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Hypoplasia of the Cerebellar Vermis and Cognitive Deficits in Survivors of Childhood Leukemia

Hypoplasia of the Cerebellar Vermis and Cognitive Deficits in Survivors of Childhood Leukemia Abstract Background: Neurodevelopmental evidence of the cerebellum's protracted course of postnatal development suggests that it is particularly sensitive to early toxic insult from cancer therapy. If this is the case, one would expect that there is a relationship between the pattern of neuropsychological and magnetic resonance imaging deficits and that both may indicate cerebellar abnormalities. Objective: To investigate the profiles of neuropsychological functions and the morphologic features of the cerebellum, using in vivo magnetic resonance imaging planimetry in survivors of acute lymphoblastic leukemia (ALL) treated with radiation and chemotherapy. Design: Thirteen survivors of childhood ALL with onset at age 2 to 5 years and a uniform protocol of treatment involving cranial radiation of 24 Gy and five doses of intrathecal methotrexate sodium participated in the study. Ten controls matched the patients in age and socioeconomic status. Each child was assessed with a comprehensive battery of neuropsychological tests and with magnetic resonance imaging of the brain. Measurements: The neuropsychological scores were transformed into z scores and clustered into right and left hemisphere measures. Planimetric measures of the cerebellar vermis and pons were collected in the midsagittal plane. Results: Consistently observed in survivors of ALL were the following: (1) significant cognitive deficits in visualspatial-motor coordination and figural memory, functions commonly related to the right side of the brain; and (2) hypoplasia of the cerebellar vermis, lobuli I through V and particularly VI to VII. Lateralization of the neurobehavioral deficits was not reflected in structural brain abnormalities. Conclusions: Coexistence of the cerebellar hypoplasia and visual-motor coordination and memory deficits supports the neurodevelopmental approach to brain sequelae in survivors of ALL; it also suggests significance of the cerebellum for both motor and complex nonmotor cognitive processing. References 1. Packer RJ, Meadows AT, Rorke LB, Goldwein JL, D'Angio G. Long-term sequelae of cancer treatment on the central nervous system in childhood . Med Pediatr Oncol . 1987;15:241-253.Crossref 2. Moore IM, Kramer JH, Wara W, Halberg F, Ablin AR. Cognitive function in children with leukemia: effects of radiation dose and time since irradiation . Cancer . 1991;68:1913-1917.Crossref 3. Ochs J, Mulhern RK. Late effects of antileukemic treatment . Pediatr Clin North Am . 1988;35:815-834. 4. Bleyer WA. Acute lymphoblastic leukemia in children: advances and prospectus . Cancer . 1990;65:689-695.Crossref 5. Brouwers P. Neuropsychological abilities of long-term survivors of childhood leukemia . In: Aaronson NK, Beckman J. The Quality of Life of Cancer Patients . New York, NY: Raven Press; 1987:153-165. 6. Cousens P, Waters JS, Stevens M. Cognitive effects of cranial irradiation in leukemia: a survey and meta-analysis . J Child Psychol Psychiatry . 1988;29: 839-852.Crossref 7. Meadows AT, Massari DJ, Fergusson J, Gordon J, Littman P, Moss K. Declines in IQ scores and cognitive dysfunction in children with acute lymphocytic leukemia treated with cranial irradiation . Lancet . 1981;2:1015-1018.Crossref 8. Peckham VC, Meadows AT, Bartel N, Marrero O. Educational late effects in long-term survivors of childhood acute lymphocytic leukemia . Pediatrics . 1988; 81:127-133. 