Processing Speed and Time since Diagnosis Predict Adaptive Functioning Measured with WeeFIM in Pediatric Brain Tumor Survivors

(1) Background: Brain tumor (BT) survivors show difficulties in the acquisition of developmental milestones, related to academic achievement, vocational employment, social relationships, and autonomy. The skills underlying adaptive functioning (AF) are usually damaged in BT survivors due to the presence of the brain tumor, treatment-related factors, and other neurological sequelae. In this study, we aimed to explore the contribution of different cognitive factors in children with BT to AF, considering diagnosis-related variables. (2) Methods: Standardized cognitive assessment was undertaken and clinical information was collected from a retrospective cohort of 78 children with a BT, aged between 6 and 18 year old at the time of the assessment. Regression models were computed to investigate the influence of the selected variables on daily functional skills as measured by the Functional Independence Measure for Children (WeeFIM). (3) Results: The analyses showed that the main explanatory variables are processing speed and time since diagnosis. Other clinical variables, such as age at diagnosis and hydrocephalus, differentially influence functional skills according to distinct domains (i.e., self-care, mobility, and cognition). (4) Conclusions: The main explanatory variables of AF that emerged in our models point to a potential target of improving AF management in pediatric BT survivors.

Download Full-text

Improved neuropsychological outcomes following proton therapy relative to X-ray therapy for pediatric brain tumor patients

Neuro-Oncology ◽

10.1093/neuonc/noz070 ◽

2019 ◽

Vol 21 (7) ◽

pp. 934-943 ◽

Cited By ~ 18

Author(s):

Jeffrey P Gross ◽

Stephanie Powell ◽

Frank Zelko ◽

William Hartsell ◽

Stewart Goldman ◽

...

Keyword(s):

Brain Tumor ◽

Processing Speed ◽

Adaptive Functioning ◽

Pediatric Brain Tumor ◽

Neuropsychological Evaluation ◽

Tumor Patients ◽

X Ray ◽

Neuropsychological Outcomes ◽

Pediatric Brain

AbstractBackgroundSurvivors of pediatric brain tumors are at risk for impaired development in multiple neuropsychological domains. The purpose of this study was to compare neuropsychological outcomes of pediatric brain tumor patients who underwent X-ray radiotherapy (XRT) versus proton radiotherapy (PRT).MethodsPediatric patients who underwent either XRT or PRT and received posttreatment age-appropriate neuropsychological evaluation—including measures of intelligence (IQ), attention, memory, visuographic skills, academic skills, and parent-reported adaptive functioning—were identified. Multivariate analyses were performed to assess differences in neuropsychological outcomes and included tests for interaction between treatment cohort and follow-up time.ResultsBetween 1998 and 2017, 125 patients with tumors located in the supratentorial (17.6%), midline (28.8%), or posterior fossa (53.6%) compartments received radiation and had posttreatment neuropsychological evaluation. Median age at treatment was 7.4 years. The PRT patient cohort had higher estimated SES and shorter median time from radiotherapy completion to last neuropsychological evaluation (6.7 vs 2.6 y, P < 0.001). On multivariable analysis, PRT was associated with higher full-scale IQ (β = 10.6, P = 0.048) and processing speed (β = 14.4, P = 0.007) relative to XRT, with trend toward higher verbal IQ (β = 9.9, P = 0.06) and general adaptive functioning (β = 11.4, P = 0.07). Planned sensitivity analyses truncating follow-up interval in the XRT cohort re-demonstrated higher verbal IQ (P = 0.01) and IQ (P = 0.04) following PRT, with trend toward improved processing speed (P = 0.09).ConclusionsPRT is associated with favorable outcomes for intelligence and processing speed. Combined with other strategies for treatment de-intensification, PRT may further reduce neuropsychological morbidity of brain tumor treatment.

Download Full-text

Determinants of impairments in functioning, fatigue and participation ability in pediatric brain tumor survivors

Neuro-Oncology Advances ◽

10.1093/noajnl/vdab161 ◽

2021 ◽

Author(s):

Emma J Verwaaijen ◽

Coriene E Catsman-Berrevoets ◽

Heleen Maurice-Stam ◽

Arianne B Dessens ◽

Richelle Waslander ◽

...

Keyword(s):

