Computerized assessment of neuropsychological functioning in pediatric brain tumor patients

Advances in multidisciplinary treatment of childhood brain tumors have significantly prolonged survival and reduced treatment-related complications. This makes the accessibility of digital neurocognitive assessment an important issue in the post-pandemic era.

Twenty pediatric brain tumor patients were recruited between August 2023 and August 2024, and a total of eight standardized Cambridge Neuropsychological Test Automated Battery (CANTAB) tests targeting executive function, memory, and attention were applied on a digital system. Subjects with test data exceeding the 5th and 95th percentile ranges were defined as outlier in this context. Three domains (DMS, PAL, SWM) of the normative data for adult patients provided by CANTAB test were used for comparison. Mann-Whitney U test was used to compare differences in treatment modalities and age groups.

Four patients (4/20, 20%) exhibited impairments across four to six cognitive domains, with more than 14 sub-items falling outside the 5th and 95th percentiles.Another 7 patients (7/20, 35%) had impairments confined to a single domain, even though 4 out of 7 (57%) had a total IQ above 100. The subtle neurocognitive impairment of different domains can be effectively identified by automatic digital threshold analysis and reasonably associated with clinical characteristics. The normative data provided by the CANTAB battery for adult populations further enhances the accuracy of detecting neurofunctional impairments.

The CANTAB test was shown to be an evaluable and user-friendly neurocognitive assessment tool for post-treatment follow-up in pediatric patients with brain tumors.