Neuropsychological Comparison of Pediatric Medulloblastoma and Pilocytic Astrocytoma: Existing Knowledge and Future Directions

Alice Ann Holland


This paper reviews existing knowledge regarding neuropsychological late effects of pediatric medulloblastoma and cerebellar pilocytic astrocytoma, with the goal of highlighting areas for future research. Comparison of these two tumors, which occupy the same region of the brain, is arguably the ideal method for researching the late effects of craniospinal radiation, as medulloblastoma patients receive radiation, while cerebellar pilocytic astrocytoma patients do not. Such comparative research, which has yet to be extensively conducted, has the potential to enhance targeted neuropsychological interventions and help neuro-oncologists make treatment decisions regarding use, frequency, duration, and dose of radiation. A discussion of cognitive fluency is included, detailing the importance of researching this overlooked construct in these two tumor groups. Existing knowledge of differential processing speed deficits in these populations, which appears to be strongly related to administration of craniospinal radiation, provides a rationale for such investigation.

Full Text:



Aarsen, F. K., Paquier, P. F., Arts, W., Van Veelen, M., Michiels, E., Lequin, M., & Catsman-Berrevoets, C. E. (2009). Cognitive deficits and predictors 3 years after diagnosis of a pilocytic astrocytoma in childhood. Journal of Clinical Oncology, 27(21), 3526-3532.

Aarsen, F. K., Paquier, P. F., Reddingius, R. E., Streng, I. C., Arts, W. M., Evera Preesman, M., & Catsman-Berrevoets, C. E. (2006). Functional outcome after low-grade astrocytoma treatment in childhood. Cancer, 106, 396-402.

Aarsen, F. K., Van Dongen, H. R., Paquier, P. F., Van Mourik, M., Catsman-Berrevoets, C. E. (2004). Long-term sequelae after cerebellar astrocytoma surgery. Neurology, 62, 1311-1316. Ahles, T. A., & Saykin, A. J. (2007).

Candidate mechanisms for chemotherapy-induced cognitive changes. Nature Reviews Cancer, 7, 192-201. Ater, J. L., Moore, B. D., Francis, D. J., Castillo, R., Slopis, J., & Copeland, D. R. (1996). Correlation of medical and neurosurgical events with neuropsychological status in children at diagnosis of astrocytoma: Utilization of neurological severity score. Journal of Clinical Neurology, 11(6), 462-469.

Beebe, D. W., Ris, D. M., Armstrong, F. D., Fontanesi, J., Mulhern, R., Holmes, E., & Wisoff, J. H. (2005). Cognitive and adaptive outcome in low-grade pediatric cerebellar astrocytomas: Evidence of diminished cognitive and adaptive functioning in collaborative studies (CCG 9891/POG 9130). Journal of Clinical Oncology, 23(22), 5198-5204.

Blaney, S. M., Kun, L. E., Hunter, J., Rorke-Adams, L. B., Lau, C., Strother, D., et al. (2006). Tumors of the central nervous system. In P. A. Pizzo & D. G. Pollack (Eds.), Principles and practices of pediatric oncology (5th Ed., pp. 786-864). Philadelphia: Lippincott Williams & Wilkins.

Bracke-Tolkmitt, R., Linden, A., Canavan, A. G. M., Rockstroh, B., Scholz, E., Wessel, K., & Diener, H. C. (1989). The cerebellum contributes to mental skills. Behavioral Neuroscience, 103(2), 442-446.

Briere, M.-E., Scott, J. G., McNall-Knapp, R., & Adams, R. L. (2008). Cognitive outcome in pediatric brain tumor survivors: Delayed attention deficit at long-term follow-up. Pediatric Blood and Cancer, 50, 337-340.

Bunge, S. A., Dudukovic, N. M., Thomason, M.E., Vaidya, C. J., & Gabrieli, J. D. E. (2002). Immature frontal lobe contributions to cognitive control in children. Neuron, 33, 301-311.

Butler, R. W. & Haser, J. K. (2006). Neurocognitive effects of treatment for childhood cancer. Mental Retardation and Developmental Disabilities Research Reviews, 12, 184-191.

