Cognitive deficits and psychopathological symptoms among children with medulloblastoma
Corresponding Author
Annamária Szentes
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Correspondence
Annamária Szentes, 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Email: [email protected]
Search for more papers by this authorNikoletta Erős
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Search for more papers by this authorZoltán Kekecs
Department of Psychology, Lund University, Lund, Sweden
Search for more papers by this authorZsuzsanna Jakab
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Search for more papers by this authorSzabolcs Török
Institute of Mental Health, Semmelweis University, Budapest, Hungary
Search for more papers by this authorDezső Schuler
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Search for more papers by this authorPéter Hauser
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Authors are equally contributed as last or senior authors.Search for more papers by this authorMiklós Garami
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Authors are equally contributed as last or senior authors.Search for more papers by this authorCorresponding Author
Annamária Szentes
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Correspondence
Annamária Szentes, 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Email: [email protected]
Search for more papers by this authorNikoletta Erős
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Search for more papers by this authorZoltán Kekecs
Department of Psychology, Lund University, Lund, Sweden
Search for more papers by this authorZsuzsanna Jakab
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Search for more papers by this authorSzabolcs Török
Institute of Mental Health, Semmelweis University, Budapest, Hungary
Search for more papers by this authorDezső Schuler
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Search for more papers by this authorPéter Hauser
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Authors are equally contributed as last or senior authors.Search for more papers by this authorMiklós Garami
2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
Authors are equally contributed as last or senior authors.Search for more papers by this authorAbstract
Children with medulloblastoma (MB) are predisposed for negative cognitive sequela, which has been widely identified in this population. The purpose of the present study was to explore cognitive deficits and psychopathological symptoms and analyse their relation among MB survivors. The Wechsler Intelligence Scale for Children and the Mini International Neuropsychiatric Interview (MINI-KID) was administered to 34 MB survivors to measure cognitive functioning and psychopathological symptoms. The MB survivors had lower global IQ (86.41 [79.70–93.13]) compared with the control population mean. We found impaired functioning in all IQ subscales in the MB survivors group, of which processing speed (84.15 [77.71–90.58]) was the most affected. Higher radiation dose and high-dose chemotherapy with stem cell rescue were significantly associated factors for lowered global IQ, while age at diagnosis, sex and time period from diagnosis were not significantly associated. Compulsive disorder, generalised anxiety, separation anxiety and posttraumatic stress disorder were significantly more prevalent in the MB survivor group than a group of 46 control participants. No correlation was found between the cognitive deficits and the psychopathological symptoms. Our results identify that MB survivors suffer from cognitive and psychopathological impairments, and these could exist independently from each other.
CONFLICT OF INTEREST
The authors declare that they have no conflict of interests.
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REFERENCES
- Arvidson, J., Kihlgren, M., Hall, C., & Lonnerholm, G. (1999). Neuropsychological functioning after treatment for hematological malignancies in childhood, including autologous bone marrow transplantation. Pediatric Hematology and Oncology, 16(1), 9–21. https://doi.org/10.1080/088800199277551
- Balázs, J., Bíró, A., Dálnoki, D., Lefkovics, E., Tamás, Z., Nagy, P., & Gádoros, J. (2004). A Gyermek MINI kérdőív magyar nyelvű változatának ismertetése. Psychiatria Hungarica, 19, 358–364.
- Balázs, J., & Gádoros, J. (2001). A M.I.N.I. Plusz és a DIS kérdőív validitás vizsgálata. Psychiatria Hungarica, 16, 5–11.
- Bass, L., Kő, N., Kuncz, E., Lányiné, E. Á., Mészáros, A., Mlinkó, R., … Rózsa, S. (2008). Tapasztalatok a WISC–IV gyermek-intelligenciateszt magyarországi standardizálásáról. Budapest: Educatio.