Brain Tumor ◽

Medical Center ◽

Pediatric Brain Tumor ◽

Normative Values ◽

Limited Participation ◽

Related Factors ◽

Quality Of Life Inventory ◽

Erasmus Medical ◽

History Of ◽

Pediatric Brain

Abstract Introduction Pediatric brain tumor survivors (PBTS) experience disease- and treatment-related sequelae. We aimed to investigate the occurrence of participation limitations, impairments in functioning, fatigue, and the association between patient, tumor- and treatment-related factors and these outcomes. Methods Children (4-18 years) after treatment for a brain tumor between 2005-2014 at the Erasmus Medical Center, Rotterdam, the Netherlands, were eligible. The parent-reported Child and Family Follow-up Survey developed to measure participation and impairments in functioning in youth with acquired brain injury, was used. Fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale. Associations with patient, tumor- and treatment-related factors were explored using univariable analyses. Results Ninety-one PBTS (median age: 11.3 years [range: 9.5-14.1], time since treatment: 3.9 years [range: 4-6.2]) were included (response rate: 55%). Participation limitations were reported in 53% and were associated with impairments in functioning (15-67%) (p≤0.01) and fatigue (p≤0.03). Parent- and child-reported fatigue was increased compared to normative values (p=≤0.02). History of hydrocephalus was associated with increased fatigue (p≤0.04). Younger age at diagnosis and longer time since diagnosis were associated with impairments in functioning and cognitive fatigue (p=<0.05). Participation limitations, impairments in functioning and fatigue were similar in PBTS who were <3 or ≥3 years since completion of treatment. Conclusion More than half of PBTS reported limited participation ability, which is associated with impairments in functioning and fatigue. The complication hydrocephalus seems to lead to more fatigue. Participation limitations, impairments in functioning and fatigue appear not to diminish in the longer term.

Download Full-text

NQPC-07 IMMEDIATE POSTOPERATIVE REHABILITATION FOR PATIENTS WITH NEWLY-DIAGNOSED GLIOMA

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.138 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii31-ii31

Author(s):

Mitsuyo Ikeda ◽

Shin Yamada ◽

Yasutomo Okajima ◽

Kuniaki Saito ◽

Keiichi Kobayashi ◽

...

Keyword(s):

Brain Tumor ◽

Functional Independence Measure ◽

Functional Independence ◽

Tumor Type ◽

Postoperative Rehabilitation ◽

Cognitive Improvement ◽

Post Surgery ◽

Before And After ◽

Comprehensive Rehabilitation ◽

Intensive Rehabilitation

Abstract BACKGROUNDS Importance of early intensive rehabilitation is recently emphasized not only for Stroke Unit but for Intensive Care Unit. We have started such early comprehensive rehabilitation for patients after brain tumor surgery. Rehabilitation therapists were specially assigned to our brain surgery unit as members of the ward staffers. The purpose of this study is to show how this rehabilitation trial works for post-surgery patients with glioma. METHODS Thirty-two patients with glioma (20 males and 12 females) who were admitted to our institution in the year of 2018 were included. Mean age was 61.8±13.3 years; glioblastoma was the major tumor type (24 patients). We retrospectively analyzed rehabilitation outcome focusing on improvement of the Functional Independence Measure (FIM) scores during hospitalization. RESULTS Mean duration from surgery to the first rehabilitation intervention was 2.4±1.2 days, and mean hospital stay was 74.4±31.4days. Twenty patients were discharged to home (62 %) and 12 were transferred to other hospitals for convalescence. Motor, cognitive and total FIM scores were 41.0±22.2, 18.0±7.5, and 59.1±27.3 before surgery, whereas they were 61.4±28.6, 21.8±9.4, and 83.2±36.9, respectively, at discharge. Motor FIM items revealed more remarkable improvement than those of cognitive ones. Since starting the early intensive rehabilitation trial, patients with brain tumor have been systematically rehabilitated with an organized manner before and after surgery. CONCLUSION Early intensive rehabilitation for patients with brain tumor is recommended to be done by on-ward therapists who are assigned to work specially as members of the ward. Both motor and cognitive improvement is expected during hospitalization even in patients with malignant brain tumor.

Download Full-text

Cognitive Predictors of Adaptive Functioning Vary According to Pediatric Brain Tumor Location

Developmental Neuropsychology ◽

10.1080/87565640802101490 ◽

2008 ◽

Vol 33 (4) ◽

pp. 505-520 ◽

Cited By ~ 19

Author(s):

Aimilia Papazoglou ◽

Tricia Z. King ◽

Robin D. Morris ◽

Nicolas S. Krawiecki

Keyword(s):

Brain Tumor ◽

Adaptive Functioning ◽

Pediatric Brain Tumor ◽

Tumor Location ◽

Cognitive Predictors ◽

Pediatric Brain

Download Full-text

Predictors of adaptive functioning and psychosocial adjustment in children with pediatric brain tumor: A report from the brain radiation investigative study consortium

Pediatric Blood & Cancer ◽

10.1002/pbc.25323 ◽

2014 ◽

Vol 62 (3) ◽

pp. 509-516 ◽

Cited By ~ 13

Author(s):

Kristen E. Robinson ◽

Kelly R. Wolfe ◽

Keith O. Yeates ◽

E. Mark Mahone ◽

Kim M. Cecil ◽

...

Keyword(s):

Brain Tumor ◽

Psychosocial Adjustment ◽

Adaptive Functioning ◽

Pediatric Brain Tumor ◽

Brain Radiation ◽

Pediatric Brain ◽

The Brain

Download Full-text

Slower processing speed after treatment for pediatric brain tumor and acute lymphoblastic leukemia

Psycho-Oncology ◽

10.1002/pon.3255 ◽

2013 ◽

Vol 22 (9) ◽

pp. 1979-1986 ◽

Cited By ~ 49

Author(s):

Lisa S. Kahalley ◽

Heather M. Conklin ◽

Vida L. Tyc ◽

Melissa M. Hudson ◽

Stephanie J. Wilson ◽

...

