Related Experiment Video
Updated: Nov 12, 2025
Adaptation of Microelectrode Array Technology for the Study of Anesthesia-induced Neurotoxicity in the Intact Piglet Brain
Published on: May 12, 2018
Longitudinal associations between exposure to anesthesia and neurocognitive functioning in pediatric medulloblastoma
M Partanen1, D L Anghelescu2, L Hall2
1Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Insights
Longer anesthesia exposure is linked to neurocognitive decline in pediatric medulloblastoma survivors. Limiting anesthesia may improve long-term quality of life for these children.
Area of Science:
- Pediatric Oncology
- Neuroscience
- Anesthesiology
Background:
- Pediatric medulloblastoma treatment often involves anesthesia.
- Long-term neurocognitive effects are a concern for survivors.
- The association between anesthesia exposure and neurocognitive decline requires further investigation.
Purpose of the Study:
- To determine if anesthesia exposure correlates with neurocognitive decline in pediatric medulloblastoma patients.
- To identify specific neurocognitive domains affected by anesthesia duration.
Main Methods:
- 107 pediatric medulloblastoma patients from a clinical trial were analyzed.
- Neurocognitive assessments were conducted annually for 5 years.
- Anesthesia exposure data was abstracted from medical records.
Main Results:
- Longer anesthesia duration was significantly associated with declines in IQ, attention, and processing speed.
- These associations were consistent across various subgroups, including different age groups and risk levels.
- Mean cumulative anesthesia duration was 20.4 hours.
Conclusions:
- Increased anesthesia exposure is a risk factor for neurocognitive decline in pediatric medulloblastoma survivors.
- Strategies to limit anesthesia exposure may help mitigate long-term neurocognitive deficits.
- Reducing anesthesia exposure could enhance the quality of life for survivors.
Aim:
To examine whether anesthesia exposure is associated with neurocognitive decline in pediatric medulloblastoma.
Methods:
Patients were treated at St. Jude Children's Research Hospital and completed ≥2 protocol-directed neurocognitive assessments (n = 107) as part of a multisite clinical trial for pediatric medulloblastoma (NCT00085202). Patients received risk-adapted craniospinal photon irradiation, followed by four cycles of high-dose chemotherapy and stem cell rescue. Neurocognitive testing was completed at study baseline (after surgery and <2 weeks of starting radiation therapy) and annually for 5 years. Data on anesthesia exposure during treatment was abstracted from medical records.
Results:
Patients were 10.2 years at diagnosis on average (SD = 4.5; 37% female, 73% average-risk). Mean cumulative anesthesia duration was 20.4 h (SD = 15.2; range 0.7-55.6 h). In the overall group, longer anesthesia duration was associated with greater declines in IQ (Estimate = -0.08, P < 0.001), attention (Estimate = -0.10, P < .001) and processing speed (Estimate = -0.13, P < 0.001). Similar results were shown in subgroups of patients who were <7 years at diagnosis (IQ = -0.14, P = 0.027; Attention = -0.25: P = 0.011), ≥7 years at diagnosis (Attention = -0.07, P = 0.039; Processing Speed = -0.08, P = 0.022), treated for high-risk disease (IQ = -0.09, P = 0.024; Attention = -0.11, P = 0.034; Processing Speed = -0.13, P = 0.001), or treated for average-risk disease (IQ = -0.05, P = .022; Attention = -0.08, P = 0.011; Processing Speed = -0.10, P < 0.001).
Conclusion:
Greater anesthesia exposure is a risk factor for clinically significant neurocognitive decline, in addition to factors of age at diagnosis and treatment risk arm. This result is notable as there are evidence-based strategies that can limit the need for anesthesia. Limiting anesthesia exposure, as feasible, may mitigate neurocognitive late effects, and thus, improve quality of life for survivors.
More Related Videos
08:41Lateral Chronic Cranial Window Preparation Enables In Vivo Observation Following Distal Middle Cerebral Artery Occlusion in Mice
Published on: December 29, 2016
06:38Use of a Piglet Model for the Study of Anesthetic-induced Developmental Neurotoxicity AIDN: A Translational Neuroscience Approach
Published on: June 11, 2017