Executive function in paediatric medulloblastoma: The role of cerebrocerebellar connections

Executive functions ( EF s) are involved in the attainment, maintenance, and integration of information; these functions may play a key role in cognitive and behavioural outcomes in children treated for medulloblastoma ( MB ). At present, it remains unclear which EF s are most sensitive to the treatment effects for MB and whether damage to cerebrocerebellar circuitry is associated with EF . We completed a comprehensive evaluation of EF in 24 children treated for MB and 20 age‐matched healthy children ( HC ) and distilled these measures into components. Six components (C1–C6) were extracted from our model, reflecting dissociable constructs of EF : C1 = cognitive efficiency; C2 = planning/problem‐solving; C3 = positive cognitive emotion regulation; C4 = working memory; C5 = negative cognitive emotion regulation; and C6 = mixed cognitive emotion regulation. Group differences were found for C1, C2, C3, and C4; the MB group showed poorer performance on EF tasks and made less use of positive cognitive emotion regulation strategies relative to HC . Compromise to cerebrocerebellar microstructure – cerebro‐ponto‐cerebellar and cerebello‐thalamo‐cerebral pathways – was evident in children treated for MB compared to HC . We found that cerebrocerebellar circuitry has a mediating effect on one component of EF following treatment for MB – working memory.