Pretreatment Cognition in Patients Diagnosed with Pediatric Brain Tumors

Publication date: Available online 22 November 2017
Source:Pediatric Neurology
Author(s): Elin Irestorm, Sean Perrin, Ingrid Tonning Olsson
BackgroundThere is a large body of literature identifying risk factors for the long-term cognitive alterations found in survivors of Pediatric Brain Tumors (PBTs). Less is known about baseline cognitive functioning in this population but studies suggest cognitive dysfunctions are often present at the time of diagnosis. This study aimed to identify potential risk factors for lower cognitive function at the time of PBT diagnosis.MethodsParticipants were children and adolescents (n=101) diagnosed with a PBT between 2006 and 2015, who underwent a pretreatment neuropsychological assessment. Multivariate regression models were used to estimate the association between gender, age-at-diagnosis, tumor size and location, increased intracranial pressure, epilepsy, and six different indicators of cognitive functioning.ResultsOverall, cognitive performance was relatively intact, with results close to norm means, but impairments were found in memory and cognitive processing speed. Male gender, older age, epilepsy, increased intracranial pressure, and larger tumors were all associated with lower cognitive function at PBT diagnosis; while tumor location was not.ConclusionsPretreatment neuropsychological assessments, with some adjustments, can be carried out with children and adolescents with PBTs. The current study adds to a small but growing body of literature finding cognitive impairments at the time of diagnosis; impairments which may partly explain the longer-term deficits which are common in PBT survivors. Consistent with previous research, pretreatment impairments were more common among boys, older children and those with increased intracranial pressure, epilepsy, and larger tumors. The relationship between baseline and longer-term cognitive deficits requires further examination.



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