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Neuropsychological Performance and Its Predictors in the Early Treatment Phase of Non-CNS Pediatric Cancer
Marisa H Huisman1, Sterre Sanstra1, Daniëlle P A Bos1
1Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Insights
Pediatric cancer patients with non-central nervous system (CNS) cancers showed average performance on neuropsychological tests. However, scores were lower than estimated IQ, indicating potential vulnerabilities, with family psychosocial risk linked to memory deficits.
Area of Science:
- Pediatric Oncology
- Neuropsychology
- Childhood Cancer Survivorship
Background:
- Pediatric cancer survivors often face long-term neuropsychological challenges.
- Early-phase neuropsychological performance and predictors in non-central nervous system (CNS) cancers remain understudied.
Purpose of the Study:
- To describe the early neuropsychological performance of children diagnosed with leukemia, lymphoma, or non-CNS solid tumors.
- To identify predictors of neuropsychological outcomes in this pediatric cancer population.
Main Methods:
- Neuropsychological assessments (IQ, attention, memory, processing speed, etc.) were conducted on 104 children (aged 5-18) 4.5 months post-diagnosis.
- Performance was compared to age-matched norms and individual estimated IQ (EIQ).
- Multiple regression analyses examined medical factors, developmental vulnerabilities, and family psychosocial risk as predictors.
Main Results:
- Participants' estimated IQ was above average; most neuropsychological scores were within the average range compared to norms.
- However, scores on most neuropsychological tests were significantly lower than participants' EIQ.
- Medical factors and developmental vulnerabilities were not associated with outcomes; family psychosocial risk was linked to memory.
Conclusions:
- Children with non-CNS cancers exhibit average performance on tests but show deficits relative to their EIQ, suggesting potential vulnerabilities.
- Family psychosocial risk may impact memory function in the early treatment phase.
- Longitudinal studies with alternative predictors are needed to understand early neuropsychological difficulties.
Background:
Pediatric cancer survivors can experience neuropsychological problems in the long term. Less is known about neuropsychological performance and its possible predictors in the early treatment phase of non-central nervous system (CNS) cancers.
Procedure:
This study describes the neuropsychological performance of 104 children with leukemia (n = 43), lymphoma (n = 29), or a non-CNS solid tumor (n = 33) aged 5-18 years at diagnosis (M = 11.78, SD = 3.71, 48% female), 4.52 months (SD = 0.77) after diagnosis. Using one-sample t-tests, measures of IQ, attention, memory, working memory, verbal fluency, processing speed, and reading were compared to age-matched norm scores. Individual comparisons were performed with paired t-tests, comparing participants' neuropsychological scores to their estimated IQ (EIQ). Multiple regression analyses related medical factors, pre-existing developmental vulnerabilities, and family psychosocial risk to neuropsychological outcomes, corrected for age at diagnosis, sex, and EIQ.
Results:
EIQ was significantly above the population mean (M = 105.25, SD = 12.15, p < 0.05), and most neuropsychological outcomes were within the average range compared to age-matched norms. Compared to their EIQ, however, participants' scores were on average significantly lower for almost all neuropsychological outcomes (p < 0.05). Medical factors, developmental vulnerabilities, and family psychosocial risk were not associated with neuropsychological outcomes (p > 0.05) in multivariable models. In a follow-up analysis, family psychosocial risk was related to memory (p < 0.05).
Conclusions:
Children with non-CNS cancers perform within the average range on most neuropsychological tests. However, most scores are lower than participants' EIQ, revealing potential vulnerabilities. Family psychosocial risk may relate to memory. Future studies should include longitudinal follow-up and alternative predictors to clarify what contributes to early neuropsychological difficulties.
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