9. Cousens P, Ungerer JA, Crawford JA, Stevens MM. Cognitive effects of childhood leukemia therapy: a case for four specific deficits . J Pediatr Psychol . 1991;16:475-488.Crossref 10. Schuler D, Bakos M, Borsi J, et al. Neuropsychologic and CT examinations in leukemia patients surviving 10 or more years . Med Pediatr Oncol . 1990;18: 123-125.Crossref 11. Twaddle V, Britton PB, Craft AC, Noble TC, Kernahan J. Intellectual function after treatment for leukemia or solid tumors . Arch Dis Child . 1983;58:949-952.Crossref 12. Jannoun L. Are cognitive and educational development affected by age at which prophylactic therapy is given in acute lymphoblastic leukemia? Arch Dis Child . 1983;58:953-958.Crossref 13. Rowland JH, Glidewell OJ, Sibley RF, et al. Effects of different forms of central nervous systems prophylaxis on neuropsychological function in childhood leukemia . J Clin Oncol . 1984;2:1327-1335. 14. Eiser C. Intellectual abilities among survivors of childhood leukemia as a function of CNS irradiation . Arch Dis Child . 1978;53:391-395.Crossref 15. Meadows AT, Massari DJ, Fergusson J, Gordon J, Littman P, Moss K. Declines in IQ scores and cognitive dysfunctions in children with acute lymphoblastic leukemia treated with irradiation . Lancet . 1981;2:1015-1018.Crossref 16. Shalen PR, Ostrow PT, Glass PJ. Enhancement of the white matter following prophylactic therapy of the ventral nervous system for leukemia . Radiology . 1981;140:409-412.Crossref 17. Riccardi R, Brouwers P, DiChiro GD, Poplack DG. Abnormal computed tomography brain scans in children with acute lymphoblastic leukemia: serial longterm follow-up . J Clin Oncol . 1985;3:12-18. 18. Dow RS. The evolution and anatomy of the cerebellum . Biol Rev Camb Philos Soc . 1942;17:179-220.Crossref 19. Leiner HC, Leiner AL, Dow RS. Does the cerebellum contribute to mental skills? Behav Neurosci . 1986;100:443-454.Crossref 20. McCormick DA, Thompson RF. Cerebellum: essential involvement in the classically conditioned eyelid response . Science . 1984;223:296-299.Crossref 21. Baier WK, Beck U, Duose H, Klinge H, Hirsch W. Cerebellar atrophy following diphenylhydantoin intoxication . Neuropediatrics . 1984;15:76-81.Crossref 22. Schmidt D. Adverse effects of valproate . Epilepsia . 1984;25( (suppl) ):44-49.Crossref 23. Melgaard B, Ahlgran P. Ataxia and cerebellar atrophy in chronic alcoholics . J Neurol . 1986;233:13-15.Crossref 24. Harper CG, Kril JJ. Neuropathology in alcoholism . Alcohol Alcohol . 1990;25: 207-216. 25. Mullenix PM, Norton S, Culver B. Locomotor damage in rats after x-irradiation in utero . Exp Neurol . 1975;48:310-324.Crossref 26. Norton S, Kimler BF, Mullinex PM. Progressive behavioral changes in rats after exposure to low levels of ionizing radiation in utero . Neurotoxicol Teratol . 1991;13:181-188.Crossref 27. Altman J. Morphological development of the rat cerebellum and some of its mechanisms . In: Palay SL, Chan-Palay V, eds. The Cerebellum—New Vistas . New York, NY: Springer-Verlag NY Inc; 1982:8-49. 28. Wiznitzer M, Packer RJ, Rorke LB, Meadows AT. Cerebellar sclerosis in pediatric cancer patients . J Neurooncol . 1987;4:353-360. 29. Schwartz ML, Goldman-Rakic PS. Development and plasticity of the primate cerebral cortex . Clin Perinatol . 1990;17:83-102. 30. Goldman-Rakic PS. Development of cortical circuitry and cognitive function . Child Dev . 1987;58:601-622.Crossref 31. Rakic P, Sidmann RL. Histogenesis of cortical layers in human cerebellum, particularly the lamina dissecans . J Comp Neurol . 1970;139:473-500.Crossref 32. Jacobson M. Developmental Neurobiology . New York, NY: Plenum Press; 1978. 