Intelligence and posterior fossa tumors in Brazilian youth

Abstract

Central nervous system tumors are the most frequent solid neoplasms in childhood and are frequently located in posterior fossa (PF). In Brazil, this diagnosis is associated to high mortality rates and this context is increasingly worrisome outside of large urban centers in which delayed diagnosis and defaulting from treatment compromise survivorship. Moreover, the lesion and therapeutic toxicity compromise cognitive domains. This study investigated the impact of PF tumors and their treatments on the intellectual capacity of 37 children and adolescents aged 6 to 16, divided into two groups: patients with low grade tumors, submitted only to neurosurgery (G1) and with tumors of higher malignancy submitted to neurosurgery, chemotherapy, and/or radiotherapy (G2). Using the Wechsler Intelligence Scales for Children, data reveal that G1 presented preserved mean performance, while G2 presented low average performance. Cluster-type analysis divided the participants into two groups regarding intelligence, clinical and sociodemographic variables. Inferential statistical analysis highlighted the influence of antineoplastic treatment on nonverbal domains. Mother's schooling demonstrated influence on verbal domains, revealing an important dissociation pattern. The results suggest the relevance of sociocultural factors on the expression of the damage, as well as the administration of radiotherapy at critical neurodevelopmental stages.

Keywords:

• Intelligence
• pediatric oncology
• posterior fossa tumors

Acknowledgments

To the collaborators from Laboratório de Pesquisa e Extensão em Neuropsicologia, especially to Rosália Freire, Cyndiane Cavalcanti, Leilani Fossa, Natália Silva, Laura Soares, and Sarah Oliveira for aiding in collecting, interpreting, and analyzing data. To the teams of the Hospital Infantil Varela Santiago, Liga Norte-Riograndense Contra o Câncer, Hospital Napoleão Laureano, and Complexo de Pediatria Arlinda Marques, and especially to Rafaela Varela, Maria Isabel Aguiar, Edileuza, and Christian Diniz. The authors also want to thank the reviewers and the editor for helpful comments on how to improve the manuscript.

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

This study was financed in part by the Coordenaçao de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.