CMS-09
BEHAVIOR AND TEMPERAMENT IN CHILDREN TREATED FOR PEDIATRIC MEDULLOBLASTOMA WITH POSTOPERATIVE CEREBELLAR MUTISM SYNDROME

Postoperative Cerebellar Mutism Syndrome (CMS) has been documented in up to 25% of patients following resection of a posterior fossa tumor (e.g. medulloblastoma). CMS can present with diminished or absent speech output, emotional lability, affective disturbances, and other neurological, cognitive, and behavioral impairments. Although mutism is typically transient, speech/language and behavioral disturbances may persist. Behavior in the years following a diagnosis of CMS remains unclear and temperament has yet to be investigated in this population. We assessed behavior in 25 children treated for medulloblastoma (7 with CMS, 18 without CMS), approximately 6 years following diagnosis/treatment, using the Child Behavior Checklist (parent rated). Further, we examined post-treatment measures of self-reported temperament using the Early Adolescent Temperament Questionnaire-Revised. Although comparable in age at diagnosis and testing, sex, full-scale IQ, radiation dose, hydrocephalus, and time from diagnosis to testing, patients with CMS had elevated rates of behavior and temperament difficulties compared to patients without CMS. Specifically, patients with CMS had greater social problems (p < .05) and increased externalizing behavior (p = .009); the latter was driven by higher ratings of aggressive behavior (e.g. fighting and arguing) in the CMS group (p = .03). Self-reported frustration and aggression was also higher in patients with CMS compared to patients without CMS (ps < .02). Our results suggest that patients with medulloblastoma who develop CMS are at risk for externalizing behavior, social problems, and temperament issues, including frustration and aggression, in the years following treatment. We provide novel evidence that the behavior and temperament problems that follow a diagnosis of CMS may be more persistent and long-term than have been documented to date. Overall, our findings underscore the behavior and temperament challenges in patients with CMS and the importance of targeted interventions to address and mitigate these problems.