33. Kolb B. Brain, development, plasticity, and behavior . Am Psychol . 1989;9: 1203-1212.Crossref 34. Huttenlocher PR. Synaptic density in human frontal cortex: developmental changes and effects of aging . Brain Res . 1979;163:195-205.Crossref 35. Huttenlocher PR. Morphometric study of human cerebral cortex development . Neuropsychologia . 1990;28:517-527.Crossref 36. Brodal A. Neurological Anatomy . 3rd ed. New York, NY: University Press; 1981. 37. Benton AL. Revised Visual Retention Test: Clinical and Experimental Applications . 4th ed. New York, NY: Psychological Corp; 1973. 38. Harris RJ. A Primer in Multivariate Statistics . Orlando, Fla: Academic Press Inc; 1975. 39. Bracke-Tolkmitt R, Linden A, Canavan AGM, et al. The cerebellum contributes to mental skills . Behav Neurosci . 1989;103:442-446.Crossref 40. Fiez JA, Petersen SE, Cheney MK, Raichle ME. Impaired non-motor learning and error detection associated with cerebellar damage . Brain . 1992;115:155-178.Crossref 41. Brouwers P, Riccardi R, Fedio R, Poplack D. Long-term neuropsychological sequelae of childhood leukemia: correlations with CT brain scan abnormalities . J Pediatr . 1985;106:723-728.Crossref 42. Moss HA, Nannis ED, Poplack DG. The effects of prophylactic treatment of the central nervous system on intellectual function of children with acute lymphocytic leukemia . JAMA . 1981;71:47-52.Crossref 43. Peylan-Ramu N, Poplack D, Pizzo P, Adornato BT, Chiro GJ. Abnormal CT scans of the brain in asymptomatic children with acute lymphocytic leukemia after prophylactic treatment of the cerebral nervous system with radiation and intrathecal chemotherapy . N Engl J Med . 1978;298:815-819.Crossref 44. Butler RW, Copeland DR. Neuropsychological effects of central nervous system prophylactic treatment in childhood leukemia: methodological considerations . J Pediatr Psychol . 1993;18:319-338.Crossref 45. Teuber H-L. Recovery of function after brain injury in man . In: Central Nervous System . Amsterdam, the Netherlands: Ciba Foundation Symposium; 1975: 159-190. 46. Fischer KW. Relations between brain and cognitive development . Child Dev . 1987;58:623-632.Crossref 47. Black JE, Isaacs KR, Anderson BJ, Akantara AA, Greenough WT. Learning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult rats . Proc Natl Acad Sci U S A . 1990;87:5568-5572.Crossref 48. Rakic P. Mechanisms of ocular dominance segregation in the lateral geniculate nucleus: competitive elimination hypothesis . Trends Neurosci . 1986;9:11-15.Crossref 49. Rakic P. Neuro-glia relationship during granular cell migration in developing cerebellar cortex: a Golgi and electromicroscopic study in macaque resus . J Comp Neurol . 1971;141:283-312.Crossref 50. Caveness WF. Experimental observations: delayed neurosis in normal monkey brain . In: Gilbert HA, Kagan AR, eds. Radiation Damage to the Nervous System . New York, NY: Raven Press; 1980:1-38. 51. Floeter MK, Greenough WT. Cerebellar plasticity: modification of Purkinje cell structure by differential rearing in monkeys . Science . 1979;206:227-229.Crossref 52. Juraska JM, Ritch J, Henderson C, Rivers N. Sex differences in the dendritic branching of dentate granule cells following differential experience . Brain Res . 1985;333:73-80.Crossref 53. Yim YS, Mahoney DH, Oshamnn DG. Hemiparesis and ischemic changes of the white matter after intrathecal therapy for children with acute lymphocytic leukemia . Cancer . 1991;67:2058-2061.Crossref 54. Sheline GE. Irradiation injury of the human brain: a review of clinical experience . In: Gilbert HA, Kagan AR, eds. Radiation Damage to the Nervous System . New York, NY: Raven Press; 1980:39-58. 