Skip to main content
SpringerLink
Log in

Parent-reported cognitive function is associated with leukoencephalopathy in children with brain tumors

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

Cognitive dysfunction is a major concern for children with brain tumors. A valid, user-friendly screening tool could facilitate prompt referral for comprehensive neuropsychological assessments and therefore early intervention. Applications of the pediatric perceived cognitive function item bank (pedsPCF) such as computerized adaptive testing can potentially serve as such a tool given its brevity and user-friendly nature. This study aimed to evaluate whether pedsPCF was a valid indicator of cerebral compromise using the criterion of structural brain changes indicated by leukoencephalopathy grades.

Methods

Data from 99 children (mean age = 12.6 years) with brain tumors and their parents were analyzed. Average time since diagnosis was 5.8 years; time since last treatment was 4.3 years. Leukoencephalopathy grade (range 0–4) was based on white matter damage and degree of deep white matter volume loss shown on MRI. Parents of patients completed the pedsPCF. Scores were based on the US general population-based T-score metric (mean = 50; SD = 10). Higher scores reflect better function.

Results

Leukoencephalopathy grade distributions were as follows: 36 grade 0, 27 grade 1, 22 grade 2, 13 grade 3, and 1 grade 4. The mean pedsPCF T-score was 48.3 (SD = 8.3; range 30.5–63.7). The pedsPCF scores significantly discriminated patients with different leukoencephalopathy grades, F = 4.14, p = 0.0084. Effect sizes ranged from 0.09 (grade 0 vs. 1) to 1.22 (grade 0 vs. 3/4).

Conclusion

This study demonstrates that the pedsPCF is a valid indicator of leukoencephalopathy and provides support for its use as a screening tool for more comprehensive neurocognitive testing.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Oeffinger, K. C., & Robison, L. L. (2007). Childhood cancer survivors, late effects, and a new model for understanding survivorship. The Journal of the American Medical Association, 297(24), 2762–2764.

    CAS  PubMed  Google Scholar 

  2. Geenen, M. M., Cardous-Ubbink, M. C., Kremer, L. C., van den, B. C., van der Pal, H. J., Heinen, R. C., et al. (2007). Medical assessment of adverse health outcomes in long-term survivors of childhood cancer. The Journal of the American Medical Association, 297(24), 2705–2715.

    CAS  PubMed  Google Scholar 

  3. Meyers, C. A., Hess, K. R., Yung, W. K., & Levin, V. A. (2000). Cognitive function as a predictor of survival in patients with recurrent malignant glioma. Journal of Clinical Oncology, 18(3), 646–650.

    CAS  PubMed  Google Scholar 

  4. Parisi, M. T., Fahmy, J. L., Kaminsky, C. K., & Malogolowkin, M. H. (1999). Complications of cancer therapy in children: A radiologist’s guide. Radiographics, 19(2), 283–297.

    CAS  PubMed  Google Scholar 

  5. Packer, R. J., Goldwein, J., Nicholson, H. S., Vezina, L. G., Allen, J. C., Ris, M. D., et al. (1999). Treatment of children with medulloblastomas with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: A Children’s Cancer Group Study. Journal of Clinical Oncology, 17(7), 2127–2136.

    CAS  PubMed  Google Scholar 

  6. Lavigne, J. V., & Faier-Routman, J. (1992). Psychological adjustment to pediatric physical disorders: A meta-analytic review. Journal of Pediatric Psychology, 17(2), 133–157.

    CAS  PubMed  Google Scholar 

  7. Patenaude, A. F., & Kupst, M. J. (2005). Psychosocial functioning in pediatric cancer. Journal of Pediatric Psychology, 30(1), 9–27.

    PubMed  Google Scholar 

  8. Hays, D. M., Dolgin, M., Steele, L. L., Patenaude, A. F., Hewett, K. D., Ruymann, F., et al. (1997). Educational achievement, employment and workplace experience of adult survivors of childhood cancer. International Journal of Pediatric Hematology/Oncology, 4, 327–337.

    Google Scholar 

  9. Packer, R. J., Gurney, J. G., Punyko, J. A., Donaldson, S. S., Inskip, P. D., Stovall, M., et al. (2003). Long-term neurologic and neurosensory sequelae in adult survivors of a childhood brain tumor: Childhood cancer survivor study. Journal of Clinical Oncology, 21(17), 3255–3261.