Butler, R., Kerr, M., & Marchand, A. (1999). Attention and executive functions following cranial irradiation in children. Journal of the International Neuropsychological Society, 5, 108.

Callu, D., Viguier, D., Laroussinie, F., Puget, S., Boddaert, N., Kieffer, V., Piana, H., . . . Dellatolas, G. (2009). Cognitive and academic outcome after benign or malignant cerebellar tumor in children. Cognitive and Behavioral Neurology, 22(4), 270-278.

Cohen, M. E., & Duffner, P. K. (Eds.). (1994). Brain tumors in children: Principles of diagnosis and treatment (2nd ed.). New York: Raven Press.

Copeland, D. R., deMoor, C., Moore, B. D. III, & Ater, J. L. (1999). Neurocognitive development of children after a cerebellar tumor in infancy: A longitudinal study. Journal of Clinical Oncology, 17, 3476-3486.

Daszkiewicz, P., Maryniak, A., Roszkowski, M., & Barszcz, S. (2009). Long-term functional outcome of surgical treatment of juvenile pilocytic astrocytoma of the cerebellum in children. Child’s Nervous System, 25, 855-860.

Daum, I., Ackermann, H., Schugens, M. M., Reimold, C., Dichgans, J., & Birbaumer, N. (1993). The cerebellum and cognitive function in humans. Behavioral Neuroscience, 107, 411-419.

Dennis, M., Hetherington, C. R., & Spiegler, B. J. (1998). Memory and attention after childhood brain tumors. Medical and Pediatric Oncology Supplement (1), 25-33.

Dennis, M., Spiegler, B. J., Hetherington, C. R., & Greenberg, M. L. (1996). Neuropsychological sequelae of the treatment of medulloblastoma. Journal of Neurooncology, 29(1), 91-101.

Desmond, J. E. (2001). Cerebellar involvement in cognitive function: Evidence from neuroimaging. International Review of Psychiatry, 13, 283-294.

Evans, A. E., Jenkin, D. T., Sposto, R., Ortega, J. A.,Wilson, C. B., Wara, W., . . . Hammond, D. (1990). The treatment of medulloblastoma. Journal of Neurosurgery, 72, 572-582.

Exner, C., Weniger, G., & Irle, E. (2004). Cerebellar lesions in the PICA but not SCA territory impair cognition. Neurology, 63, 2132-2135.

Fiez, J. A., Petersen, S. E., Cheney, M. K., & Raichle, M. (1992). Impaired non-motor learning and error detection associated with cerebellar damage. Brain, 115, 155-178.

Fisk, A. D., Fisher, D. L., & Rogers, W. A. (1992). General slowing alone cannot explain age-related search effects: Reply to Cerella (1991). Journal of Experimental Psychology: General, 120, 215-223.

Fuss, M., Poljanc, K., & Hug, E. B. (2000). Full Scale IQ (FSIQ) changes in children treated with whole brain and partial brain irradiation: A review and analysis. Strahlenther und Onkologie, 176(12), 573-581.

Garcia-Perez, A., Narbona-Garcia, J., Sierrasesumaga, L., Aguirre-Ventallo, M., & Calvo-Manuel, F. (1993). Neuropsychological outcome of children after radiotherapy for intracranial tumours. Developmental Medicine and Child Neurology, 35, 139-148.

Garcia-Perez, A., Sierrasesumaga, L., Narbona-Garcia, J., Calvo-Manuel, F., & Aguirre-Ventallo, M. (1994). Neuropsychological evaluation of children with intracranial tumors: Impact of treatment modalities. Medical and Pediatric Oncology, 23, 116-123.

George, A. P., Kuehn, S. M., Vassilyadi, M., Richards, P. M. P., Parlow, S. E., Keene, D. L., & Ventureya, E. C. G. (2003). Cognitive sequelae in children with posterior fossa tumors. Pediatric Neurology, 28(1), 42-47.

Gómez-Pérez, E., Ostrosky-Solís, F., & Prospero-García, O (2003). Desarrollo de la atención, la memoria, y los procesos inhibitorios: Relación temporal con maduración de la estructura y función cerebral. Revista de Neurologia, 37, 561-567.

Gottardo, N. G., & Gajjar, A. (2006). Current therapy for medulloblastoma. Current Treatment Opinions in Neurology, 8(4), 319-334.

