion network was independently reproduced in ASD and correlated with communication and social deficits, but not repetitive behaviors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our findings indicate that CMS-associated lesions may result in an ASD-like network disturbance that occurs during sensitive windows of brain development. A common network disturbance between CMS and ASD may inform improved treatment strategies for affected children.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/neuonc\/noad230","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T01:46:03Z","timestamp":1702345563000},"page":"950-964","source":"Crossref","is-referenced-by-count":11,"title":["Postoperative cerebellar mutism syndrome is an acquired autism-like network disturbance"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0412-5655","authenticated-orcid":false,"given":"Hrishikesh","family":"Suresh","sequence":"first","affiliation":[{"name":"Institute of Biomedical Engineering, University of Toronto , Toronto, Ontario , Canada"},{"name":"Program in Neuroscience and Mental Health, The Hospital for Sick Children Research Institute , Toronto, Ontario , Canada"},{"name":"Division of Neurosurgery, The Hospital for Sick Children, Department of Surgery, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin R","family":"Morgan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8094-3070","authenticated-orcid":false,"given":"Karim","family":"Mithani","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, The Hospital for Sick Children, Department of Surgery, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4885-3080","authenticated-orcid":false,"given":"Nebras M","family":"Warsi","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering, University of Toronto , Toronto, Ontario , Canada"},{"name":"Program in Neuroscience and Mental Health, The Hospital for 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UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres M","family":"Lozano","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University Health Network, Department of Surgery, University of Toronto , Toronto, Ontario , Canada"},{"name":"Institute of Medical Science, University of Toronto , Toronto, Ontario , Canada"},{"name":"Krembil Brain Institute, University Health Network , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0067-6177","authenticated-orcid":false,"given":"Bassam","family":"Al-Fatly","sequence":"additional","affiliation":[{"name":"Department of Neurology and Experimental Neurology, Movement Disorders and Neuromodulation Unit, Charit\u00e9, Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin Institute of Health , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea A","family":"K\u00fchn","sequence":"additional","affiliation":[{"name":"Department of Neurology and Experimental Neurology, Movement Disorders and Neuromodulation Unit, Charit\u00e9, Universit\u00e4tsmedizin Berlin, Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, Berlin Institute of Health , Berlin , Germany"},{"name":"Exzellenzcluster NeuroCure, Charit\u00e9, Universit\u00e4tsmedizin , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Laughlin","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2736-8596","authenticated-orcid":false,"given":"Michael C","family":"Dewan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center , Nashville, Tennessee , 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