    PubMed  Google Scholar 

  10. Walsh, K. S., Noll, R. B., Annett, R. D., Patel, S. K., Patenaude, A. F., & Embry, L. (2016). Standard of care for neuropsychological monitoring in pediatric neuro-oncology: lessons from the Children’s Oncology Group (COG). Pediatric Blood & Cancer, 63(2), 191–195.

    Google Scholar 

  11. Selove, R., Kroll, T., Coppes, M., & Cheng, Y. (2012). Psychosocial services in the first 30 days after diagnosis: Results of a web-based survey of children’s oncology group (COG) member institutions. Pediatric Blood & Cancer, 58(3), 435–440.

    Google Scholar 

  12. Eisman, E. J., Dies, R. R., Finn, S. E., Eyde, L. D., Kay, G. G., Kubiszyn, T. W., et al. (2000). Problems and limitations in using psychological assessment in the contemporary health care delivery system. Professional Psychology: Research and Practice, 31(2), 131.

    Google Scholar 

  13. Bull, K. S., Liossi, C., Peacock, J. L., Yuen, H. M., & Kennedy, C. R. (2015). Screening for cognitive deficits in 8 to 14-year old children with cerebellar tumors using self-report measures of executive and behavioral functioning and health-related quality of life. Neuro-oncology, 17(12), 1628–1636.

    PubMed  PubMed Central  Google Scholar 

  14. Mahone, E. M., Martin, R., Kates, W. R., Hay, T., & Horska, A. (2009). Neuroimaging correlates of parent ratings of working memory in typically developing children. Journal of the International Neuropsychological Society, 15(1), 31–41.

    PubMed  PubMed Central  Google Scholar 

  15. de Groot, J. C., de Leeuw, F. E., Oudkerk, M., van Gijn, J., Hofman, A., Jolles, J., et al. (2000). Cerebral white matter lesions and cognitive function: The Rotterdam scan study. Annals of Neurology, 47(2), 145–151.

    PubMed  Google Scholar 

  16. de Groot, J. C., de Leeuw, F. E., Oudkerk, M., Hofman, A., Jolles, J., & Breteler, M. M. (2001). Cerebral white matter lesions and subjective cognitive dysfunction: The Rotterdam Scan Study. Neurology, 56(11), 1539–1545.

    PubMed  Google Scholar 

  17. O’Brien, J., Desmond, P., Ames, D., Schweitzer, I., Harrigan, S., & Tress, B. (1996). A magnetic resonance imaging study of white matter lesions in depression and Alzheimer’s disease. British Journal of Psychiatry, 168(4), 477–485.

    Google Scholar 

  18. Saykin, A. J., Wishart, H. A., Rabin, L. A., Santulli, R. B., Flashman, L. A., West, J. D., et al. (2006). Older adults with cognitive complaints show brain atrophy similar to that of amnestic MCI. Neurology, 67(5), 834–842.

    CAS  PubMed  Google Scholar 

  19. Ferguson, R. J., McDonald, B. C., Saykin, A. J., & Ahles, T. A. (2007). Brain structure and function differences in monozygotic twins: Possible effects of breast cancer chemotherapy. Journal of Clinical Oncology, 25(25), 3866–3870.

    PubMed  Google Scholar 

  20. Achenbach, T. M. (1991). Integrative guide to the 1991 CBCL/4-18, YSR, and TRF profiles. Burlington, VT: University of Vermont, Department of Psychology.

    Google Scholar 

  21. Conners, C. K. (2000). Conners’ rating scales-revised technical manual. North Tonawanda, NY: Multi Health Systems.

    Google Scholar 

  22. Gioia, G. A., Isquith, P., Guy, S., & Kenworthy, L. (2000). Behavior rating inventory of executive function (BRIEF): Professional manual. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  23. Hardy, K. K., Willard, V. W., Wigdor, A. B., Allen, T. M., & Bonner, M. J. (2015). The potential utility of parent-reported attention screening in survivors of childhood cancer to identify those in need of comprehensive neuropsychological evaluation. Neuro-oncology Practice, 2(1), 32–39.

    PubMed  Google Scholar 

  24. Lai, J.-S., Butt, Z., Zelko, F., Cella, D., Krull, K., Kieran, M., et al. (2011). Development of a parent-report cognitive function item bank using item response theory and exploration of its clinical utility in computerized adaptive testing. Journal of Pediatric Psychology, 36(7), 766–779.

