Qos-43a Two-Year Follow-Up Study of Neurocognition in Children Treated for a Brain Tumor

Abstract

Most studies that investigate cognitive long-term problems are crosssectional, making it difficult to evaluate the evolution of neurocognition and to disentangle tumor specific from treatment factors. In the present study we investigated the evolution of neurocognition between two time-points (at diagnosis and two years after diagnosis). A total of 35 children diagnosed with a brain tumor at the University Hospitals Leuven were tested twice with a comprehensive neuropsychological test battery. The first assessment was conducted as soon as possible after diagnosis and before initiation of chemo-and/or radiotherapy. Mean age at diagnosis was 9.27 years. The most common diagnoses were pilocytic astrocytoma (54.29%) and medulloblastoma (22.86%). 34.29% received ventricular drainage and 57.1% underwent surgery before baseline testing. Respectively, 28.6% and 25.7% received focal or craniospinal irradiation. A repeated measures analysis with cranial irradiation (no, focal, craniospinal) as between factor demonstrated no main effect of time or no interaction effect between time and cranial irradiation for intelligence, verbal and visual memory and visuomotor function. For some measures of selective, divided and sustained attention a main effect of time was found. For divided and sustained attention an interaction effect was present, indicating that cranial irradiation, especially craniospinal, had a negative impact. Two years after diagnosis we found only for some attentional functions a significant decline and this effect was more pronounced for children that received cranial irradiation. Our results are in line with other studies, indicating that especially attentional functions are vulnerable in children treated for a brain tumor.