Longitudinal associations between exposure to anesthesia and neurocognitive functioning in pediatric medulloblastoma

Anesthetic Exposure During Childhood and Neurodevelopmental Outcomes

“…The systemic review identified 14 301 studies published between June 17, 2017, and August 31, 2021, after removal of duplicates. By combining 65 studies identified by Clausen and colleagues, and 43 studies (4 were identified by reviewing reference lists of included studies) in the present review, a total of 108 studies met criteria for inclusion for systematic review and grouping of cognitive domains (Figure 1). Outcomes from studies were classified into 13 domains: academics, adaptive behavior, behavioral problems, cognition, clinical diagnoses and symptoms (only neurodevelopmental disorder diagnoses were evaluated in the meta-analysis), executive function, general development, general health and well-being, language, motor function, nonverbal reasoning, sensory, and social cognition (eTable 1 in the Supplement), with some outcomes also mapping to subdomains.…”

Clinical Studies in Anesthetic Neurotoxicity Research: An Update

“…Jacola et al2 examined the contribution of anesthesia exposure during the treatment of childhood medulloblastoma on neurocognitive outcomes 3 years after tumor diagnosis and found that, compared with population norms, the children in this anesthetic-exposed medulloblastoma cohort had a significantly greater frequency of at-risk scores in the outcome measures of intelligence, attention, working memory, processing speed, and reading. Partanen et al3 examined the same cohort of children and evaluated neurocognitive tests at the study baseline and then annually for 5 years and reported greater declines in intelligence quotient (IQ), attention, and processing speed with longer durations of anesthesia exposure. Walsh et al4 evaluated cognition, motor function, and magnetic resonance imaging scans in very preterm infants (born at ≤30 wk gestation) who were exposed to general anesthesia.…”

“…Six of the recently published studies evaluated children with major baseline comorbidities who were exposed to anesthesia. Of these, 2 evaluated a cohort of children with medulloblastoma, where children received from 1 to 52 anesthetic exposures with a mean cumulative duration of exposure of 21 hours 2,3. Jacola et al2 examined the contribution of anesthesia exposure during the treatment of childhood medulloblastoma on neurocognitive outcomes 3 years after tumor diagnosis and found that, compared with population norms, the children in this anesthetic-exposed medulloblastoma cohort had a significantly greater frequency of at-risk scores in the outcome measures of intelligence, attention, working memory, processing speed, and reading.…”