- Bower, G. H. (1981). Mood and Memory. American Psychologist, 36(2), 129. https://doi.org/10.1037/0003-066X.36.2.129
- Brown, R. T., Madan-Swain, A., & Lambert, R. (2003). Posttraumatic stress symptoms in adolescent survivors of childhood cancer and their mothers. Journal of Traumatic Stress, 16(4), 309–318. https://doi.org/10.1023/A:1024465415620
- Bruce, M. (2006). A systematic and conceptual review of posttraumatic stress in childhood cancer survivors and their parents. Clinical Psychology Review, 26(3), 233–256. https://doi.org/10.1016/j.cpr.2005.10.002
- Carey, M. E., Barakat, L. P., Foley, B., Gyato, K., & Phillips, P. C. (2001). Neuropsychological functioning and social functioning of survivors of pediatric brain tumors: Evidence of nonverbal learning disability. Child Neuropsychology: A Journal on Normal and Abnormal Development in Childhood and Adolescence, 7, 265–272. https://doi.org/10.1076/chin.7.4.265.8730
- Conklin, H. M., Ogg, R. J., Ashford, J. M., Scoggins, M. A., Zou, P., Clark, K. N., … Zhang, H. (2015). Computerized cognitive training for amelioration of cognitive late effects among childhood cancer survivors: a randomized controlled trial. Journal of Clinical Oncology, 33, 3894–3902.
- Daniel, L., Kazak, A. E., Li, Y., Hobbie, W., Ginsberg, J., Butler, E., & Schwartz, L. (2016). Relationship between sleep problems and psychological outcomes in adolescent and young adult cancer survivors and controls. Supportive Care in Cancer, 24, 539–546. https://doi.org/10.1007/s00520-015-2798-2
- Dennis, M., Spiegler, B. J., Hetherington, C. R., & Greenberg, M. L. (1996). Neuropsychological sequelae of the treatment of children with medulloblastoma. Journal of neuro-oncology, 29, 91–101. https://doi.org/10.1007/BF00165522
- Dobson, C. (2012). Effects of academic anxiety on the performance of students with and without learning disablities and how students can cope with anxiety at school. Michigan: Northern Michigan University.
- Doger De Speville, E., Robert, C., Perez-Guevara, M., Grigis, A., Bolle, S., Pinaud, C., … Noulhiane, M. (2017). Relationships between regional radiation doses and cognitive decline in children treated with cranio-spinal irradiation for posterior fossa tumors. Frontiers in Oncology, 7, 166. https://doi.org/10.3389/fonc.2017.00166
- Howard Sharp, K. M., Rowe, A. E., Russell, K., Long, A., & Phipps, S. (2015). Predictors of psychological functioning in children with cancer: Disposition and cumulative life stressors. Psycho-Oncology, 24(7), 779–786. https://doi.org/10.1002/pon.3643
- Kazak, A. E. (2006). Pediatric Psychosocial Preventative Health Model (PPPHM): Research, practice, and collaboration in pediatric family systems medicine. Families, Systems, & Health, 24(4), 381.
10.1037/1091-7527.24.4.381 Google Scholar
- Kazak, A. E., & Noll, R. B. (2015). The integration of psychology in pediatric oncology research and practice: Collaboration to improve care and outcomes for children and families. The American Psychologist, 70, 146–158. https://doi.org/10.1037/a0035695
- Landolt, M. A., Vollrath, M., Ribi, K., Gnehm, H. E., & Sennhauser, F. H. (2003). Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients. Journal of Child Psychology and Psychiatry, 44(8), 1199–1207. https://doi.org/10.1111/1469-7610.00201
- Margelisch, K., Studer, M., Ritter, B. C., Steinlin, M., Leibundgut, K., & Heinks, T. (2015). Cognitive dysfunction in children with brain tumors at diagnosis. Pediatric Blood & Cancer, 62, 1805–1812. https://doi.org/10.1002/pbc.25596
- McDonnell, G., Baily, C., Schuler, T., & Verdeli, H. (2015). Anxiety among adolescent survivors of pediatric cancer: A missing link in the survivorship literature. Palliative & supportive care, 13(2), 345-349.
