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 #40 Cognitive Outcomes in Pediatric Cancer Patients: A Brief Review of Literature from 2018-2023 Lauren Frick, University of Mississippi Medical Center, Jackson, United States Julie Schumacher, University of Mississippi Medical Center, Jackson, United States Cynthia Karlson, University of Mississippi Medical Center, Jackson, United States Category: Cancer Keyword 1: cancer Keyword 2: pediatric neuropsychology Keyword 3: brain function Objective: Pediatric cancer is a prominent public health concern (American Cancer Society, 2023). While treatment advances have led to increased survival rates, cancer and its treatments increase risk for cognitive decline post-treatment. An estimated 35% to 60% of survivors experience late cognitive decline (Jacola et al., 2021). However, the full long-term impacts of childhood cancer and treatment on cognition are not well synthesized. Therefore, the current study sought to catalog the past 5 years of literature on cognitive outcomes in pediatric cancer/neoplasm survivors at least one-year post-treatment. Participants and Methods: A review of PubMed, PsycInfo, and PsycArticles was conducted using the terms “pediatric cancer,” “cognition,” “outcomes,” and “long-term.” Studies were excluded if they involved participants diagnosed with cancer after age 20, did not include formal objective or subjective cognitive assessment measures, were review studies, were not conducted in English, or focused on parent-reported outcomes only. Results were narrowed to articles from the past five years to capture articles after the 2016 Moonshot Initiative and returned 177 articles. Upon removing duplicates and screening titles, 96 articles were excluded. After review of abstracts, studies were removed if they did not meet inclusion/exclusion criteria. Eighteen articles were included in the final review. Results: Across the reviewed studies, deficits were most frequently observed on objective tests of memory (particularly verbal encoding and retrieval), processing speed, attention, working memory, and executive functioning. Academic difficulties in math, reading, and overall learning were also noted. Some studies found impairment in language, perceptual reasoning, and visuospatial/visual-motor abilities; however, these findings were less consistent. Notably, although studies indicated statistical significance or ratings of impairment, effect sizes were often not included. Thus, the extent of the impact on daily functioning is unclear. Subjectively, patients reported the most concerns with learning, memory, and attention. Several studies explored risk factors for poor cognitive outcomes. With regard to medical factors, nucleotide polymorphisms, high grade tumor, higher chemotherapy doses, use of photon radiation, and craniospinal chemotherapy and radiation were associated with increased cognitive difficulties. Additionally, baseline cognitive deficits, younger age at treatment, male sex, alcohol use, poor family environment, and lack of resources were associated with worse cognitive outcomes. Finally, medical complications, cerebellar mutism syndrome, and poor sleep were also associated with worse cognitive outcomes and more subjective complaints. Several studies implicated white matter tracts and network hubs in observed cognitive deficits. Conclusions: Overall, children diagnosed and treated for cancer/neoplasms tend to experience significant impact on their cognition, specifically in memory, attention, and executive functioning. Numerous identified medical and social variables may adversely affect cognitive outcomes. Clinicians should seek to identify patients at highest risk for cognitive deficits to help plan early screening and intervention strategies for at-risk pediatric cancer survivors. Future research should seek to expand on the current, limited review. Studies that report effect sizes and impact of functional impairment are needed.

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 #40

Cognitive Outcomes in Pediatric Cancer Patients: A Brief Review of Literature from 2018-2023

Lauren Frick, University of Mississippi Medical Center, Jackson, United States
Julie Schumacher, University of Mississippi Medical Center, Jackson, United States
Cynthia Karlson, University of Mississippi Medical Center, Jackson, United States

Category: Cancer

Keyword 1: cancer
Keyword 2: pediatric neuropsychology
Keyword 3: brain function

Objective:

Pediatric cancer is a prominent public health concern (American Cancer Society, 2023). While treatment advances have led to increased survival rates, cancer and its treatments increase risk for cognitive decline post-treatment. An estimated 35% to 60% of survivors experience late cognitive decline (Jacola et al., 2021). However, the full long-term impacts of childhood cancer and treatment on cognition are not well synthesized. Therefore, the current study sought to catalog the past 5 years of literature on cognitive outcomes in pediatric cancer/neoplasm survivors at least one-year post-treatment.

Participants and Methods:

A review of PubMed, PsycInfo, and PsycArticles was conducted using the terms “pediatric cancer,” “cognition,” “outcomes,” and “long-term.” Studies were excluded if they involved participants diagnosed with cancer after age 20, did not include formal objective or subjective cognitive assessment measures, were review studies, were not conducted in English, or focused on parent-reported outcomes only. Results were narrowed to articles from the past five years to capture articles after the 2016 Moonshot Initiative and returned 177 articles. Upon removing duplicates and screening titles, 96 articles were excluded. After review of abstracts, studies were removed if they did not meet inclusion/exclusion criteria. Eighteen articles were included in the final review.

Results:

Across the reviewed studies, deficits were most frequently observed on objective tests of memory (particularly verbal encoding and retrieval), processing speed, attention, working memory, and executive functioning. Academic difficulties in math, reading, and overall learning were also noted. Some studies found impairment in language, perceptual reasoning, and visuospatial/visual-motor abilities; however, these findings were less consistent. Notably, although studies indicated statistical significance or ratings of impairment, effect sizes were often not included. Thus, the extent of the impact on daily functioning is unclear. Subjectively, patients reported the most concerns with learning, memory, and attention. Several studies explored risk factors for poor cognitive outcomes. With regard to medical factors, nucleotide polymorphisms, high grade tumor, higher chemotherapy doses, use of photon radiation, and craniospinal chemotherapy and radiation were associated with increased cognitive difficulties. Additionally, baseline cognitive deficits, younger age at treatment, male sex, alcohol use, poor family environment, and lack of resources were associated with worse cognitive outcomes. Finally, medical complications, cerebellar mutism syndrome, and poor sleep were also associated with worse cognitive outcomes and more subjective complaints. Several studies implicated white matter tracts and network hubs in observed cognitive deficits.

Conclusions:

Overall, children diagnosed and treated for cancer/neoplasms tend to experience significant impact on their cognition, specifically in memory, attention, and executive functioning. Numerous identified medical and social variables may adversely affect cognitive outcomes. Clinicians should seek to identify patients at highest risk for cognitive deficits to help plan early screening and intervention strategies for at-risk pediatric cancer survivors. Future research should seek to expand on the current, limited review. Studies that report effect sizes and impact of functional impairment are needed.