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Neuropsychological consequences of childhood medulloblastoma and possible interventions: A review
E Doger de Spéville1, V Kieffer2, C Dufour3
1Inserm U1129, CEA, Paris Descartes university, 75005 Paris, France; UNIACT, institut Joliot, DRF, Neurospin, CEA, Paris Saclay university, 91190 Gif-sur-Yvette, France; Department of pediatric and adolescent oncology, Gustave-Roussy, 94800 Villejuif, France.
Insights
Children treated for medulloblastoma often experience cognitive impairments affecting processing speed and attention. Early, personalized rehabilitation is crucial for improving their quality of life.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Cognitive Psychology
Background:
- Childhood medulloblastoma survivors frequently face long-term cognitive deficits impacting academics and life quality.
- Neuropsychological consequences and risk factors for these impairments require thorough understanding.
Purpose of the Study:
- To review the neuropsychological consequences of childhood medulloblastoma.
- To discuss risk factors influencing cognitive impairments.
- To explore interventions enhancing quality of life for survivors.
Main Methods:
- A narrative review approach was employed.
- Electronic searches of PubMed were conducted to identify relevant studies.
Main Results:
- Core cognitive domains affected include processing speed, attention, and working memory.
- Deficit emergence and severity are influenced by age at diagnosis, parental education, treatment factors (radiation dose, posterior fossa syndrome), and intervention quality.
- Interventions like school adaptations and cognitive rehabilitation programs show promise.
Conclusions:
- Survivors need specialized, multidisciplinary rehabilitation with timely, adapted assessments.
- Personalized intervention goals should be set with patients and families.
- Long-term follow-up is essential until transition to adult services.
Background:
Children who have been treated for a medulloblastoma often suffer long-term cognitive impairments that often negatively affect their academic performance and quality of life. In this article, we will review the neuropsychological consequences of childhood medulloblastoma and discuss the risk factors known to influence the presence and severity of these cognitive impairments and possible interventions to improve their quality of life.
Methods:
This narrative review was based on electronic searches of PubMed to identify all relevant studies.
Results:
Although many types of cognitive impairments often emerge during a child's subsequent development, the core cognitive domains that are most often affected in children treated for a medulloblastoma are processing speed, attention and working memory. The emergence and magnitude of these deficits varies greatly among patients. They are influenced by demographic (age at diagnosis, parental education), medical and treatment-related factors (perioperative complications, including posterior fossa syndrome, radiation therapy dose, etc.), and the quality of interventions such as school adaptations provided to the child or rehabilitation programs that focus on cognitive skills, behavior and psychosocial functioning.
Conclusion:
These patients require specialized and coordinated multidisciplinary rehabilitation follow-up that provides timely and adapted assessments and culminates in personalized intervention goals being set with the patient and the family. Follow-up should be continued until referral to adult services.
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