Gottwald, B., Wilde, B., Mihajilovic, Z., & Medhorn, H. M (2004). Evidence for distinct cognitive deficits after focal cerebellar lesions. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 1524-1531.

Grill, J., Renaux, V. K., Bulteau, C., Viguier, D., Levy-Piebois, C., Sainte-Rose, C., . . . Kalifa, C. (1999). Long-term intellectual outcome in children with posterior fossa tumors according to radiation doses and volumes. International Journal of Radiation Oncology, Biology, Physics, 45(1), 137-145.

Grill, J., Viguier, D., Kieffer, V., Bulteau, C., Sainte-Rose, C., Hartmann, O., . . . Dellatolas, G. (2004). Critical risk factors for intellectual impairment in children with posterior fossa tumors: the role of cerebellar damage. Journal of Neurosurgery, 101(2 Supplement), 152-158.

Gurney, J.G., Wall, D.A., Jukich, P.J., & Davis, F.G. (1999). The contribution of nonmalignant tumors to CNS tumor incidence rates among children in the United States. Cancer Causes and Control, 10, 101-105.

Hardy, K. K., Bonner, M. J., Willard, V. W., Watral, M. A., & Gururangan, S. (2008). Hydrocephalus as a possible additional contributor to cognitive outcome in survivors of pediatric medulloblastoma. Psychooncology, 17(11), 1157-1161.

Hildebrand, J., & Baleriaux, D. (2002). Cerebellar disorders in cancer. In M. U. Manto & M.Pandolfo (Eds.), The cerebellum and its disorders (pp. 265-287). New York: Cambridge University Press.

Hockenberry, M. J., Krull, K., Moore, I. M., Pasvogel, A., Gregurich, M., & Kaemingk, K. (2006). Longitudinal evaluation of fine motor deficits in children with leukemia. Journal of Clinical Oncology, ASCO Annual Meeting Proceedings Part I, 24(18S), 8559.

Hoppe-Hirsch, E., Brunet, L., Laroussinie, F., Cinalli, G., Pierre-Kahn, A., Renier, D., ... Hirsch, J. F. (1995). Intellectual outcome in children with malignant tumors of the posterior fossa: Influence of the field of irradiation and quality of surgery. Child’s Nervous System, 11(6), 340-345.

Hoppe-Hirsch, E., Renier, D., Lellouch-Tubiana, A., Sainte-Rose, C., Pierre-Kahn, A., & Hirsch, J. F. (1990). Medulloblastoma in childhood: Progressive intellectual deterioration. Child’s Nervous System, 6(2), 60-65.

Horner, M. J., Ries, L. A. G., Krapcho, M., Neyman, N., Aminou, R., Howlader, N., . . . Edwards, B. K. SEER Cancer Statistics Review, 1975-2006, National Cancer Institute. Bethesda, MD, Retrieved from:, based on November 2008 SEER data submission, posted to the SEER web site, 2009.

Hubbard, J. L., Scheithauer, B. W., Kispert, D. B., Carpenter, S. M., Wick, M. R., & Laws, E. R. (1989). Adult cerebellar medulloblastomas: The pathological, radiographic, and clinical disease spectrum. Journal of Neurosurgery, 70, 536-544. Ito, M. (1984). The cerebellum and neural control. New York: Raven Press.

Ivry, R. B., & Baldo, J. V. (1992). Is the cerebellum involved in learning and cognition? Current Opinion in Neurobiology, 2, 212-216.

Jain, N., Krull, K. R., Brouwers, P., Chintagumpala, M. M., & Woo, S. Y. (2008). Neuropsychological outcome following intensity-modulated radiation therapy for pediatric medulloblastoma. Pediatric Blood and Cancer, 51(2), 275-279.

Johnson, D. L., McCabe, M. A., Nicholson, H.S., Joseph, A. L., Getson, P. R., Byrne, J., . . .Reaman, G. (1994). Quality of long-term survival in young children with medulloblastoma. Journal of Neurosurgery, 80, 1004-1010.

Kail, R. (1986). Sources of age differences in speed of processing. Child Development, 57, 969-987.

