Journal of Neuro-Oncology

, Volume 80, Issue 3, pp 295–303

Intelligence and adaptive function in children diagnosed with brain tumour during infancy

  • Robyn Stargatt
  • Jeffrey V. Rosenfeld
  • Vicki Anderson
  • Timothy Hassall
  • Wirginia Maixner
  • David Ashley
Clinical – Patient Studies

Abstract

Background

Late effects of treatment in children diagnosed and treated for brain tumours in infancy is a major concern. Assessment of infants presenting with brain tumours is difficult and there is little information available regarding the development of infants prior to treatment and hence the impact of the tumour itself on developmental outcomes.

Aim

To describe the development of children diagnosed with brain tumours in infancy and to document their cognitive and adaptive function at school entry.

Method

Infants were psychologically evaluated at the time of diagnosis of a brain tumour and during their fifth or sixth year in preparation for school entry.

Results

Children diagnosed with brain tumours in infancy display developmental delays in a number of areas of adaptive function. By the time these children are school age they display further compromise in cognitive and academic skills and adaptive behaviour. Higher levels of deficit at follow-up were associated with tumour location in the supratentorium, younger age at diagnosis and longer time since diagnosis. The effect of radiotherapy could not be determined because of differing degrees of developmental compromise in the treatment groups at baseline.

Conclusion

Brain tumours in infancy confer a risk of poor developmental progress at the time of diagnosis. These children display additional compromise of development by the time they reach school age. Research protocols evaluating the impact of treatment in infants diagnosed with brain tumours need to take account of the developmental status of the child at diagnosis.

