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J Neurooncol. 2019 Jan;141(2):403-411. doi: 10.1007/s11060-018-03046-2. Epub 2018 Nov 22.

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

Author information

1
Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA.
2
Takeda Pharmaceuticals International Co, Cambridge, MA, USA.
3
Cogstate Limited, New Haven, CT, USA.
4
Paediatric Rehabilitation Service, Lady Cilento Children's Hospital, Bribane, QLD, Australia.
5
Division of Child Neurology, Stanford University/Lucile Packard Children's Hospital, Palo Alto, CA, USA.
6
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
7
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
8
Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
9
Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
10
Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105-2794, USA. heather.conklin@stjude.org.

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 3 months later (6 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.

KEYWORDS:

Brain tumor; Cogstate; Medulloblastoma; Neuropsychology; Pediatric

PMID:
30467812
PMCID:
PMC6344264
[Available on 2020-01-01]
DOI:
10.1007/s11060-018-03046-2
[Indexed for MEDLINE]

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