Kail, R. (1988). Developmental functions for speeds of cognitive processes. Journal of Experimental and Child Psychology, 45, 339-364.

Kail, R. (1991). Developmental change in speed of processing during childhood and adolescence. Psychological Bulletin, 109, 490-501.

Kandel, E., Schwartz, J., & Jessell, T. (2000). Principles of Neural Science. New York: McGraw-Hill.

Kao, G. D., Goldwein, J. W., Schultz, D. J., Radcliffe, J., Sutton, L., & Lange, B. (1994). The impact of perioperative factors on intelligence quotient deficits in children treated for medulloblastoma/posterior fossa primitive neuroectodermal tumors. Cancer, 74(3), 965-971.

Karatekin, C., Lazareff, J. A., & Asarnow, R. F. (2000). Relevance of the cerebellar hemispheres for executive function. Pediatric Neurology, 22(2), 106-112.

Keating, D. P., & Bobbitt, B. L. (1978). Individual and developmental differences in cognitive processing components of mental ability. Child Development, 49, 155-169.

Khong, P. L., Leung, L. H. T., Fung, A. S. M., Fong, D. Y. T., Qui, D., Kwong, D. L. W., . . . Chan, G.C. F. (2006). White matter anisotropy in childhood cancer survivors: Preliminary evidence of association with neurocognitive function. Clinical Oncology, 24, 884-890.

Kieffer-Renaux, V., Bulteau, C., Grill, J., Kalifa, C., Viguier, D., & Jambaque, I. (2000). Patterns of neuropsychological deficits in children with medulloblastoma according to craniospatial irradiation doses. Developmental Medicine and Child Neurology, 42(11), 741-745.

Kieffer-Renaux, V., Viguier, D., Raquin, M.A., Laurent-Vannier, A., Habrand, J.L., Dellatolas, G., . . . Grill, J. (2005). Therapeutic schedules influence the pattern of intellectual decline after irradiation of posterior fossa tumors. Pediatric Blood and Cancer, 45(6), 814-819.

Kimmings, E., Kleinlugtebeld, A. T., Casey, A., & Hayward, R. D. (1995). Medulloblastoma: Factors influencing the educational potential of surviving children. British Journal of Neurosurgery, 9(5), 611-617.

Kirschen, M. P., Davis-Ratner, M. S., Milner, M. W., Chen, S. H., Schraedley-Desmond, P., Fisher, P. G., Desmond, J. E. (2008). Verbal memory impairments in children after cerebellar tumor resection. Behavioral Neurology, 20(1-2), 39-53.

Kombogiorgas, D., Sgouros, S., Walsh, A. R., Hockley, A. D., Stevens, M., Grundy, R., . . . Spooner, D. (2007). Outcome of children with posterior fossa medulloblastoma: A single institution experience over the decade 1994-2003. Child’s Nervous System, 23, 399-405.

Konczak, J., Schoch, B., Dimitrova, A., Gizewski, E., & Timmann, D. (2005). Functional recovery of children adolescents after cerebellar tumour resection. Brain, 128, 1428-1441.

Lafay-Cousin, L., Bouffet, E., Hawkins, C., Amid, A., Huang, A., & Mabbott, D. J. (2009). Impact of radiation avoidance on survival and neurocognitive outcome in infant medulloblastoma. Current Oncology, 16(6), 21-28.

Leiner, H. C., Leiner, A. L., & Dow, R. S. (1986). Does the cerebellum contribute to mental skills? Behavioral Neuroscience, 100, 443-454.

Leiner, H. C., Leiner, A. L., & Dow, R. S. (1989). Reappraising the cerebellum: What does the hindbrain contribute to the forebrain? Behavioral Neuroscience, 103(5), 998-1008.

Levisohn, L., Cronin-Golomb, A., & Schmahmann, J. (2000). Neuropsychological consequences of cerebellar tumour resection in children: Cerebellar cognitive affective syndrome in a paediatric population. Brain, 123, 1041-1050.

Mabbott, D. J., Noseworthy, M. D., Bouffet, E., Rockel, C., & Laughlin, S. (2006). Diffusion tensor imaging of white matter after cranial irradiation in children for medulloblastoma: Correlation with IQ. Neuro-Oncology, 8(3), 244-252.

