Functional Alteration in the Brain Due to Tumour Invasion in Paediatric Patients: A Systematic Review

SIMPLE SUMMARY: Brain tumours can result in cognitive, language, motor, and visual deficits in paediatric patients by invading the functional regions of the brain and altering neuronal networks. The specific mechanisms of tumour invasion and the cognitive impact of various treatments remain uncertain. In this systematic review, we discuss the functional alteration in the brain of paediatric patients caused by the tumours in different locations. The present study proposes to understand the changes in the functional connectivity of paediatric patients after tumour invasion using resting-state and task-based fMRI. ABSTRACT: Working memory, language and speech abilities, motor skills, and visual abilities are often impaired in children with brain tumours. This is because tumours can invade the brain’s functional areas and cause alterations to the neuronal networks. However, it is unclear what the mechanism of tumour invasion is and how various treatments can cause cognitive impairment. Therefore, this study aims to systematically evaluate the effects of tumour invasion on the cognitive, language, motor, and visual abilities of paediatric patients, as well as discuss the alterations and modifications in neuronal networks and anatomy. The electronic database, PubMed, was used to find relevant studies. The studies were systematically reviewed based on the type and location of brain tumours, cognitive assessment, and pre- and post-operative deficits experienced by patients. Sixteen studies were selected based on the inclusion and exclusion criteria following the guidelines from PRISMA. Most studies agree that tumour invasion in the brain causes cognitive dysfunction and alteration in patients. The effects of a tumour on cognition, language, motor, and visual abilities depend on the type of tumour and its location in the brain. The alteration to the neuronal networks is also dependent on the type and location of the tumour. However, the default mode network (DMN) is the most affected network, regardless of the tumour type and location.Furthermore, our findings suggest that different treatment types can also contribute to patients’ cognitive function to improve or deteriorate. Deficits that persisted or were acquired after surgery could result from surgical manipulation or the progression of the tumour’s growth. Meanwhile, recovery from the deficits indicated that the brain has the ability to recover and reorganise itself.