55. Bleyer WA, Griffin TW. White matter neurosis, mineralizing microangiopathy, and intellectual abilities in survivors of childhood leukemia . In: Gilbert HA, Kagan AR, eds. Radiation Damage to the Nervous System . New York, NY: Raven Press; 1980:155-174. 56. Priest JR, Ramsey NKC, Latchaw RE, et al. Thrombotic and hemorrhagic stroke complicating early therapy for childhood acute lymphoblastic leukemia . Cancer . 1980;46:1548-1554.Crossref 57. Taylor GH, Albo VC, Phebus CK, Sachs BR, Bierl PG. Post-irradiation treatment outcomes for children with acute lymphoblastic leukemia: clarification of risk . J Pediatr Psychol . 1987;12:395-411.Crossref 58. Pleasure ED, Scholland DL. Peripheral nervous disorders . In: Rowland LP, ed. Merritt's Textbook of Neurology . Philadelphia, Pa: Lea & Febiger;1984;7:477-498. 59. Marr D. A theory of cerebellar cortex . J Physiol . 1969;202:437-470. 60. Albus JS. A theory of cerebellar function . Math Biosci . 1971;10:25-61.Crossref 61. Keating JG, Thach WT. Cerebellar motor learning: quanitification of movement adaptation and performance in rhesus monkeys and humans implicates cortex as the site of adaptation . Soc Neurosci Abstracts . 1990;16:762. Abstract. 62. Leiner HC, Leiner AL, Dow RS. Reappraising the cerebellum: what does the hindbrain contribute to the forebrain? Behav Neurosci . 1989;103;998-1008.Crossref 63. Newman PP, Reza H. Functional relationships between the hippocampus and the cerebellum: an electrophysiological study of the cat . J Physiol . 1979;287: 405-426. 64. Gaffney GR, Tsai LY, Kupermass S, Minchin S, Hesselink JR. Structure in autism . AJDC . 1987;141:1330-1332. 65. Courchesne E, Yeung-Courchesne R, Press GA, Hesselink JR, Jernigan TL. Hypoplasia of cerebellar vermal lobules VI and VII in autism . N Engl J Med . 1988;318:1349-1354.Crossref 66. Bauman M, Kemper TL. Histoanatomic observations of the brain in early infantile autism . Neurology . 1985;35:866-874.Crossref 67. Ritvo ER, Freeman BJ, Scheibel AB, et al. Lower Purkinje cell counts in the cerebella of four autistic subjects: initial findings of the UCLA-NSAC autopsy research report . Am J Psychiatry . 1986;143:862-866. 68. Ciesielski KT, Knight JE. Cerebellar abnormality in autism: a nonspecific effect of early brain damage? Acta Neurobiol Exp . 1994;54;151-154. 69. Mitchell DE, Timney B. Postnatal development of function in the mammalian nervous system . In: Brookhart JM, Mountcastle VR, eds. Handbook of Physiology, Section 1: The Nervous System . Bethesda, Md: American Physiological Society; 1984:1-37. 70. Coleman PD, Riesen AH. Environmental effects on cortical dendritic fields, I: rearing in the dark . J Anat . 1968;102:363-374. 71. Winfield DA. The postnatal development of synapses in the visual cortex of the cat and the effects of eyelid closure . Brain Res . 1981;206:166-171.Crossref 72. Pysh JJ, Weiss M. Exercise during development induces an increase in Purkinje cell dendritic tree size . Science . 1979;206:230-232.Crossref 73. Goldman PS. Functional development of the prefrontal cortex in early life and the problem of neuronal plasticity . Exp Neurol . 1971;32:366-387.Crossref 74. Greenough WT, Fass B, DeVoogd TJ. The influence of experience on recovery following brain damage in rodents: hypotheses based on development research . In: Walsh RN, Greenough WT, eds. Environments as Therapy for Brain Dysfunction . New York, NY: Plenum Press; 1976:10-50. 75. Peckham VC. Learning disorders associated with the treatment of cancer in children . J Assoc Pediatr Oncol Nurses . 1988;5:10-13.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Hypoplasia of the Cerebellar Vermis and Cognitive Deficits in Survivors of Childhood Leukemia