Mabbott, D. J., Penkman, L., Witol, A., Strother, D., & Bouffet, E. (2008). Core neurocognitive functions in children treated for posterior fossa tumors. Neuropsychology, 22(2), 159-168.

Mabbott, D. J., Snyder, J. J., Penkman, L., & Witol, A. (2009). The effects of treatment for posterior fossa brain tumors on selective attention. Journal of the International Neuropsychological Society, 15, 205-216.

Mabbott, D. J., Spiegler, B. J., Greenberg, M. L., Rutka, J. T., Hyder, D. J., Bouffet, E. (2005). Serial evaluation of academic and behavioral outcome after treatment with cranial radiation in childhood. Journal of Clinical Oncology, 23(10), 2256-2263.

Maddrey, A. M., Bergeron, J. A., Lombardo, E. R., McDonald, N. K., Mulne, A. F., Barenberg, P.D., & Bowers, D. C. (2005). Neuropsychological performance and quality of life of 10 year survivors of childhood medulloblastoma. Journal of Neuro-Oncology, 72, 245-253.

Malm, J., Kristensen, B., Karlsson, T., Carlberg, B., Fagerlund, M., & Olsson, T. (1998). Cognitive impairment in young adults with infratentorial infarcts. Neurology, 51(2), 433-440.

McCabe, M. A., Getson, P., Brasseux, C. & Johnson, D. L. (1995). Survivors of medulloblastoma: Implications for program planning. Cancer Practice, 3, 47-53.

Medina, D., Detoledo-Morrell, L., Urresta, F., Gabrieli, J. D., Moseley, M., Fleischman, D., . . . Stebbins, G. T. (2006). White matter changes in mild cognitive impairment and AD: A diffusion tensor imaging study. Neurobiology of Aging, 27, 663-672.

Merchant, T. E., Kiehna, E. N., Miles, M. A., Zhu, J., Xiong, X., & Mulhern, R. K. (2002). Acute effects of irradiation on cognition: Changes in attention on a computerized continuous performance test during radiotherapy in pediatric patients with localized primary brain tumors. Journal of Radiation Oncology, Biology, Physics, 53(5), 1271-1278.

Mitby, P. A., Robison, L. L., Whitton, J. A., Zevon, M. A., Gibbs, I. C., Tersak, J. M., . . . Mertens, A. C. (2003). Utilization of special education services and educational attainment among long-term survivors of childhood cancer. Cancer, 97(4), 1115-1126.

Monje, M. L., Mizumatsu, S., Fike, J. R., & Palmer, T. D. (2002). Irradiation induces neural precursorcell dysfunction. Nature Medicine, 8, 955-962.

Mulhern, R. K., Kepner, J. L., Thomas, P. R., Armstrong, F. D., Friedman, H. S., & Kun, L. E. (1998). Neuropsychologic functioning of survivors of childhood medulloblastoma randomized to receive conventional or reduced-dose craniospinal irradiation: A Pediatric Oncology Group study. Journal of Clinical Oncology, 16, 1723-1728.

Mulhern, R. K., Palmer, S. L., Reddick, W. E., Glass, J. O., Kun, L. E., Taylor, J., . . . Gajjar, A. (2001). Risks of young age for selected neurocognitive deficits in medulloblastoma are associated with white matter loss. Journal of Clinical Oncology, 2, 472-479.

Mulhern, R. K., Reddick, W. E., Palmer, S. L., Glass, J., Elkin, D., Kun, L. E., . . . Gajjar, A. (1999). Neurocognitive deficits in medulloblastoma survivors and white matter loss. Annals of Neurology, 46, 834-841.

Mulhern, R. K., White, H. A., Glass, J. O., Kun, L. E., Leigh, L., Thompson, S. J., & Reddick, W. E. (2004). Attentional functioning and white matter integrity among survivors of malignant brain tumors of childhood. Journal of the International Neuropsychological Society, 10, 180–189.

Mulhern, R. K., Palmer, S. L., Merchant, T. E., Wallace, D., Kocack, M., Brouwers, P., . . . Gajjar, A. (2005). Neurocognitive consequences of risk adapted therapy for childhood medulloblastoma. Journal of Clinical Oncology, 23, 5511-5519.

