Computerized assessment of cognitive impairment among children undergoing radiation therapy for medulloblastoma

Abstract

Purpose: Advantages to computerized cognitive assessment include increased precision of response time measurement and greater availability of alternate forms. Cogstate is a computerized cognitive battery developed to monitor attention, memory, and processing speed. Although the literature suggests the domains assessed by Cogstate are areas of deficit in children undergoing treatment for medulloblastoma, the validity of Cogstate in this population has not been previously investigated. Methods: Children participating in an ongoing prospective trial of risk-adapted therapy for newly diagnosed medulloblastoma (n = 73; mean age at baseline = 12.1 years) were administered Cogstate at baseline (after surgery, prior to adjuvant therapy) and three months later (six weeks after completion of radiation therapy). Gold-standard neuropsychological measures of similar functions were administered at baseline. Results: Linear mixed models revealed performance within age expectations at baseline across Cogstate tasks. Following radiation therapy, there was a decline in performance on Cogstate measures of reaction time (Identification and One Back). Females exhibited slower reaction time on One Back and Detection tasks at baseline. Higher-dose radiation therapy and younger age were associated with greater declines in performance. Pearson correlations revealed small-to-moderate correlations between Cogstate reaction time and working memory tasks with well-validated neuropsychological measures. Conclusions: Cogstate is sensitive to acute cognitive effects experienced by some children with medulloblastoma and demonstrates associations with clinical predictors established in the literature. Correlations with neuropsychological measures of similar constructs offer additional evidence of validity. The findings provide support for the utility of Cogstate in monitoring acute cognitive effects in pediatric cancer.

An Integrated Analysis of Clinical, Genomic, and Imaging Features Reveals Predictors of Neurocognitive Outcomes in a Longitudinal Cohort of Pediatric Cancer Survivors, Enriched with CNS Tumors (Rad ART Pro)

“…Neurocognitive assessments were completed for all patients at an initial visit and regular follow-up intervals (about yearly) using computer-based CogState testing. CogState has been validated for patients 5 years and older, across a variety of populations, including the CNS tumor population (34)(35)(36) Initial neurocognitive screens were typically conducted following completion of tumor-directed therapy for the primary diagnosis. Subsequent screens were completed at standard of care clinic visits for regular tumor surveillance.…”

Post-Surgery Cognitive Dysfunction Diagnostics in Children

“…В частности, была продемонстрирована связь оценки по CogState с уровнем белка, связывающего жирные кислоты головного мозга [58]. Накоплен опыт применения CogState у детей для оценки когнитивных функций на фоне терапии злокачественных новообразований [59,60].…”

Medulloblastoma genomics in the modern molecular era

“…The importance of such therapy highlights previous observations that MB could spread along the leptomeninges, seed the cerebrospinal fluid with abnormal cells, and recur in distant sites along the neuraxis (42). Despite favorable survival outcomes, exposure of younger patients to CSI often led to neurocognitive and neuroendocrine deficits (38,52). Furthermore, the risk of secondary malignancies, particularly high-grade gliomas, also increased as a result of CSI (12).…”