- Mitchell, A. J., Ferguson, D. W., Gill, J., Paul, J., & Symonds, P. (2013). Depression and anxiety in long-term cancer survivors compared with spouses and healthy controls: A systematic review and meta-analysis. The Lancet Oncology, 14(8), 721–732. https://doi.org/10.1016/S1470-2045(13)70244-4
- Moxon-Emre, I., Bouffet, E., Taylor, M. D., Laperriere, N., Scantlebury, N., Law, N., … Mabbott, D. (2014). Impact of craniospinal dose, boost volume, and neurologic complications on intellectual outcome in patients with medulloblastoma. Journal of Clinical Oncology, 32(17), 1760–1768. https://doi.org/10.1200/JCO.2013.52.3290
- Mulhern, R. K., Merchant, T. E., Gajjar, A., Reddick, W. E., & Kun, L. E. (2004). Late neurocognitive sequelae in survivors of brain tumours in childhood. The Lancet. Oncology, 5, 399–408.
- Nagyné RézI., Lányiné EngelmayerÁ., KunczE., MészárosA., MlinkóR. (2009) WISC-IV Technikai és értelmező kézikönyv, OS Hungary Tesztfejlesztő Kft., Budapest.
- Olson, K., & Sands, S. A. (2016). Cognitive training programs for childhood cancer patients and survivors: A critical review and future directions. Child Neuropsychology: A Journal on Normal and Abnormal Development in Childhood and Adolescence, 22, 509–536. https://doi.org/10.1080/09297049.2015.1049941
- Palmer, S. L., Armstrong, C., Onar-Thomas, A., Wu, S., Wallace, D., Bonner, M. J., … Gajjar, A. (2013). Processing speed, attention, and working memory after treatment for medulloblastoma: An international, prospective, and longitudinal study. Journal of Clinical Oncology, 31, 3494–3500.
- Phipps, S., Jurbergs, N., & Long, A. (2009). Symptoms of post-traumatic stress in children with cancer: Does personality trump health status? Psycho-oncology, 18, 992–1002. https://doi.org/10.1002/pon.1496
- Picoraro, J. A., Womer, J. W., Kazak, A. E., & Feudtner, C. (2014). Posttraumatic growth in parents and pediatric patients. Journal of Palliative Medicine, 17, 209–218. https://doi.org/10.1089/jpm.2013.0280
- Poggi, G., Liscio, M., Galbiati, S., Adduci, A., Massimino, M., Gandola, L., … Castelli, E. (2005). Brain tumors in children and adolescents: Cognitive and psychological disorders at different ages. Psycho-oncology, 14, 386–395. https://doi.org/10.1002/pon.855
- Scherwath, A., Schirmer, L., Kruse, M., Ernst, G., Eder, M., Dinkel, A., … Dolan, K. (2013). Cognitive functioning in allogeneic hematopoietic stem cell transplantation recipients and its medical correlates: A prospective multicenter study. Psycho-Oncology, 22(7), 1509–1516. https://doi.org/10.1002/pon.3159
- Schulte-Körne, G. (2016). Mental health problems in a school setting in children and adolescents. Deutsches Ärzteblatt International, 113(11), 183. https://doi.org/10.3238/arztebl.2016.0183
- Sirachainan, N., Nuchprayoon, I., Thanarattanakorn, P., Pakakasama, S., Lusawat, A., Visudibhan, A., … Hongeng, S. (2011). Outcome of medulloblastoma in children treated with reduced-dose radiation therapy plus adjuvant chemotherapy. Journal of Clinical Neuroscience, 18, 515–519. https://doi.org/10.1016/j.jocn.2010.08.012
- Turken, A., Whitfield-Gabrieli, S., Bammer, R., Baldo, J. V., Dronkers, N. F., & Gabrieli, J. D. (2008). Cognitive processing speed and the structure of white matter pathways: Convergent evidence from normal variation and lesion studies. NeuroImage, 42, 1032–1044. https://doi.org/10.1016/j.neuroimage.2008.03.057
- Ullrich, N. J., & Embry, L. (2012). Neurocognitive dysfunction in survivors of childhood brain tumors. Seminars in Pediatric Neurology, 19, 35–42. https://doi.org/10.1016/j.spen.2012.02.014
- Zeltzer, L. K., Recklitis, C., Buchbinder, D., Zebrack, B., Casillas, J., Tsao, J. C., … Krull, K. (2009). Psychological status in childhood cancer survivors: A report from the Childhood Cancer Survivor Study. Journal of Clinical Oncology, 27, 2396–2404.
