White Matter Microstructure and Emotional Functioning in Children Treated for Posterior Fossa Tumours

Children treated for brain tumours that arise in the posterior fossa (PF) experience lifelong cognitive and emotional difficulties, and exhibit white matter (WM) damage. This thesis combined diffusion tensor imaging (DTI), eye-tracking and standardized measures of cognitive and emotional functioning in children treated for PF tumours and typically developing children, to: 1) characterize outcomes related to decreases in treatment intensity, 2) objectively evaluate emotional functioning, and 3) examine the associations between WM microstructure and emotional functioning. It was found that treatment with the lowest intensity craniospinal irradiation protocol spared WM in the temporal lobe of children treated for malignant PF tumours. In addition, patients treated on lower intensity protocols had largely preserved cognitive, social and affective functioning. However, novel eye-tracking tasks designed to evaluate emotional functioning uncovered some remaining deficits; children treated for PF tumours had difficulty recognizing facial emotions despite attending to the faces, and difficulty regulating their initial attention away from emotional faces. Notably, this eye-tracking measure of emotion regulation was associated with emotional control in daily life. The current work also revealed that relations between WM microstructure and emotional functioning can diverge in the injured and uninjured brain; WM predicted facial emotion recognition in typically developing children only, whereas WM was associated with emotion regulation in patients only. In a field dominated by findings that characterize negative sequelae, this work highlights the possibility of favourable outcomes for PF tumour patients who are eligible for treatment with lower intensity protocols. Despite these positive outcomes, subtle emotional functioning deficits not captured by standardized questionnaires persist. To better understand how emotional processes are altered in children treated for PF tumours, novel objective measures are required. This thesis detailed one such behavioural marker to evaluate emotion regulation, using eye-tracking technology, and characterized an oculomotor response that may warrant interventional follow-up.

Department dc:contributor.department

Psychology

Year dc:date.issued

2019

Author dc:creator

• Moxon-Emre, Iska

Advisor dc:contributor.advisor

• Mabbott, Donald J

• Diffusion tensor imaging
• Eye-tracking
• Neuropsychology
• Paediatric brain tumours
• White matter

Handle dc:identifier.uri

http://hdl.handle.net/1807/95990

OAI identifier oai:identifier

oai:utoronto.scholaris.ca:1807/95990