Keyword(s):

Brain Tumor ◽

Acute Lymphoblastic Leukemia ◽

Processing Speed ◽

Lymphoblastic Leukemia ◽

Pediatric Brain Tumor ◽

Pediatric Brain

Download Full-text

SWK-08. DELAYED DIAGNOSIS OF CENTRAL NERVOUS SYSTEM (CNS) TUMORS IN CHILDREN: PERSPECTIVE FROM THE FRONTLINE

Neuro-Oncology ◽

10.1093/neuonc/noaa222.825 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii466-iii466

Author(s):

Manisha Jogendran ◽

Rebecca Ronsley ◽

Ran D Goldman ◽

Sylvia Cheng

Keyword(s):

Brain Tumor ◽

Delayed Diagnosis ◽

Geographical Location ◽

Family Physicians ◽

Pediatric Brain Tumor ◽

Cns Tumors ◽

Related Factors ◽

Educational Effort ◽

Pediatric Brain ◽

Pediatric Cns Tumors

Abstract Delayed diagnosis of CNS tumors in children is well documented, partially due to challenges in recognizing rare diagnoses. Our objective was to describe Canadian family physicians’ attitudes and confidence in diagnosing and managing pediatric CNS tumors. A standardized questionnaire was administered at a Canadian national family physicians’ conference. Items were based on observations from our institutional study of prediagnostic symptomatic interval in pediatric CNS tumors. 449 surveys were completed. 302/443 (68%) physicians practice in cities. 153/447 (34%) report encountering parents that inquire about their children having brain tumors. 261/449 (58%) have not managed a pediatric brain tumor. 153/447 (34%) report they are not confident, 255/447 (57%) somewhat confident and 39/447 (9%) confident in managing a suspected brain tumor in a stable child. 259/447 (58%) would refer directly to a hospital/specialist. The reported median time for suspicion of a brain tumor was 8–14 days for children with vomiting and/or headache and 1 day for children with seizure and/or ataxia. 410/447 (97%) report not knowing any guidelines to help with management. 235/447 (53%) suggested barriers they experience to include 52/235 (22%) wait times for imaging/specialists, 37/235 (16%) geographical location of the child, 27/235 (12%) knowledge, 25/235 (11%) access to imaging/specialist, and 15/235 (6%) patient-related factors or system barriers, and 8/235 (3%) specialist attitudes. 68/235 (29%) identified no barriers in their practice. This study provides insight into family physicians’ perceived challenges and barriers in diagnosing and managing new suspected pediatric CNS tumors. Educational effort and overcoming systemic perceived barriers may increase physicians’ confidence.

Download Full-text

QOL-11. COMPARISON OF TREATMENT BURDEN RATING SCALES ON NEUROCOGNITIVE OUTCOMES IN A MIXED SAMPLE OF PEDIATRIC BRAIN TUMOR SURVIVORS

Neuro-Oncology ◽

10.1093/neuonc/noaa222.674 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii432-iii433

Author(s):

Muhammad Baig ◽

Ineke Olsthoorn ◽

Grace Yang ◽

Wafik Zaky ◽

Peter Stavinoha

Keyword(s):

Working Memory ◽

Brain Tumor ◽

Processing Speed ◽

Pediatric Brain Tumor ◽

Psychosocial Outcomes ◽

Treatment Intensity ◽

Treatment Burden ◽

Younger Age ◽

Neurocognitive Outcomes ◽

Pediatric Brain

Abstract BACKGROUND Predicting neurocognitive outcomes in pediatric brain tumor (PBT) patients is challenging. Rarity of PBT makes inclusion of detailed risk factors (e.g., treatment modality, intensity, individual complications) difficult when sample sizes are small. The Neurological Predictor Scale (NPS) summarizes complications and treatment factors associated with neurocognitive risks and has modest validation. Recently, the Pediatric Neuro-Oncology Rating of Treatment Intensity (PNORTI) was developed to evaluate the impact of treatment intensity on psychosocial outcomes but has not been compared to neurocognitive outcomes. This study compared the NPS and PNORTI in terms of relationship to neurocognitive outcomes known to be at risk in PBT survivors. METHODS 88 PBT survivors’ neuropsychological outcomes were retrospectively analyzed in relation to the NPS and PNORTI. Variables of interest included IQ, working memory, and processing speed. RESULTS NPS associated with lower IQ (rs=-.476, p=.001), lower working memory (rs=-.323, p=.010), and lower processing speed (rs=-.389, p=.007) in patients diagnosed at a younger age, but only processing speed for children diagnosed after age 7 years (rs=-.262, p=.036). PNORTI was not correlated with neurocognitive variables for either group. CONCLUSION NPS has value in predicting neurocognitive outcomes, though much more in a younger age at diagnosis group compared to older patients. The PNORTI did not demonstrate predictive value for these neurocognitive domains in our sample. Given the potential clinical and research value of a summary rating of treatment burden relating to long-term outcome, future research should include relationship to psychosocial outcomes and quality of life.

Download Full-text