Cognitive, language, and school performance in children and young adults treated for low‐grade astrocytoma in the posterior fossa in childhood

Abstract

Background Pilocytic astrocytoma is the most common brain tumour type in childhood located in the posterior fossa, and treated mainly with surgery. These tumours have low mortality, but knowledge concerning its long‐term outcome is sparse. Aim The aim of this study was to investigate whether children treated for pilocytic astrocytoma in the posterior fossa had late complications affecting cognition, language and learning. Methods This descriptive single‐centre study includes eight children and 12 adults treated as children for pilocytic astrocytoma in the posterior fossa, with a mean follow‐up time of 12.4 (range 5–19) years. Well‐established tests of intelligence, executive, language and academic function were used. Results Intelligence tests showed average results compared with norms. Five patients scored <−1 SD (70–84) and 3 low average (85–92) on full scale IQ. The patients scored average on subtests regarding executive function, except for significantly lower results in inhibition/switching (p = .004). In Rey complex figure test half of the patients scored below −1 SD. Language tests were normal except for significantly lower results in naming ability (p = .049) and in inference (p = .046). In academic tests, results were average, except for significantly lower results in reading speed (p = .024). Patients with learning difficulties performed worse in the tests. Conclusions The patients' functional outcome was favourable but, a not‐negligible part of the patients displayed neurocognitive difficulties as revealed by extensive neuro‐cognitive and academic testing. Thus, it is important to identify those in need of more thorough cognitive and pedagogic follow‐up programmes, including school interventions.

An investigation of language learning and processing in children with developmental language disorder and pediatric cerebellar tumor survivors

“…Five of the 15 studies assessing phonology found an impairment (Brinkman et al, 2012;Kirschen et al, 2008;McGahan, 2013;Riva & Giorgi, 2000;Rønning et al, 2005), such as auditory sequential memory (Kirschen et al, 2008;Riva & Giorgi, 2000) or long-term verbal memory problems (McGahan, 2013). Two out of three studies found pragmatic impairments (Hudson & Murdoch, 1992c;Kristiansen et al, 2021). Among others, inference (Kristiansen et al, 2021) and story grammar difficulties (Hudson & Murdoch, 1992c) were reported.…”

“…Two out of three studies found pragmatic impairments (Hudson & Murdoch, 1992c;Kristiansen et al, 2021). Among others, inference (Kristiansen et al, 2021) and story grammar difficulties (Hudson & Murdoch, 1992c) were reported. For literacy skills, nine out of 20 studies reported reading impairments (e.g., problems with reading fluency; Brinkman et al, 2012;and comprehension;Hodgson, 2018), while six out of 15 studies reported spelling impairments (e.g., reduced spelling accuracy; Hodgson, 2018;Johnson et al, 1994;McDonald, 2005;Merchant et al, 2014;Moxon-Emre, 2013;Mulhern et al, 1998).…”

“…Regarding age at diagnosis, older children might have more favorable postoperative language outcomes. Four out of 12 group studies reported that children who were older at diagnosis performed better for literacy (Kristiansen et al, 2021), verbal learning (Nagel et al, 2006) or lexical-semantics (Brinkman et al, 2012;Vaquero et al, 2008). Other studies found no relation between age at diagnosis and these language functions (n = 8; Ait Khelifa-Gallois et al, 2015;Johnson et al, 1994;Levitch et al, 2022;McGahan, 2013;Moxon-Emre, 2013;Pletschko et al, 2018;Reeves et al, 2006;Steinlin et al, 2003).…”

“…Spelling (e.g., Johnson et al, 1994;Mulhern et al, 1998;Palmer et al, 2010) and phonology (e.g., Benavides-Varela et al, 2019;Brinkman et al, 2012;O'Neil et al, 2020) were assessed 15 and 14 times respectively. Morphosyntax (n = 7; e.g., Di Rocco et al, 2011;Docking et al, 2016;Riva & Giorgi, 2000) and pragmatics (n = 3; Docking et al, 2016;Hudson & Murdoch, 1992c, 1992bKristiansen et al, 2021) were studied less frequently.…”

“…Individually, language deficits were reported least often in the survivorship phase and most often during tumor treatment (see Table 4.2). Yet, mixed patterns of impairment were reported in all phases following tumor treatment (e.g., Kristiansen et al, 2021;Mulhern et al, 1998;Rønning et al, 2005).…”