Keywords

Brain tumour Infants Neuropsychology Intelligence Adaptive function 

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References

  1. 1.
    Rosenfeld JV, Ashley D (2000) Management of brain tumours in the pediatic patient. In: Kaye AH, Laws ER (eds) Brain tumours, 2nd edn. Churchill Livingston, LondonGoogle Scholar
  2. 2.
    Hoppe-Hirsch E, Renier D, Lelliuch-Tubiana A, Sainte-Rosen C, Pierre-Kahn A, Hirsch JF (1990) Medulloblastoma in childhood: progressive intellectual deterioration. Childs Nerv Syst 6:60–65PubMedCrossRefGoogle Scholar
  3. 3.
    Glauser T, Packer RJ (1991) Cognitive deficits in long-term survivors of childhood brain tumours. Childs Nerv Syst 7:2–12PubMedCrossRefGoogle Scholar
  4. 4.
    Ris MD, Noll RB (1994) Long-term neurobehavioural outcome in pediatric brain tumour patients: review and methodological critique. J Clin Exp Neuropsychol 16:21–42PubMedGoogle Scholar
  5. 5.
    Dennis M, Spiegler BJ, Hetherington CR, Greenberg ML (1996) Neuropsychological sequelae of the treatment of children with medulloblastoma. J Neuro-Oncol 29:91–101CrossRefGoogle Scholar
  6. 6.
    Stargatt R, Anderson V, Rosenfeld JV (2002) Neuropsychological outcomes of children treated for posterior fossa tumours: a review. Brain Impair 3(2):92–104CrossRefGoogle Scholar
  7. 7.
    Merchant TE, Lee H, Zhu J, Xiong X, Wheeler G, Phipps S, Boop F, Sandford RA (2004) The effects of hydrocephalus on intelligence quotient in children with localized infratentorial ependymoma before and after focal radiation therapy. J Neurosurg Pediatr 2(101):159–168Google Scholar
  8. 8.
    Ellenberg L, McComb JG, Siegel SE, Stowe S (1987) Factors affecting intellectual outcome in pediatric brain tumour patients. Neurosurgery 21:638–644PubMedGoogle Scholar
  9. 9.
    Pompili A, Caperle M, Pace A, Ramazzotti V, Raus L, Jandolo B, Occhipinti E (2002) Quality of life assessment in patients who had been surgically treated for cerebellar pilocytic astrocytoma in childhood. J Neurosurg 96:229–234PubMedGoogle Scholar
  10. 10.
    Mulhern RK, Horowitz ME, Kovnar EH, Langston J, Sanford RA, Kun LE (1989) Neurodevelopmental status of infants and young children treated for brain tumours with pre-irradiation chemotherapy. J Clin Oncol 7:1660–1666PubMedGoogle Scholar
  11. 11.
    Anderson V, Smibert E, Ekert H, Godber T (1994) Intellectual, educational, and behavioural sequelae after cranial irradiation and chemotherapy. Arch Dis Child 70(6):476–483PubMedCrossRefGoogle Scholar
  12. 12.
    Espy KA, Moore IM, Kaufmann PM, Kramer J, Hutter JJ, Matthay K (1999) Treatment-related change in neuropsychologic function in children with ALL. International Neuropsychological Society, Boston, MAGoogle Scholar
  13. 13.
    Espy KA, Moore IM, Kaufmann PM, Kramer JH, Matthay K, Hutter JJ (2001) Chemotherapeutic CNS prophylaxis and neuropsychologic change in children with acute lymphoblastic leukemia: a prospective study. J Pediatr Psychol 26(1):1–9PubMedCrossRefGoogle Scholar
  14. 14.
    Kiltie A, Lasford LS, Gattamaneni HR (1997) Survival and late effects in medulloblastoma patients treated with craniospinal irradiation under three years old. Med Pediatr Oncol 28:348–354PubMedCrossRefGoogle Scholar
  15. 15.
    Rutkowski S, Bode U, Deinlein F, Ottensmeier H, Warmuth-Metz M, Soerensen N, Graf N, Emser A, Tietsch T, Wolff J, Kortmann R, Kuehl J (2005) Treatment of early childhood medulloblastoma by postoperative chemotherapy alone. N Engl J Med 352(10):978–986PubMedCrossRefGoogle Scholar
  16. 16.
    Heideman R, Packer R et’al (1997) Tumours of the central nervous system. In: Poplack PPD (ed) Principles and practice of pediatric oncology. Lippincott-Raven, Philadelphia, p 682Google Scholar
  17. 17.
    Pfefferbaum-Levine B, Copeland D, Fletcher J, Reid H, Jaffe N, McKinnon W (1984) Neuropsychological assessment of long-term survivors of childhood leukaemia. Am J Pediatr Hematol/Oncol 6:123–128CrossRefGoogle Scholar
  18. 18.
    Hoppe-Hirsch E, Brunet L, Laroussinie F, Cinalli G, Pierr-Kahn A, Renier D, Sainte-Rose C, Hirsch JF (1995) Intellectual outcome in children with malignant tumors of the posterior fossa: influence of the field of irradiation and quality of surgery. Childs Nerv Syst 11(6):340–345PubMedCrossRefGoogle Scholar
  19. 19.
    Cousens P, Waters B, Said J, Stevens M (1988) Cognitive effects of cranial irraditation in leukaemia: a survey and meta-analysis. J Child Psychol Psychiatry 29(6):839–852PubMedGoogle Scholar
  20. 20.
    Danoff B, Cowchock S, Marquette C, Mulgrew L, Kramer S (1982) Assessment of the long-term effects of primary radiation therapy for brain tumors in children. Cancer 49:1580–1586PubMedCrossRefGoogle Scholar
  21. 21.
    Packer JR, Sutton LN, Atkins TE, Radcliff J, Bunin GR, D’Angio G, Seigel KR, Schut L (1989) A prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2 year results. J Neurosurg 70:707–713PubMedCrossRefGoogle Scholar
  22. 22.
    Jenkin D, Danjoux C, Greenberg M (1998) Subsequent quality of life for children irradiated for a brain tumor before age four years. Med Pediatr Oncol 31:506–511PubMedCrossRefGoogle Scholar
  23. 23.
    Duffner PK, Jackson LA, Cohen ME (1996) Neurobehavioral abnormalities resulting from brain tumors and their therapy. CRC Press Inc., pp 289–307Google Scholar
  24. 24.
    Walter AW, Mulhern RK, Gajjar A, Heideman RL, Reardon D, Sandord RA, Xiong X, Kun L (1999) Survival and neurodevelopmental outcome of young children with medulloblastoma at St Jude Children’s Research Hospital. J Clin Oncol 17(12):3720–3728PubMedGoogle Scholar
  25. 25.
    Sparrow S, Balla DA, Cichetti DV (1984) Vineland adaptive behaviour scales: interview edition, survey form manual. American Guidance Services, Circle Pines, MNGoogle Scholar
  26. 26.
    Wechsler D (1989) Manual for the Wechsler preschool and primary scale of intelligence – revised. The Psychological Corporation, San AntonioGoogle Scholar
  27. 27.
    Delis DC, Kramer JH, Kaplan E, Ober BA (1994) Manual for the California verbal learning test – children’s version. The Psychological Corporation, San AntonioGoogle Scholar
  28. 28.
    Wechsler D (1992) The manual for the Wechsler individual achievement test. The Psychological Corporation, San AntonioGoogle Scholar
  29. 29.
    Korkman M, Kirk U, Kemp S (1998) The manual for the NEPSY: a developmental neuropsychological assessment. The Psychological Corporation, San AntonioGoogle Scholar
  30. 30.
    Beery KE, Buktenica NA (1997) The manual for the developmental test of visual-motor integration. Modern Curriculum PressGoogle Scholar
  31. 31.
    Tabachnick BG, Fidell LS (2000) Using multivariate statistics, 4th edn. Allyn & Bacon, BostonGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Robyn Stargatt
    • 1
    • 6
  • Jeffrey V. Rosenfeld
    • 2
  • Vicki Anderson
    • 1
  • Timothy Hassall
    • 3
  • Wirginia Maixner
    • 4
  • David Ashley
    • 5
  1. 1.Department of PsychologyMurdoch Childrens’ Research Institute, Royal Children’s HospitalMelbourneAustralia
  2. 2.Department of Neurosurgery & SurgeryAlfred Hospital & Monash UniversityMelbourneAustralia
  3. 3.Department of Haemotology/OncologyRoyal Children’s HospitalBrisbaneAustralia
  4. 4.Department of NeurosurgeryRoyal Children’s HospitalMelbourneAustralia
  5. 5.Children’s Cancer CentreRoyal Children’s HospitalMelbourneAustralia
  6. 6.Department of PsychologyRoyal Children’s HospitalParkvilleAustralia

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