    PubMed  PubMed Central  Google Scholar 

  25. Lai, J.-S., Zelko, F., Krull, K., Cella, D., Nowinski, C., Manley, P., et al. (2014). Parent-reported cognition of children with cancer and its potential clinical usefulness. Quality of Life Research, 23(4), 1049–1058.

    PubMed  Google Scholar 

  26. Lai, J.-S., Stucky, B., Thissen, D., Varni, J., DeWitt, E., Irwin, D., et al. (2013). Development and psychometric properties of the PROMIS® pediatric fatigue item banks. Quality of Life Research, 22(9), 2417–2427.

    PubMed  Google Scholar 

  27. National Cancer Institute. (2010). Common terminology criteria for adverse events: (CTCAE) Version 4.0. from http://evs.nci.nih.gov/ftp1/CTCAE/Documentation/CTCAE_Governance_2010-03-11.pdf

  28. Schneider, W., Lockl, K., & Perfect, T. (2002). The development of metacognition knowledge in children and adolescents. Applied metacognition (pp. 224EP–259). West Nyack, NY: Cambridge University Press.

    Google Scholar 

  29. Hinds, P. S., Quargnenti, A., Bush, A. J., Pratt, C., Fairclough, D., Rissmiller, G., Betcher, D., & Gilchrist, G. S. (2000). An evaluation of the impact of a self-care coping intervention on psychological and clinical outcomes in adolescents with newly diagnosed cancer. European Journal of Oncology Nursing, 4(1), 6–17; discussion 18–19.

  30. DeWitt, E. M., Stucky, B. D., Thissen, D., Irwin, D. E., Langer, M., Varni, J. W., et al. (2011). Construction of the eight-item patient-reported outcomes measurement information system pediatric physical function scales: Built using item response theory. Journal of Clinical Epidemiology, 64(7), 794–804.

    PubMed  PubMed Central  Google Scholar 

  31. Irwin, D. E., Stucky, B., Langer, M. M., Thissen, D., Dewitt, E. M., Lai, J. S., et al. (2010). An item response analysis of the pediatric PROMIS anxiety and depressive symptoms scales. Quality of Life Research, 19(4), 595–607.

    PubMed  PubMed Central  Google Scholar 

  32. Dewalt, D. A., Thissen, D., Stucky, B. D., Langer, M. M., Morgan Dewitt, E., Irwin, D. E., et al. (2013). PROMIS pediatric peer relationships scale: Development of a peer relationships item bank as part of social health measurement. Health Psychology, 32(10), 1093–1103.

    PubMed  Google Scholar 

  33. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: L. Erlbaum Associates.

    Google Scholar 

  34. Iuvone, L., Mariotti, P., Colosimo, C., Guzzetta, F., Ruggiero, A., & Riccardi, R. (2002). Long-term cognitive outcome, brain computed tomography scan, and magnetic resonance imaging in children cured for acute lymphoblastic leukemia. Cancer, 95(12), 2562–2570.

    PubMed  Google Scholar 

  35. Conklin, H. M., Ogg, R. J., Ashford, J. M., Scoggins, M. A., Zou, P., Clark, K. N., et al. (2015). Computerized cognitive training for amelioration of cognitive late effects among childhood cancer survivors: A randomized controlled trial. Journal of Clinical Oncology, 33(33), 3894–3902.

    PubMed  PubMed Central  Google Scholar 

  36. Butler, R. W., Copeland, D. R., Fairclough, D. L., Mulhern, R. K., Katz, E. R., Kazak, A. E., et al. (2008). A multicenter, randomized clinical trial of a cognitive remediation program for childhood survivors of a pediatric malignancy. Journal of Consulting and Clinical Psychology, 76(3), 367–378.

    PubMed  PubMed Central  Google Scholar 

  37. van’t Hooft, I., Andersson, K., Bergman, B., Sejersen, T., von Wendt, L., & Bartfai, A. (2007). Sustained favorable effects of cognitive training in children with acquired brain injuries. NeuroRehabilitation, 22(2), 109–116.

    Google Scholar 

  38. Moore, I. M., Hockenberry, M. J., Anhalt, C., McCarthy, K., & Krull, K. R. (2012). Mathematics intervention for prevention of neurocognitive deficits in childhood leukemia. Pediatric Blood & Cancer, 59(2), 278–284.

