Timed performance weaknesses on computerized tasks in pediatric brain tumor survivors: A comparison with sibling controls

ABSTRACT

With more children surviving a brain tumor, insight into the late effects of the disease and treatment is of high importance. This study focused on profiling the neurocognitive functions that might be affected after treatment for a pediatric brain tumor, using a broad battery of computerized tests. Predictors that may influence neurocognitive functioning were also investigated. A total of 82 pediatric brain tumor survivors (PBTSs) aged 8–18 years (M = 13.85, SD = 3.15, 49% males) with parent-reported neurocognitive complaints were compared to a control group of 43 siblings (age M = 14.27, SD = 2.44, 40% males) using linear mixed models. Neurocognitive performance was assessed using measures of attention, processing speed, memory, executive functioning, visuomotor integration (VMI), and intelligence. Tumor type, treatment, tumor location, hydrocephalus, gender, age at diagnosis, and time since diagnosis were entered into regression analyzes as predictors for neurocognitive functioning. The PBTSs showed slower processing speeds and lower intelligence (range effect sizes .71–.82, p < .001), as well as deficits in executive attention, short-term memory, executive functioning, and VMI (range effect sizes .40–.57, p < .05). Older age at assessment was associated with better neurocognitive functioning (B = .450, p < .001) and younger age at diagnosis was associated with lower intelligence (B = .328, p < .05). Medical risk factors, e.g., hydrocephalus, did not show an association with neurocognitive functioning. Late effects in PBTSs include a broad range of neurocognitive deficits. The results suggest that even PBTSs that were traditionally viewed as low risk for neurocognitive problems (e.g., surgery only, no hydrocephalus) may suffer from decreased neurocognitive functioning.

KEYWORDS:

• Cancer
• brain tumor
• attention
• speed
• memory

Acknowledgements

Research was conducted in the Psychosocial Department of Emma Children’s Hospital AMC, Amsterdam, The Netherlands. The authors would like to thank Juliette Greidanus, Zeliha Pekcan, Leontine Stolk, Dora Csermak, Arnout Smit, and Sander Schippers for their contribution to the data collection for the study. Furthermore we would like to acknowledge Nan van Geloven for her statistical advice. Finally, we wish to thank all participating parents, patients, and their siblings for their cooperation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Dutch Cancer Society KWF Kankerbestrijding [grant number UVA 2008-4013]; and the Tom Voûte Fund, Part of the Dutch Children Cancer Free Foundation, KiKa [grant number SKK-PRISMA].