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References (79)

Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1994.00540220031012
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: Neurodevelopmental evidence of the cerebellum's protracted course of postnatal development suggests that it is particularly sensitive to early toxic insult from cancer therapy. If this is the case, one would expect that there is a relationship between the pattern of neuropsychological and magnetic resonance imaging deficits and that both may indicate cerebellar abnormalities. Objective: To investigate the profiles of neuropsychological functions and the morphologic features of the cerebellum, using in vivo magnetic resonance imaging planimetry in survivors of acute lymphoblastic leukemia (ALL) treated with radiation and chemotherapy. Design: Thirteen survivors of childhood ALL with onset at age 2 to 5 years and a uniform protocol of treatment involving cranial radiation of 24 Gy and five doses of intrathecal methotrexate sodium participated in the study. Ten controls matched the patients in age and socioeconomic status. Each child was assessed with a comprehensive battery of neuropsychological tests and with magnetic resonance imaging of the brain. Measurements: The neuropsychological scores were transformed into z scores and clustered into right and left hemisphere measures. Planimetric measures of the cerebellar vermis and pons were collected in the midsagittal plane. Results: Consistently observed in survivors of ALL were the following: (1) significant cognitive deficits in visualspatial-motor coordination and figural memory, functions commonly related to the right side of the brain; and (2) hypoplasia of the cerebellar vermis, lobuli I through V and particularly VI to VII. Lateralization of the neurobehavioral deficits was not reflected in structural brain abnormalities. Conclusions: Coexistence of the cerebellar hypoplasia and visual-motor coordination and memory deficits supports the neurodevelopmental approach to brain sequelae in survivors of ALL; it also suggests significance of the cerebellum for both motor and complex nonmotor cognitive processing. References 1. Packer RJ, Meadows AT, Rorke LB, Goldwein JL, D'Angio G. Long-term sequelae of cancer treatment on the central nervous system in childhood . Med Pediatr Oncol . 1987;15:241-253.Crossref 2. Moore IM, Kramer JH, Wara W, Halberg F, Ablin AR. Cognitive function in children with leukemia: effects of radiation dose and time since irradiation . Cancer . 1991;68:1913-1917.Crossref 3. Ochs J, Mulhern RK. Late effects of antileukemic treatment . Pediatr Clin North Am . 1988;35:815-834. 4. Bleyer WA. Acute lymphoblastic leukemia in children: advances and prospectus . Cancer . 1990;65:689-695.Crossref 5. Brouwers P. Neuropsychological abilities of long-term survivors of childhood leukemia . In: Aaronson NK, Beckman J. The Quality of Life of Cancer Patients . New York, NY: Raven Press; 1987:153-165. 6. Cousens P, Waters JS, Stevens M. Cognitive effects of cranial irradiation in leukemia: a survey and meta-analysis . J Child Psychol Psychiatry . 1988;29: 839-852.Crossref 7. Meadows AT, Massari DJ, Fergusson J, Gordon J, Littman P, Moss K. Declines in IQ scores and cognitive dysfunction in children with acute lymphocytic leukemia treated with cranial irradiation . Lancet . 1981;2:1015-1018.Crossref 8. Peckham VC, Meadows AT, Bartel N, Marrero O. Educational late effects in long-term survivors of childhood acute lymphocytic leukemia . Pediatrics . 1988; 81:127-133. 