INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #23 Cognitive Mediators of Quality of Life in Pediatric Medulloblastoma Survivors: A Comparison of Survivors with and without Postoperative Cerebellar Mutism Syndrome Krystal Christopher, Texas Children's Hospital, Baylor College of Medicine, Houston, United States Heather Stancel, Texas Children's Hospital, Baylor College of Medicine, Houston, United States Kimberly Raghubar, Texas Children's Hospital, Baylor College of Medicine, Houston, United States Lisa Kahalley, Texas Children's Hospital, Baylor College of Medicine, Houston, United States Category: Cancer Keyword 1: brain tumor Keyword 2: pediatric neuropsychology Keyword 3: neuro-oncology Objective: Previous research has examined the neurocognitive implications of pediatric posterior fossa tumors and has strongly advocated for outcome measures for cancer treatment to incorporate health-related quality of life (HRQOL) to get a better understanding of factors that negatively affect HRQOL over time. Additionally, surgical resection of posterior fossa tumors may result in a specific type of cerebellar damage leading to postoperative cerebellar mutism syndrome (CMS). Children who develop CMS are noted to experience even lower performance in various neurocognitive domains when compared to medulloblastoma patients who did not have CMS. However, few studies have examined the relationship between neurocognitive functioning and HRQOL into survivorship within the context of individuals with and without a CMS diagnosis. The purpose of this study is to examine neurocognitive variables (i.e., EF, processing speed, verbal fluency) as potential mediators of CMS on HRQOL outcomes in pediatric medulloblastoma survivors with or without a history of CMS. Participants and Methods: This present study is a retrospective analysis of archival data collected from a larger study. Participants included 35 children (M_age= 12.32; SD_age=3.12) having been diagnosis with CMS (N=9) or Non-CMS (N=26) who were administered the Delis Kaplan Executive Function System (D-KEFS), and Weschler Intelligence Scale for Children-V (WISC-V) as part of a comprehensive neuropsychological evaluation. Parent report measures such as the Pediatric Quality of Life Inventory (PedsQL) and the Behavior Rating Inventory (BRIEF). A mediation analysis was used in order to examine neurocognitive variables (i.e., EF, processing speed, verbal fluency) as potential mediators of PFS on HRQOL outcomes. Results: Participants with a history of CMS performed significantly worse than those without a history of CMS on measures of performance-based EF (p < 0.01) and processing speed (p < 0.05), suggesting a deleterious effect of CMS. However, groups did not differ significantly in parent-rated EF, verbal fluency, HRQOL, or physical functioning (all p >0.05). Notably, group means indicated that parent-rated overall HRQOL and physical functioning were impaired for participants with CMS (M = 64.53; M = 62.99) compared to average for those without CMS (M = 76.80; M = 78.13). While there was no significant mediation effect, parent-rated EF (β = -0.91, p < 0.001) predicted overall HRQOL. Although no significant neurocognitive predictors emerged for physical functioning, parent-rated EF was marginally significant (β = -0.53, p = 0.06) Conclusions: There were a few limitations to this study (e.g., small sample size, group proportions). However, these findings demonstrate group differences in neurocognitive outcomes for those with a history of CMS, who may be at risk for greater long-term neurocognitive late effects. Parent-rated EF significantly predicted overall HRQOL with marginal significance in predicting physical functioning. These results may represent vital indicators of HRQOL deficits in this population. Findings support the need for long-term monitoring of neurocognitive outcomes within the context of CMS for potential processing speed and performance-based EF impairment.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #23

Cognitive Mediators of Quality of Life in Pediatric Medulloblastoma Survivors: A Comparison of Survivors with and without Postoperative Cerebellar Mutism Syndrome

Krystal Christopher, Texas Children's Hospital, Baylor College of Medicine, Houston, United States
Heather Stancel, Texas Children's Hospital, Baylor College of Medicine, Houston, United States
Kimberly Raghubar, Texas Children's Hospital, Baylor College of Medicine, Houston, United States
Lisa Kahalley, Texas Children's Hospital, Baylor College of Medicine, Houston, United States

Category: Cancer

Keyword 1: brain tumor
Keyword 2: pediatric neuropsychology
Keyword 3: neuro-oncology

Objective:

Previous research has examined the neurocognitive implications of pediatric posterior fossa tumors and has strongly advocated for outcome measures for cancer treatment to incorporate health-related quality of life (HRQOL) to get a better understanding of factors that negatively affect HRQOL over time. Additionally, surgical resection of posterior fossa tumors may result in a specific type of cerebellar damage leading to postoperative cerebellar mutism syndrome (CMS). Children who develop CMS are noted to experience even lower performance in various neurocognitive domains when compared to medulloblastoma patients who did not have CMS. However, few studies have examined the relationship between neurocognitive functioning and HRQOL into survivorship within the context of individuals with and without a CMS diagnosis. The purpose of this study is to examine neurocognitive variables (i.e., EF, processing speed, verbal fluency) as potential mediators of CMS on HRQOL outcomes in pediatric medulloblastoma survivors with or without a history of CMS.

Participants and Methods:

This present study is a retrospective analysis of archival data collected from a larger study. Participants included 35 children (M_age= 12.32; SD_age=3.12) having been diagnosis with CMS (N=9) or Non-CMS (N=26) who were administered the Delis Kaplan Executive Function System (D-KEFS), and Weschler Intelligence Scale for Children-V (WISC-V) as part of a comprehensive neuropsychological evaluation. Parent report measures such as the Pediatric Quality of Life Inventory (PedsQL) and the Behavior Rating Inventory (BRIEF). A mediation analysis was used in order to examine neurocognitive variables (i.e., EF, processing speed, verbal fluency) as potential mediators of PFS on HRQOL outcomes.

Results:

Participants with a history of CMS performed significantly worse than those without a history of CMS on measures of performance-based EF (p < 0.01) and processing speed (p < 0.05), suggesting a deleterious effect of CMS. However, groups did not differ significantly in parent-rated EF, verbal fluency, HRQOL, or physical functioning (all p >0.05). Notably, group means indicated that parent-rated overall HRQOL and physical functioning were impaired for participants with CMS (M = 64.53; M = 62.99) compared to average for those without CMS (M = 76.80; M = 78.13). While there was no significant mediation effect, parent-rated EF (β = -0.91, p < 0.001) predicted overall HRQOL. Although no significant neurocognitive predictors emerged for physical functioning, parent-rated EF was marginally significant (β = -0.53, p = 0.06)

Conclusions:

There were a few limitations to this study (e.g., small sample size, group proportions). However, these findings demonstrate group differences in neurocognitive outcomes for those with a history of CMS, who may be at risk for greater long-term neurocognitive late effects. Parent-rated EF significantly predicted overall HRQOL with marginal significance in predicting physical functioning. These results may represent vital indicators of HRQOL deficits in this population. Findings support the need for long-term monitoring of neurocognitive outcomes within the context of CMS for potential processing speed and performance-based EF impairment.