Nagel, B. J., Delis, D. C., Palmer, S. L., Reeves,C., Gajjar, A., & Mulhern, R. K. (2006). Early patterns of verbal memory impairment in children treated for medulloblastoma. Neuropsychology, 20(1), 105-112.

Nagel, B. J., Palmer, S. L., Reddick, W. E., Glass, J. O., Helton, K. J., Wu, S., . . . Mulhern, R. K. (2004). Abnormal hippocampal development in children with medulloblastoma treated with risk-adapted irradiation. American Journal of Neuroradiology, 25(9), 1575-1582.

O’Donnell, W. E., De Soto, C. B., & De Soto, J. L. (1993). Validity and reliability of the revised Neuropsychological Impairment Scale (NIS). Journal of Clinical Psychology, 49, 372-382.

Packer, R. J., Friedman, H. S., Kun, L. E., & Fuller, G. N. (2002). Tumors of the brain stem, cerebellum, and fourth ventricle. In V. A. Levin (Ed.), Cancer in the nervous system (2nd Ed., pp. 171-192). New York: Oxford University Press.

Packer, R. J., Sutton, L. N., Atkins, T. E., Radcliffe, J., Bunin, G. R., D’Angio, G., . . . Schut, L. (1989). A prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results. Journal of Neurosurgery, 70, 707-713.

Packer, R. J., Sutton, L. N., Elterman, R., Lange, B., Goldwein, J., Nicholsen, H. S., ... Schut, L. (1994). Outcome for children with medulloblastoma treated with radiation and cisplatin, CCNU, and vincristine chemotherapy. Journal of Neurosurgery, 81, 690-698.

Palmer, S. L. (2008). Neurodevelopmental impact on children treated for medulloblastoma: A proposed conceptual model. Developmental Disabilities Research Reviews, 14, 203-210.

Palmer, S. L., Gajjar, A., Reddick, W. E., Glass, J. O., Kun, L. E., Wu, S., . . . Mulhern, R. K. (2003). Predicting intellectual outcome among children treated with 35-40 Gy craniospinal irradiation for medulloblastoma. Neuropsychology, 17(4), 548-555.

Palmer, S. L., Goloubeva, O., Reddick, W. E., Glass, J. O., Gajjar, A., Kun, L., . . . Mulhern, R. K. (2001). Patterns of intellectual development among survivors of pediatric medulloblastoma: A longitudinal analysis. Journal of Clinical Oncology, 19(8), 2302-2308.

Palmer, S. L. & Leigh, L. (2009). Survivors of pediatric posterior fossa tumors: Cognitive outcome, intervention, and risk-based care. European Journal of Oncology Nursing, 13, 171-178.

Palmer, S. L., Reddick, W. E., & Gajjar, A. (2007). Understanding the cognitive impact on children treated for medulloblastoma. Journal of Pediatric Psychology, 32(9), 1040-1049.

Palmer, S. L., Reddick, W. E., Glass, J. O., Gajjar, A., Goloubeva, O., & Mulhern, R. K. (2002). Decline in corpus callosum volume among pediatric patients with medulloblastoma: Longitudinal MR imaging study. American Journal of Neuroradiology, 23(7), 1088-1094.

Quastoff, S., & Hartung, H. P. (2002). Chemotherapy-induced peripheral neuropathy. Journal of Neurology, 249, 9-17.

Radcliffe, J., Bunin, G. R., Sutton, L. N., Goldwein, J. W., & Phillips, P. C. (1994). Cognitive deficits in long-term survivors of childhood medulloblastoma and other noncortical tumors: Age-dependent effects of whole-brain radiation. International Journal of Developmental Neuroscience, 12(4), 327-334.

Reddick, W. E., Glass, J., Helton, K., Langston, J., Xiong, X., Wu, S., & Pui, C. (2005). Prevalence of leukoencephalopathy in children treated for acute lymphoblastic leukemia with high-dose methotrexate. American Journal of Neuroradiology, 26, 1263-1269.

Reddick, W. E., Russell, J. M., Glass, J. O., Xiong, X., Mulhern, R. K., Langston, J. W., . . . Gajjar, A. (2000). Subtle white matter volume differences in children treated for medulloblastoma with conventional or reduced dose craniospinal irradiation. Magnetic Resonance Imaging, 18(7), 787-793.