9. Cousens P, Ungerer JA, Crawford JA, Stevens MM. Cognitive effects of childhood leukemia therapy: a case for four specific deficits . J Pediatr Psychol . 1991;16:475-488.Crossref 10. Schuler D, Bakos M, Borsi J, et al. Neuropsychologic and CT examinations in leukemia patients surviving 10 or more years . Med Pediatr Oncol . 1990;18: 123-125.Crossref 11. Twaddle V, Britton PB, Craft AC, Noble TC, Kernahan J. Intellectual function after treatment for leukemia or solid tumors . Arch Dis Child . 1983;58:949-952.Crossref 12. Jannoun L. Are cognitive and educational development affected by age at which prophylactic therapy is given in acute lymphoblastic leukemia? Arch Dis Child . 1983;58:953-958.Crossref 13. Rowland JH, Glidewell OJ, Sibley RF, et al. Effects of different forms of central nervous systems prophylaxis on neuropsychological function in childhood leukemia . J Clin Oncol . 1984;2:1327-1335. 14. Eiser C. Intellectual abilities among survivors of childhood leukemia as a function of CNS irradiation . Arch Dis Child . 1978;53:391-395.Crossref 15. Meadows AT, Massari DJ, Fergusson J, Gordon J, Littman P, Moss K. Declines in IQ scores and cognitive dysfunctions in children with acute lymphoblastic leukemia treated with irradiation . Lancet . 1981;2:1015-1018.Crossref 16. Shalen PR, Ostrow PT, Glass PJ. Enhancement of the white matter following prophylactic therapy of the ventral nervous system for leukemia . Radiology . 1981;140:409-412.Crossref 17. Riccardi R, Brouwers P, DiChiro GD, Poplack DG. Abnormal computed tomography brain scans in children with acute lymphoblastic leukemia: serial longterm follow-up . J Clin Oncol . 1985;3:12-18. 18. Dow RS. The evolution and anatomy of the cerebellum . Biol Rev Camb Philos Soc . 1942;17:179-220.Crossref 19. Leiner HC, Leiner AL, Dow RS. Does the cerebellum contribute to mental skills? Behav Neurosci . 1986;100:443-454.Crossref 20. McCormick DA, Thompson RF. Cerebellum: essential involvement in the classically conditioned eyelid response . Science . 1984;223:296-299.Crossref 21. Baier WK, Beck U, Duose H, Klinge H, Hirsch W. Cerebellar atrophy following diphenylhydantoin intoxication . Neuropediatrics . 1984;15:76-81.Crossref 22. Schmidt D. Adverse effects of valproate . Epilepsia . 1984;25( (suppl) ):44-49.Crossref 23. Melgaard B, Ahlgran P. Ataxia and cerebellar atrophy in chronic alcoholics . J Neurol . 1986;233:13-15.Crossref 24. Harper CG, Kril JJ. Neuropathology in alcoholism . Alcohol Alcohol . 1990;25: 207-216. 25. Mullenix PM, Norton S, Culver B. Locomotor damage in rats after x-irradiation in utero . Exp Neurol . 1975;48:310-324.Crossref 26. Norton S, Kimler BF, Mullinex PM. Progressive behavioral changes in rats after exposure to low levels of ionizing radiation in utero . Neurotoxicol Teratol . 1991;13:181-188.Crossref 27. Altman J. Morphological development of the rat cerebellum and some of its mechanisms . In: Palay SL, Chan-Palay V, eds. The Cerebellum—New Vistas . New York, NY: Springer-Verlag NY Inc; 1982:8-49. 28. Wiznitzer M, Packer RJ, Rorke LB, Meadows AT. Cerebellar sclerosis in pediatric cancer patients . J Neurooncol . 1987;4:353-360. 29. Schwartz ML, Goldman-Rakic PS. Development and plasticity of the primate cerebral cortex . Clin Perinatol . 1990;17:83-102. 30. Goldman-Rakic PS. Development of cortical circuitry and cognitive function . Child Dev . 1987;58:601-622.Crossref 31. Rakic P, Sidmann RL. Histogenesis of cortical layers in human cerebellum, particularly the lamina dissecans . J Comp Neurol . 1970;139:473-500.Crossref 32. Jacobson M. Developmental Neurobiology . New York, NY: Plenum Press; 1978. 33. Kolb B. Brain, development, plasticity, and behavior . Am Psychol . 