Neurocognitive Function and Health-Related Quality of Life in Pediatric Korean Survivors of Medulloblastoma

Abstract

The neurocognitive function and quality of life of 58 Korean survivors of childhood medulloblastoma were assessed after surgery, cranial radiation and chemotherapy. All patients were evaluated with a battery of neurocognitive function tests and the Pediatric Functional Assessment of Cancer Therapy-Brain Tumor Survivors, which consists of self-report questionnaires on quality of life. The mean full-scale intelligence quotient (IQ), verbal IQ, and performance IQ scores were 90.2, 97.1, and 84.16, respectively. The mean memory quotient (MQ) score was 86.78, which was within 1 standard deviation of the average score of 100. Processing speed, attention, and executive function showed mild to moderate deficits. Intelligence, memory, executive function, visuospatial function, and simple motor function were significantly lower in the patients diagnosed before 8 years of age compared with those diagnosed after 8. The cognitive deficits in the patients diagnosed at younger ages might be related to earlier exposure to craniospinal irradiation and chemotherapy. The patient and parent proxy evaluations of attention, fine motor function, and quality of life did not differ. We found significant neurocognitive changes in a wide range of neurocognitive functional domains in Korean survivors of childhood medulloblastoma. Long-term follow-up studies of survivors of childhood medulloblastoma beginning at the time of their first diagnosis are required to better understand the deficits exhibited by survivors of childhood medulloblastoma, so that intervention strategies and treatment refinements that reduce the long-term neurocognitive decline can be developed.

Keywords: Cognition; Korea; Medulloblastoma; Quality of Life; Survivors.

Fig. 1

Mean scores of the KWISC-III and KWAIS subtests of all patients (n = 58). The bold horizontal line represents the normal value. KWISC-III = Korean Wechsler Intelligence Scale for Children-III, KWAIS = Korean Wechsler Adult Intelligence Scale, FSIQ = full-scale intelligence quotient, INF = information, COM = comprehension, SIM = similarities, ARI = arithmetic, DSP = digit span, DSF = digit span forward, DSB = digit span backward, VOC = vocabulary, DS = digit symbol, PC = picture completion, PA = picture arrangement, BD = block design, OA = object assembly.

Fig. 2

Mean scores on the Rey-Kim memory test of all of the patients (n = 58). MQ=memory quotient, A1=auditory verbal 1, A2=auditory verbal 2, A3=auditory verbal 3, VD=verbal delayed recall, VR=verbal delayed recognition, VSI=visual immediate recall, VSD=visual delayed recall, VC=visual copy.