Cognitive Fatigue and Processing Speed in Children Treated for Brain Tumours

Abstract

Objective: The relationship between fatigue and cognition has not been fully elucidated in children and adolescent survivors of brain tumours. The aim of the present study was to investigate the potential relationship between fatigue and cognitive impairments in these survivors, as this group is at risk for both types of deficits. Methods: Survivors of paediatric brain tumours (n = 45) underwent a neuropsychological testing on average 4 years after diagnosis. Mean age at follow-up was 13.41 years. Cognition was assessed with neuropsychological tests, and fatigue with the Pediatric Quality of Life (PedsQL™) Multidimensional Fatigue Scale. Regression analysis, adjusted for cranial radiotherapy and age at diagnosis, was used to investigate the associations between cognitive variables and fatigue subscales. Cognitive variables associated with fatigue were subsequently exploratively assessed. Results: Significant associations were found for cognitive fatigue and measures of cognitive processing speed; Coding: p = .003, r = .583, 95% CI [9.61; 22.83] and Symbol Search: p = .001, r = .585, 95% CI [10.54; 24.87]. Slower processing speed was associated with poorer results for cognitive fatigue. Survivors with the largest decrease in processing speed from baseline to follow-up also experienced the most cognitive fatigue. Survivors expressed more cognitive fatigue compared to other types of fatigue. Conclusions: The association between cognitive fatigue and cognitive processing speed in children and adolescents treated for brain tumours is in concordance with the results previously reported in adults. Some survivors experience fatigue without impairment in processing speed, indicating the need for comprehensive assessments. Moreover, the study supports that fatigue is a multidimensional concept which should be measured accordingly.

Neurocognitive Functions Before and After Radiotherapy in Pediatric Brain Tumor Survivors

“…One study has also shown associations between cognitive fatigue and processing speed in pediatric brain tumor survivors. 28 Our study demonstrates that the comprehensive neuropsychologic assessment and the neurological reports revealed more and diverse problems than could be inferred from the IQ measurements alone.…”

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

“…We expected to find an association between children who received radiotherapy and fatigue since radiotherapy is a known risk factor for decreased processing speed and cognitive decline, 6 which has been associated with more cognitive fatigue in PBTS. 30 The reasons we did not find such an association could be that, first, the number of children in this cohort who had radiation was too small ( n = 37, 33%). Second, the large heterogeneity in our cohort makes it difficult to detect such a possible effect in univariable analyses, and we had insufficient power to explore this in multivariable analyses.…”

Fatigue trajectories during pediatric ALL therapy are associated with fatigue after treatment: a national longitudinal cohort study

“…A score more than 1.5 standard deviations (SD) below the norm mean for the corresponding age group was considered to be an indicator of fatigue. The cut-off of − 1.5 SD was based on previous research on cancer-related fatigue [ 6 , 17 , 18 ]. The dichotomous results from assessment T3 were used as outcome variables, with the course of fatigue during treatment, sex, risk group, serious adverse event, and age at diagnosis as independent variables.…”