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Long-term cognitive outcome in adult survivors of an early childhood posterior fossa brain tumour.
Carroll C., Wagner A., WATSON, P., Spoudeas, H., Hawkins, M., Walker, D., Clare, I., Holland, T. and Ring H.
Abstract accepted to be presented by David Walker at 17th International Symposium on Pediatric Neuro-Oncology (ISPNO 2016) at Liverpool Convention Center (www.ispno2016.com).
Year of publication:
Objective: This work describes long-term cognitive outcomes, in terms of IQ, in 62 adult survivors of an early childhood posterior fossa brain tumour (PFT) and examines factors associated with these outcomes. Methods: 62 adult survivors of a PFT diagnosed before the age of 5 years and a sibling of each of these survivors were assessed an average of 32 years (range 18 – 53 years) after initial diagnosis, using the Weschler Abbreviated Scale of Intelligence (WASI). Using regression models, we explored differences between IQs of survivors and their siblings in relation to sex, tumour type and treatment. Results: Controlling for covariates, survivors scored, on average, 18 points less than their typically developing siblings on verbal IQ (VIQ) and 13 points less on performance IQ (PIQ). Female survivors had significantly lower PIQ than males. Considering effects of radiotherapy, in male survivors radiotherapy resulted in a VIQ score on average a couple of points closer to their siblings than if no radiotherapy had been received. However, in female survivors radiotherapy worsened the VIQ difference by around 20 points. Radiotherapy worsened survivors’ PIQ compared to their siblings by approximately 17 points, regardless of the sex of the survivor. Conclusions: Given the importance of the cerebellum in cognitive function and the developmental consequences of disrupting cerebellar structure and function during early development, it will be important to explore the extent to which early and sustained cognitive rehabilitation may mitigate risks of later cognitive impairment.