Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Sep;22(9):1979-86.
doi: 10.1002/pon.3255. Epub 2013 Feb 28.

Slower processing speed after treatment for pediatric brain tumor and acute lymphoblastic leukemia

Lisa S Kahalley  1 , Heather M Conklin, Vida L Tyc, Melissa M Hudson, Stephanie J Wilson, Shengjie Wu, Xiaoping Xiong, Pamela S Hinds
Affiliations

Slower processing speed after treatment for pediatric brain tumor and acute lymphoblastic leukemia

Lisa S Kahalley et al. Psychooncology. 2013 Sep.

Abstract

Background: Acute lymphoblastic leukemia (ALL) and brain tumor (BT) survivors are at risk for post-treatment IQ declines. The extent to which lower scores represent global cognitive decline versus domain-specific impairment remains unclear. This study examined discrepancies between processing speed and estimated IQ (EIQ) scores and identified clinical characteristics associated with score discrepancies in a sample of pediatric cancer survivors.

Procedure: Survivors (50 ALL, 50 BT) ages 12-17 years completed cognitive testing. The Wechsler Abbreviated Scale of Intelligence provided an untimed measure of general reasoning ability (EIQ). The age-appropriate Wechsler Intelligence Scale provided a Processing Speed Index (PSI) score. Scores were examined and compared.

Results: Survivors' PSI scores were lower than their EIQ scores (BT t(45) =6.3, p<0.001; ALL t(49) =6.9, p<0.001). For BT survivors, lower PSI scores were associated with history of craniospinal irradiation, t(44) =3.3, p<0.01. For ALL survivors, lower PSI scores were associated with male gender, grade retention, and time since diagnosis, F(3, 46) =10.1, p<0.001. Clinically significant EIQ-PSI score discrepancies were identified in 41.3% of BT and 14.0% of ALL survivors.

Conclusions: Many pediatric BT and ALL survivors exhibit slower processing speed than expected for age, whereas general reasoning ability remains largely intact. Risk factors associated with larger EIQ-PSI discrepancies include the following: BT diagnosis, craniospinal irradiation (BT only), male gender, and younger age at diagnosis (ALL only). Grade retention was frequent and associated with lower EIQ scores (both groups) and PSI scores (ALL only). Describing post-treatment cognitive declines using global measures of intellectual ability may underestimate dysfunction or fail to isolate specific underlying deficits contributing to impairment.

Keywords: intelligence; late effects of cancer treatment; pediatric hematology/oncology; processing speed.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement: None to declare.

Figures

Figure 1
Figure 1
Frequency distribution of PSI and EIQ scores for BT survivors (n = 46). Scores < 77.5 are considered clinically significant. PSI = Processing Speed Index. EIQ = Estimated IQ.
Figure 2
Figure 2
Frequency distribution of PSI and EIQ scores for ALL survivors (n = 50). Scores < 77.5 are considered clinically significant. PSI = Processing Speed Index. EIQ = Estimated IQ.
Figure 3
Figure 3
Frequency distributions of EIQ-PSI difference scores by diagnostic group (BT n = 46, ALL n = 50). Difference scores > 22.5 are considered clinically significant. EIQ = Estimated IQ. PSI = Processing Speed Index.
See this image and copyright information in PMC

References

    1. Ries LAG, Melbert D, Krapcho M, et al. SEER Cancer Statistics Review, 1975–2004. Bethesda, MD: National Cancer Institute; 2007.
    1. Fossen A, Abrahamsen TG, Storm-Mathisen I. Psychological outcome in children treated for brain tumor. Pediatr Hematol Oncol. 1998;15:479–488. - PubMed
    1. Holmquist LA, Scott J. Treatment, age, and time-related predictors of behavioral outcome in pediatric brain tumor survivors. Journal of Clinical Psychology in Medical Settings. 2002;9:315–321.
    1. Langer T, Martus P, Ottensmeier H, Hertzberg H, Beck JD, Meier W. CNS late-effects after ALL therapy in childhood. Part III: neuropsychological performance in long-term survivors of childhood ALL: impairments of concentration, attention, and memory. Med Pediatr Oncol. 2002;38:320–328. - PubMed
    1. Lockwood KA, Bell TS, Colegrove RW. Long-term effects of cranial radiation therapy on attention functioning in survivors of childhood leukemia. Journal of Pediatric Psychology. 1999;24:55–66.

Publication types

MeSH terms

Substances