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Predictors of neuropsychological late effects and white matter correlates in children treated for a brain tumor without radiation therapy
Author(s) -
Peterson Rachel K.,
Tabori Uri,
Bouffet Eric,
Laughlin Suzanne,
Liu Fang,
Scantlebury Nadia,
Mabbott Donald
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27924
Subject(s) - neuropsychology , wechsler adult intelligence scale , cognition , visual memory , white matter , working memory , psychology , medicine , audiology , intelligence quotient , psychiatry , magnetic resonance imaging , radiology
Background Little is known about cognition and predictors of neuropsychological outcomes in pediatric low‐grade glioma (PLGG) survivors treated without radiation therapy. This research expands upon our previous work by further identifying the cognitive profile of PLGG patients treated without radiation therapy, investigating the specific medical and demographic variables that predict functioning, and examining white matter structure and its relationship to neuropsychological performance. Procedure Nineteen PLGG patients (11‐19 years) were administered the Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale, and subtests from the Woodcock‐Johnson Tests of Cognition (visual matching, rapid picture naming, and pair cancellation) and Cambridge Neuropsychological Test Automated Battery (pattern recognition memory, delayed matching to sample, intra‐extra dimensional set shift, motor screening task, rapid visual information processing, and spatial span). Results The sample had normative weaknesses in verbal working memory, brief attention/vigilance, psychomotor speeded output, visual perception and matching, overall cognition, working memory, and processing speed. Increased surgeries or subtotal resections, hydrocephalus, shunting procedures, chemotherapy, NF1, and supratentorial location were predictive of cognitive deficits. Broad white matter involvement of the frontal, temporal, parietal, and occipital lobes as well as the cerebellum, as inferred from diffusion tensor imaging indices of decreased fiber orientation and increased water diffusion, was related to many cognitive difficulties. Conclusions This study comprehensively examines cognitive functioning in PLGG patients treated without radiation therapy, predictors of cognition, and its relation to white matter structure. Our findings indicate that medical and demographic variables other than radiation therapy can lead to cognitive late effects with diffuse white matter involvement.