Reddick, W. E., White, H. A., Glass, J. O., Wheeler, G. C., Thompson, S. J., Gajjar, A., . . . Mulhern, R. K. (2003). Developmental model relating white matter volume to neurocognitive deficits in pediatric brain tumor survivors. Cancer, 97, 2512-2519.

Reeves, C. B., Palmer, S. L., Reddick, W. E., Merchant, T. E., Buchanan, G. M., Gajjar, A., & Mulhern, R. K. (2006). Attention and memory functioning among pediatric patients with medulloblastoma. Journal of Pediatric Psychology, 31(3), 272-280.

Reimers, T. S., Ehrenfels, S., Mortensen, E. L., Schmiegelow, M., Sonderkaer, S., Carstensen, H., . . . Muller, J. (2003). Cognitive deficits in long-term survivors of childhood brain tumors: Identification of predictive factors. Medical and Pediatric Oncology, 40, 26-34.

Ris, M. D., & Abbey, R. (2010). Pediatric brain tumors. In K. O. Yeates, M. D. Ris, H. G. Taylor, & B. F. Pennington (Eds.), Pediatric Neuropsychology (2nd Ed., pp. 92-111). New York: Guilford Press.

Ris, M. D., Packer, R., Goldwein, J., Jones-Wallace, D., & Boyett, J. M. (2001). Intellectual outcome after reduced-dose radiation plus adjuvant chemotherapy for medulloblastoma: A Children’s Cancer Group study. Journal of Clinical Oncology, 19(15), 3470-3476.

Riva, D. & Giorgi, C. (2000). The cerebellum contributes to higher functions during development: Evidence from a series of children surgically treated for posterior fossa tumours. Brain, 123, 1051-1061.

Riva, D., Milani, N., Pantaleoni, C., Ballerini, E., & Giorgi, C. (1991). Combined treatment modality for medulloblastoma in childhood: Effects on neuropsychological functioning. Neuropediatrics, 22, 36-42.

Riva, D., Pantaleoni, C., Milani, N., & Belani, F. F. (1989). Impairment of neuropsychological functions in children with medulloblastomas and astrocytomas in the posterior fossa. Child’s Nervous System, 5, 107-110 Roman, D. D., & Sperduto, P. W. (1995).

Neuropsychological effects of cranial radiation: Current knowledge and future directions. International Journal of Radiation Oncology Biology Physics, 31(4), 983-998.

Roncadin, C., Dennis, M., Greenberg, M. L., & Spiegler, B. J. (2008). Adverse medical events associated with childhood cerebellar astrocytomas and medulloblastomas: Natural history and relation to very long-term neurobehavioral outcome. Child’s Nervous System, 24, 995-1002.

Ronning, C., Sundet, K., Due-Tonnessen, B., Lundar, T., & Helseth, E. (2005). Persistent cognitive dysfunction secondary to cerebellar injury in patients treated for posterior fossa tumors in childhood. Pediatric Neurosurgery, 41, 15-21.

Rutkowski, S., Bode, U., Deinlein, F., Ottensmeier, H., Warmuth-Metz, M., Soerensen, N., . . . Kortmann, R. D. (2005). Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. New England Journal of Medicine, 352, 978-986.

Rypma, B., Berger, J. S., Genova, H. M., Rebbechi, D., & D’Esposito, M. (2005). Dissociating age related changes in cognitive strategy and neural efficiency using event-related fMRI. Cortex, 41, 582-594.

Rypma, B., Berger, J. S., Prabhakaran, V., Bly, B. M., Kimberg, D. Y., Biswal, B. B., & D’Esposito, M. (2006). Neural correlates of cognitive efficiency. NeuroImage, 33, 969-979.

Rypma, B., & D’Esposito, M. (1999). The roles of prefrontal brain regions in components of working memory: Effects of memory load and individual differences. Proceedings of the National Academy of Sciences, 96, 6558.

Rypma, B., Prabhakaran, V., Desmond, J. E., & Gabrieli, J. D. E. (2001). Age differences in prefrontal cortical activity in working memory. Psychology of Aging, 16, 371-384.