1989;9: 1203-1212.Crossref 34. Huttenlocher PR. Synaptic density in human frontal cortex: developmental changes and effects of aging . Brain Res . 1979;163:195-205.Crossref 35. Huttenlocher PR. Morphometric study of human cerebral cortex development . Neuropsychologia . 1990;28:517-527.Crossref 36. Brodal A. Neurological Anatomy . 3rd ed. New York, NY: University Press; 1981. 37. Benton AL. Revised Visual Retention Test: Clinical and Experimental Applications . 4th ed. New York, NY: Psychological Corp; 1973. 38. Harris RJ. A Primer in Multivariate Statistics . Orlando, Fla: Academic Press Inc; 1975. 39. Bracke-Tolkmitt R, Linden A, Canavan AGM, et al. The cerebellum contributes to mental skills . Behav Neurosci . 1989;103:442-446.Crossref 40. Fiez JA, Petersen SE, Cheney MK, Raichle ME. Impaired non-motor learning and error detection associated with cerebellar damage . Brain . 1992;115:155-178.Crossref 41. Brouwers P, Riccardi R, Fedio R, Poplack D. Long-term neuropsychological sequelae of childhood leukemia: correlations with CT brain scan abnormalities . J Pediatr . 1985;106:723-728.Crossref 42. Moss HA, Nannis ED, Poplack DG. The effects of prophylactic treatment of the central nervous system on intellectual function of children with acute lymphocytic leukemia . JAMA . 1981;71:47-52.Crossref 43. Peylan-Ramu N, Poplack D, Pizzo P, Adornato BT, Chiro GJ. Abnormal CT scans of the brain in asymptomatic children with acute lymphocytic leukemia after prophylactic treatment of the cerebral nervous system with radiation and intrathecal chemotherapy . N Engl J Med . 1978;298:815-819.Crossref 44. Butler RW, Copeland DR. Neuropsychological effects of central nervous system prophylactic treatment in childhood leukemia: methodological considerations . J Pediatr Psychol . 1993;18:319-338.Crossref 45. Teuber H-L. Recovery of function after brain injury in man . In: Central Nervous System . Amsterdam, the Netherlands: Ciba Foundation Symposium; 1975: 159-190. 46. Fischer KW. Relations between brain and cognitive development . Child Dev . 1987;58:623-632.Crossref 47. Black JE, Isaacs KR, Anderson BJ, Akantara AA, Greenough WT. Learning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult rats . Proc Natl Acad Sci U S A . 1990;87:5568-5572.Crossref 48. Rakic P. Mechanisms of ocular dominance segregation in the lateral geniculate nucleus: competitive elimination hypothesis . Trends Neurosci . 1986;9:11-15.Crossref 49. Rakic P. Neuro-glia relationship during granular cell migration in developing cerebellar cortex: a Golgi and electromicroscopic study in macaque resus . J Comp Neurol . 1971;141:283-312.Crossref 50. Caveness WF. Experimental observations: delayed neurosis in normal monkey brain . In: Gilbert HA, Kagan AR, eds. Radiation Damage to the Nervous System . New York, NY: Raven Press; 1980:1-38. 51. Floeter MK, Greenough WT. Cerebellar plasticity: modification of Purkinje cell structure by differential rearing in monkeys . Science . 1979;206:227-229.Crossref 52. Juraska JM, Ritch J, Henderson C, Rivers N. Sex differences in the dendritic branching of dentate granule cells following differential experience . Brain Res . 1985;333:73-80.Crossref 53. Yim YS, Mahoney DH, Oshamnn DG. Hemiparesis and ischemic changes of the white matter after intrathecal therapy for children with acute lymphocytic leukemia . Cancer . 1991;67:2058-2061.Crossref 54. Sheline GE. Irradiation injury of the human brain: a review of clinical experience . In: Gilbert HA, Kagan AR, eds. Radiation Damage to the Nervous System . New York, NY: Raven Press; 1980:39-58. 