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Changes in executive function in pediatric brain tumor survivors.

Rachel K Peterson1,2, Lisa A Jacobson1,2

  • 1Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland, USA.

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|November 29, 2021
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Pediatric brain tumor survivors show elevated performance-based working memory (PBWM) deficits over time, despite stable parent-rated executive functions. Continued monitoring is crucial for these survivors.

Keywords:
cognitionneuro-oncologyneuropsychologyoncologyworking memory

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Area of Science:

  • Neuropsychology
  • Pediatric Oncology
  • Cognitive Science

Background:

  • Pediatric oncology survivors, particularly brain tumor (BT) survivors, face risks of executive function (EF) and working memory (WM) deficits.
  • Existing research indicates weak correlations between performance-based measures and rating scales for assessing these cognitive deficits.

Purpose of the Study:

  • To describe parent-rated EF and performance-based WM (PBWM) in pediatric brain tumor survivors.
  • To examine changes in EF and PBWM over time.
  • To investigate the relationship between parent-rated WM and PBWM.

Main Methods:

  • 56 pediatric brain tumor survivors underwent two neuropsychological evaluations.
  • Performance-based working memory (PBWM) was assessed using auditory WM scales.
  • Parental ratings of global executive function (GEC), metacognitive skills (MI/CRI), behavioral regulation (BRI), and emotional regulation (ERI) were collected using the Behavior Rating Inventory of Executive Function (BRIEF) and its variants.

Main Results:

  • Initially, GEC, MI/CRI, and ERI were elevated, while BRI and PBWM were not significantly different from norms.
  • At follow-up, all measures, including PBWM, were significantly elevated compared to normative means.
  • PBWM showed significant elevation and a significant increase over time, whereas other EF measures remained stable.
  • Correlations between PBWM and parent-rated WM were weak at both time points.

Conclusions:

  • Multiple assessment methods are necessary for comprehensive evaluation of EF and WM in pediatric brain tumor survivors.
  • The observed decline in PBWM underscores the need for ongoing monitoring and reassessment of survivors post-treatment.