The Pediatric Perceived Cognitive Function (PedsPCF) item bank is a short parent and self-reported cognitive screening questionnaire developed in the context of pediatric oncology. The PedsPCF demonstrated satisfactory psychometric properties and the scores of the PedsPCF are found to be associated with clinical outcomes. Today little research is available to evaluate whether the PedsPCF is correlated with direct assessments of neurocognitive domains. The aim of the current study is to investigate whether important cognitive domains, such as different aspects of intelligence, memory, visuomotor integration can predict the PedsPCF score. We obtained 100 PedsPCF filled in by parents from children treated for a brain tumor. All these children completed a comprehensive neuropsychological battery. Mean age at diagnosis was 7.47 years and mean age at completion of PedsPCF and testing 13.84. The most common diagnoses were pilocytic astrocytoma (n=43) and medulloblastoma (n=14). A linear regression model with verbal comprehension, perceptual reasoning, processing speed, visuomotor integration as predictors for overall PedsPCF score was significant (p.005), but the overall model fit was limited (adjusted R2: 14%). Visuomotor integration and processing speed were significant predictors (beta = 0.56 and -0.29). Our results are in line with the overall finding that the correlation between questionnaires assessing quality of survival and direct assessments of cognition are low. For clinical practice these results are important as the PedsPCF can’t be used to replace direct cognitive assessments or vice versa.
It is well known that neurocognition in children treated for a brain tumor can be affected. However, studies on the trajectory of these neurocognitive problems are scarce. In the present study we investigated the evolution of neurocognition between timepoints of diagnosis, 2, 4 and 6 years later. A total of 53 children diagnosed with a brain tumor were recruited in this study, of which all completed a comprehensive neuropsychological test battery at three successive timepoints and 30 at 4 timepoints. The first assessment was conducted as soon as possible after diagnosis and before initiation of chemo- and/or radiotherapy. Mean age at diagnosis was 8.06 years. The most common diagnoses were pilocytic astrocytoma (n=28) and medulloblastoma (n=10). 24.5% and 18.9% of these patient groups received focal or craniospinal irradiation, respectively. A repeated measures analysis with cranial irradiation (no, focal, craniospinal) as between-subjects factor demonstrated a significant interaction effect between time and type of irradiation for overall intelligence (p=0.02) for children with three assessments. The same interaction effect was found for overall intelligence and processing speed for children with four assessments (p=.005 and p=.002, respectively). The group who received craniospinal irradiation demonstrated the most pronounced decline. Interestingly, no main time effect or interaction effect was found for general memory functioning. Our results demonstrate that not all neurocognitive functions in children treated for a brain tumor decline after treatment. Overall IQ and processing speed are the most vulnerable outcomes in our cohort, especially for the children treated with craniospinal irradiation.
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