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Published on: October 18, 2011
Parent-reported cognitive function is associated with leukoencephalopathy in children with brain tumors
Jin-Shei Lai1, Corey Bregman2, Frank Zelko3
1Medical Social Sciences and Pediatrics, Feinberg School of Medicine at Northwestern University, 633 N St Clair, #19-039, Chicago, IL, 60611, USA. js-lai@northwestern.edu.
Insights
The pediatric perceived cognitive function item bank (pedsPCF) effectively screens for cognitive dysfunction in children with brain tumors. This tool can identify cerebral compromise by correlating with MRI-based leukoencephalopathy grades, aiding early intervention.
Area of Science:
- Pediatric Neuro-oncology
- Neuropsychology
- Medical Imaging
Background:
- Cognitive dysfunction is a significant challenge for pediatric brain tumor patients.
- Early detection and intervention are crucial for improving outcomes.
- A user-friendly screening tool is needed to identify children requiring comprehensive neuropsychological assessment.
Purpose of the Study:
- To evaluate the pediatric perceived cognitive function item bank (pedsPCF) as a valid indicator of cerebral compromise in children with brain tumors.
- To determine if pedsPCF scores correlate with structural brain changes, specifically leukoencephalopathy grades on MRI.
Main Methods:
- Data from 99 children with brain tumors and their parents were analyzed.
- Leukoencephalopathy grade was assessed using MRI, evaluating white matter damage and deep white matter volume loss (range 0-4).
- Parents completed the pedsPCF, with scores standardized to a US general population T-score metric (mean=50, SD=10).
Main Results:
- The pedsPCF scores significantly differentiated between patients with varying leukoencephalopathy grades (F=4.14, p=0.0084).
- Effect sizes for discrimination ranged from 0.09 (grade 0 vs. 1) to 1.22 (grade 0 vs. 3/4).
- The mean pedsPCF T-score was 48.3 (SD=8.3), indicating overall performance relative to the general population.
Conclusions:
- The pedsPCF demonstrates validity as an indicator of leukoencephalopathy in pediatric brain tumor patients.
- Findings support the use of pedsPCF as a brief, user-friendly screening tool for neurocognitive deficits.
- This tool can facilitate timely referrals for comprehensive neurocognitive evaluations and early intervention strategies.
Purpose:
Cognitive dysfunction is a major concern for children with brain tumors. A valid, user-friendly screening tool could facilitate prompt referral for comprehensive neuropsychological assessments and therefore early intervention. Applications of the pediatric perceived cognitive function item bank (pedsPCF) such as computerized adaptive testing can potentially serve as such a tool given its brevity and user-friendly nature. This study aimed to evaluate whether pedsPCF was a valid indicator of cerebral compromise using the criterion of structural brain changes indicated by leukoencephalopathy grades.
Methods:
Data from 99 children (mean age = 12.6 years) with brain tumors and their parents were analyzed. Average time since diagnosis was 5.8 years; time since last treatment was 4.3 years. Leukoencephalopathy grade (range 0-4) was based on white matter damage and degree of deep white matter volume loss shown on MRI. Parents of patients completed the pedsPCF. Scores were based on the US general population-based T-score metric (mean = 50; SD = 10). Higher scores reflect better function.
Results:
Leukoencephalopathy grade distributions were as follows: 36 grade 0, 27 grade 1, 22 grade 2, 13 grade 3, and 1 grade 4. The mean pedsPCF T-score was 48.3 (SD = 8.3; range 30.5-63.7). The pedsPCF scores significantly discriminated patients with different leukoencephalopathy grades, F = 4.14, p = 0.0084. Effect sizes ranged from 0.09 (grade 0 vs. 1) to 1.22 (grade 0 vs. 3/4).
Conclusion:
This study demonstrates that the pedsPCF is a valid indicator of leukoencephalopathy and provides support for its use as a screening tool for more comprehensive neurocognitive testing.
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