Comparison of Neurocognitive Functioning and Fine Motor Skills in Pediatric Cancer Survivors and Healthy Children

Abstract

Background: The late treatment outcomes of pediatric brain tumors and of hematopoietic and lymphoid tissue tumors are an important focus of both rehabilitation and research. Neurocognitive and motor disorders induce further learning problems impeding social-emotional adaptation throughout a whole lifespan. Core deficits in short-term and working memory, visuospatial constructional ability, verbal fluency, and fine motor skills underlie distorted intellectual and academic achievement. This study aimed to assess the individual differences in cognitive ability and fine motor skills of pediatric tumor survivors and the age-matched healthy controls. Methods: A total of 504 tumor survivors after treatment and 646 age-matched healthy controls underwent neurocognitive and fine motor assessments. Findings: The group of tumor survivors scored significantly worse in both neurocognitive and fine motor skill in compared with the healthy control group. The pediatric brain tumor survivors (PBT group) performed worse in cognitive (p < 0.001 for verbal fluency and p < 0.001 for visuospatial constructional ability) and motor tests (p < 0.001) compared to the healthy controls. Hematopoietic and Lymphoid Tissues tumors survivors (THL group) performed worse in verbal fluency (p < 0.01) and visuospatial constructional test (p < 0.001) compared to the control group. Furthermore, the PBT group had worse results in visuospatial constructional ability (p < 0.05) and fine motor (p < 0.001) ability than the THL group. Significant differences between females and males were found in fine motor test performance in the PBT group (p < 0.05), as well as in verbal fluency (p < 0.01) and visuospatial constructional ability (p < 0.01) in the control group. Neurocognitive and fine motor skill characteristics in the THL group did not correlate with age.

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“…Multiple studies have investigated cognitive functional outcomes among childhood cancer survivors. In a study of pediatric cancer survivors aged 6-17 years old by Chipeeva et al, survivors (n = 504) scored significantly worse on measures of memory, visuospatial processing, and verbal fluency than those without a history of cancer [41]. In two studies by Olsson et al, including childhood cancer survivors diagnosed with Wilms tumor and soft tissue sarcoma, survivors had lower scores than community controls in verbal reasoning, word reading, mathematics, sustained attention, long-term verbal memory, and verbal fluency [48,49].…”

“…]. Examples of other measures used to assess cognition include the Cambridge Neuropsychological Test Automated Battery (CANTAB)[59,73], NIH Toolbox for the Assessment of Neurological and Behavior Function Cognition (NIH-TB)[53], Montreal Cognitive Assessment (MoCA)[77], and Controlled Word Association Test[41,53,59]. For self-report measures, the Functional Assessment of Cancer Therapy-Cognition (FACT-Cog) was commonly used (n = 9/39; 23%)[22,31,61,63,69,72,73,78,82] followed by Childhood Cancer Survivor Study Neurocognitive Questionnaire (CCSS NCQ; n = 4/39; 10%)[43][44][45]47].…”

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“…Thus, survivors are at risk for the long-term sequelae in neuropsychological functioning, which poses a risk to their long-term quality of life. The evidence for speech and language deficits in this group is still inconclusive, possibly due to the lack of the test accurately reflecting the patterns of deficits that result from PFTs and their treatments (Shurupova et al, 2021;Chipeeva et al, 2022). To effectively address this issue, it is essential to conduct an accurate assessment of language deficits in pediatric PFTs survivors, which may be overlooked in traditional tests.…”