Salthouse, T. A. (1992). What do adult age differences in the Digit Symbol Substitution Test reflect? Journal of Gerontology, 47, 121-128.

Sawamoto, N., Honda, M., Hanakawa, T., Fukuyama, H., & Shibasaki, H. (2002). Cognitive slowing in Parkinson’s Disease: A behavioral evaluation independent of motor slowing. Journal of Neuroscience, 22, 5198-5203.

Schatz, F., Kramer, J. H., Ablin, A., & Matthay, K. K. (2000). Processing speed, working memory, and IQ: A developmental model of cognitive deficits following cranial radiation therapy. Neuropsychology, 14, 189-200.

Schmahmann, J. D. & Sherman, J. C. (1998). The cerebellar cognitive affective syndrome. Brain, 121, 1051-1061.

Schmithorst, V. J., Wilke, M., Dadzinski, B. J., & Holland, S. K. (2002). Correlation of white matter diffusivity and anisotropy with age during childhood and adolescence: A cross-sectional diffusion-tensor MR imaging study. Radiology, 222, 212-218.

Sherwood, P. R., Dahman, B. A., Donovan, H. S., Mintz, A., Given, C. W., & Bradley, C. J. (2010). Treatment disparities following the diagnosis of an astrocytoma. Journal of Neurooncology. doi:10.1007/s11060-010-0223-8

Silverman, C. L., Palkes, H., Talent, B., Kovnar, E., Clouse, J. W., & Thomas, P. R. (1984). Late effects of radiotherapy on patients with cerebellar medulloblastoma. Cancer, 54(5), 825-829.

Small, J. A., Kemper, S., & Lyons, K. (2000). Sentence repetition and processing resources in Alzheimer’s disease. Brain and Language, 75, 232.

Spiegler, B. J., Bouffet, E., Greenberg, M. L., Rutka, J. T., & Mabbott, D. J. (2004). Change in neurocognitive functioning after treatment with cranial radiation in childhood. Journal of Clinical Oncology, 22(4), 706-713.

Stavinoha, P. L. & Burrows, F. (2004). Academic speed in childhood brain tumor survivors treated with cranial radiation, Brain Impairment, 5, 99.

Steinlin, M., Imfeld, S., Zulauf, P., Boltshauser, E., Lovblad, K. O., Ridolfi Luthy, A., . . . Kaufmann, F. (2003). Neuropsychological long-term sequelae after posterior fossa tumour resection during childhood. Brain, 126, 1998-2008.

Taylor, H. G., & Alden, J. (1997). Age-related differences in outcomes following childhood brain insults: An introduction and overview. Journal of the International Neuropsychological Society, 3, 555-567.

Timmann, D. & Daum, I. (2007). Cerebellar contributions to cognitive functions: A progress report after two decades of research. The Cerebellum, 6, 159-162.

Todd, A., & Ruge, J. (1999). Medulloblastoma – late outcome. Critical Reviews in Neurosurgery, 9(3), 174-179.

Vaquero, E., Gomez, C. M., Quintero, E. A., Gonzalez-Rosa, J. J., & Marques, J. (2008). Differential prefrontal-like deficit in children after cerebellar astrocytoma and medulloblastoma tumor. Behavioral and Brain Functions, 4(18). Retrieved from

Ward, C., Phipps, K., de Sousa, C., Butler, S., & Gumley, D. (2009). Treatment factors associated with outcomes in children less than 3 years of age with CNS tumours. Child’s Nervous System, 25, 663-668.

Weaver, A. H. (2005). Reciprocal evolution of the cerebellum and neocortex in fossil humans. Proceedings of the National Academy of Sciences, 102(10), 3576-3580.

West, R. L. (1996). An application of prefrontal cortex function theory to cognitive aging. Psychological Bulletin, 2, 272-292.

Zuzak, T. J., Poretti, A., Drexel, B., Zehnder, D., Boltshauser, E., & Grotzer, M. A. (2008). Outcome of children with low-grade cerebellar astrocytoma: long-term complications and quality of life. Child’s Nervous System, 24, 1447-1455.


  • There are currently no refbacks.

Copyright (c) 2017 The New School Psychology Bulletin

© The New School Psychology Bulletin |