儿童后颅窝肿瘤 (PFT) 幸存者会经历长期的认知后遗症，包括记忆障碍，而辐射是其主要危险因素之一。本研究的目的是（1）探讨受辐射与未受辐射的 PFT 幸存者的情景、语义、工作和程序记忆系统的损伤情况，以及（2）测试自传体问卷和两阶段生态测试是否（ Epireal）评估情景记忆比常用测试对辐射引起的海马损伤更敏感。前瞻性 IMPALA 研究共纳入 60 名参与者（22 名受辐射 PFT 幸存者、17 名未受辐射 PFT 幸存者和 21 名对照者）。他们都接受了一系列广泛的测试，在两次为期 2 天、相隔 3 周的测试中评估不同的记忆系统。我们使用 -1.65 SD 作为截止值进行组间比较并分析损伤情况。对于受辐射的患者，计算了涉及记忆的关键大脑结构（海马、小脑和纹状体）的平均辐射剂量与相应的记忆评分之间的相关性。PBT 幸存者在常规的情景测试中表现明显比对照组差（p < 0.001）。语义和工作记忆：64% 的受辐射患者和 35% 的未受辐射患者至少有两个记忆系统存在缺陷，情景记忆障碍在受辐射组中更为明显。 Epireal 比其他情景记忆测试具有更大的效应量，使我们能够检测到另外 18% 的受辐射患者的缺陷。这些缺陷与左侧海马体的平均辐射剂量相关。记忆障碍是 PFT 幸存者中常见的长期认知后遗症，尤其是在放射治疗后。新的情景记忆生态测试比传统测试对辐射引起的缺陷更敏感，可以产生内侧颞叶辐射毒性的特定标记。版权所有 © 2024 作者。由爱思唯尔有限公司出版。保留所有权利。

Pediatric posterior fossa tumor (PFT) survivors experience long-term cognitive sequelae, including memory disorders, for which irradiation is one of the main risk factors. The aims of the present study were to (1) explore the profile of impairment in episodic, semantic, working and procedural memory systems in irradiated versus nonirradiated PFT survivors, and (2) test whether an autobiographical questionnaire and a two-phase ecological test (Epireal) assessing episodic memory are more sensitive to radiation-induced hippocampal damage than commonly used tests.A total of 60 participants (22 irradiated PFT survivors, 17 nonirradiated PFT survivors, and 21 controls) were included in the prospective IMPALA study. They all underwent a broad battery of tests assessing the different memory systems in two 2-day sessions 3 weeks apart. We performed between-groups comparisons and analyzed impairment profiles, using -1.65 SDs as a cut-off. For irradiated patients, correlations were calculated between mean radiation doses to key brain structures involved in memory (hippocampus, cerebellum, and striatum) and corresponding memory scores.PBT survivors performed significantly more poorly than controls (p < 0.001) on conventional tests of episodic, semantic and working memory: 64% of irradiated patients and 35% of nonirradiated patients had a deficit in at least two memory systems, with episodic memory impairment being more specific to the irradiated group. Epireal had a larger effect size than the other episodic memory tests, allowing us to detect deficits in a further 18% of irradiated patients. These deficits were correlated with the mean radiation dose to the left hippocampus.Memory impairment is a frequent long-term cognitive sequela in PFT survivors, especially after radiation therapy. New ecological tests of episodic memory that are more sensitive to radiation-induced deficits than conventional tests could yield specific markers of the toxicity of medial temporal lobe irradiation.Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.