    Google Scholar 

  39. Krull, K. R., Okcu, M. F., Potter, B., Jain, N., Dreyer, Z., Kamdar, K., et al. (2008). Screening for neurocognitive impairment in pediatric cancer long-term survivors. Journal of Clinical Oncology, 26(25), 4138.

    PubMed  Google Scholar 

  40. Lageman, S., Cerhan, J., Locke, D. C., Anderson, S. K., Wu, W., & Brown, P. (2010). Comparing neuropsychological tasks to optimize brief cognitive batteries for brain tumor clinical trials. Journal of Neuro-oncology, 96(2), 271–276.

    PubMed  Google Scholar 

  41. Armstrong, C. L., Goldstein, B., Shera, D., Ledakis, G. E., & Tallent, E. M. (2003). The predictive value of longitudinal neuropsychologic assessment in the early detection of brain tumor recurrence. Cancer, 97(3), 649–656.

    PubMed  Google Scholar 

  42. Ottensmeier, H., Zimolong, B., Wolff, J. E., Ehrich, J., Galley, N., von Hoff, K., et al. (2015). Neuropsychological short assessment of disease-and treatment-related intelligence deficits in children with brain tumours. European Journal of Paediatric Neurology, 19(3), 298–307.

    PubMed  Google Scholar 

  43. Lai, J. S., Zelko, F., Butt, Z., Cella, D., Kieran, M. W., Krull, K. R., et al. (2011). Parent-perceived child cognitive function: Results from a sample drawn from the US general population. Child’s Nervous System, 27(2), 285–293.

    PubMed  Google Scholar 

  44. Lai, J.-S., Yount, S., Beaumont, J. L., Cella, D., Toia, J., & Goldman, S. (2015). A patient-centered symptom monitoring and reporting system for children and young adults with cancer (SyMon-SAYS). Pediatric Blood & Cancer, 62(10), 1813–1818.

    Google Scholar 

  45. Anderson, V. A., Spencer-Smith, M. M., Coleman, L., Anderson, P. J., Greenham, M., Jacobs, R., et al. (2014). Predicting neurocognitive and behavioural outcome after early brain insult. Developmental Medicine and Child Neurology, 56(4), 329–336.

    PubMed  Google Scholar 

  46. Anderson, V., Catroppa, C., Godfrey, C., & Rosenfeld, J. V. (2011). Intellectual ability 10 years after traumatic brain injury in infancy and childhood: What predicts outcome? Journal of Neurotrauma, 29(1), 143–153.

    Google Scholar 

Download references

Acknowledgements

This work was supported by the National Institutes of Health/National Cancer Institute (R01CA174452; PI: Jin-Shei Lai).

Author information

Authors and Affiliations

  1. Medical Social Sciences and Pediatrics, Feinberg School of Medicine at Northwestern University, 633 N St Clair, #19-039, Chicago, IL, 60611, USA

    Jin-Shei Lai

  2. Medical Imaging (Radiology), Ann & Robert H. Lurie Children’s Hospital, Chicago, IL, 60611, USA

    Corey Bregman

  3. Pediatric Neuropsychology Service, Department of Child and Adolescent Psychiatry, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, 60611, USA

    Frank Zelko

  4. Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, 60611, USA

    Cindy Nowinski, David Cella & Jennifer J. Beaumont

  5. Hematology/Oncology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, 60611, USA

    Stewart Goldman

Authors
  1. Jin-Shei Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Corey Bregman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Frank Zelko
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Cindy Nowinski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. David Cella
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jennifer J. Beaumont
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stewart Goldman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jin-Shei Lai.

Ethics declarations

Conflicts of interest

All authors (Lai, Bregman, Zelko, Nowinski, Cella, and Goldman) report no disclosures and no conflicts of interest relevant to the manuscript.

Ethical approval

This study was approved by the Institutional Review Boards of both Northwestern University and Lurie Children’s Hospital of Chicago. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lai, JS., Bregman, C., Zelko, F. et al. Parent-reported cognitive function is associated with leukoencephalopathy in children with brain tumors. Qual Life Res 26, 2541–2550 (2017). https://doi.org/10.1007/s11136-017-1583-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-017-1583-8

Keywords

Search

Navigation