55. Bleyer WA, Griffin TW. White matter neurosis, mineralizing microangiopathy, and intellectual abilities in survivors of childhood leukemia . In: Gilbert HA, Kagan AR, eds. Radiation Damage to the Nervous System . New York, NY: Raven Press; 1980:155-174. 56. Priest JR, Ramsey NKC, Latchaw RE, et al. Thrombotic and hemorrhagic stroke complicating early therapy for childhood acute lymphoblastic leukemia . Cancer . 1980;46:1548-1554.Crossref 57. Taylor GH, Albo VC, Phebus CK, Sachs BR, Bierl PG. Post-irradiation treatment outcomes for children with acute lymphoblastic leukemia: clarification of risk . J Pediatr Psychol . 1987;12:395-411.Crossref 58. Pleasure ED, Scholland DL. Peripheral nervous disorders . In: Rowland LP, ed. Merritt's Textbook of Neurology . Philadelphia, Pa: Lea & Febiger;1984;7:477-498. 59. Marr D. A theory of cerebellar cortex . J Physiol . 1969;202:437-470. 60. Albus JS. A theory of cerebellar function . Math Biosci . 1971;10:25-61.Crossref 61. Keating JG, Thach WT. Cerebellar motor learning: quanitification of movement adaptation and performance in rhesus monkeys and humans implicates cortex as the site of adaptation . Soc Neurosci Abstracts . 1990;16:762. Abstract. 62. Leiner HC, Leiner AL, Dow RS. Reappraising the cerebellum: what does the hindbrain contribute to the forebrain? Behav Neurosci . 1989;103;998-1008.Crossref 63. Newman PP, Reza H. Functional relationships between the hippocampus and the cerebellum: an electrophysiological study of the cat . J Physiol . 1979;287: 405-426. 64. Gaffney GR, Tsai LY, Kupermass S, Minchin S, Hesselink JR. Structure in autism . AJDC . 1987;141:1330-1332. 65. Courchesne E, Yeung-Courchesne R, Press GA, Hesselink JR, Jernigan TL. Hypoplasia of cerebellar vermal lobules VI and VII in autism . N Engl J Med . 1988;318:1349-1354.Crossref 66. Bauman M, Kemper TL. Histoanatomic observations of the brain in early infantile autism . Neurology . 1985;35:866-874.Crossref 67. Ritvo ER, Freeman BJ, Scheibel AB, et al. Lower Purkinje cell counts in the cerebella of four autistic subjects: initial findings of the UCLA-NSAC autopsy research report . Am J Psychiatry . 1986;143:862-866. 68. Ciesielski KT, Knight JE. Cerebellar abnormality in autism: a nonspecific effect of early brain damage? Acta Neurobiol Exp . 1994;54;151-154. 69. Mitchell DE, Timney B. Postnatal development of function in the mammalian nervous system . In: Brookhart JM, Mountcastle VR, eds. Handbook of Physiology, Section 1: The Nervous System . Bethesda, Md: American Physiological Society; 1984:1-37. 70. Coleman PD, Riesen AH. Environmental effects on cortical dendritic fields, I: rearing in the dark . J Anat . 1968;102:363-374. 71. Winfield DA. The postnatal development of synapses in the visual cortex of the cat and the effects of eyelid closure . Brain Res . 1981;206:166-171.Crossref 72. Pysh JJ, Weiss M. Exercise during development induces an increase in Purkinje cell dendritic tree size . Science . 1979;206:230-232.Crossref 73. Goldman PS. Functional development of the prefrontal cortex in early life and the problem of neuronal plasticity . Exp Neurol . 1971;32:366-387.Crossref 74. Greenough WT, Fass B, DeVoogd TJ. The influence of experience on recovery following brain damage in rodents: hypotheses based on development research . In: Walsh RN, Greenough WT, eds. Environments as Therapy for Brain Dysfunction . New York, NY: Plenum Press; 1976:10-50. 75. Peckham VC. Learning disorders associated with the treatment of cancer in children . J Assoc Pediatr Oncol Nurses . 1988;5:10-13.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Oct 1, 1994

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