Comparison of Neurocognitive Functioning and Fine Motor Skills in Pediatric Cancer Survivors and Healthy Children

Abstract

Background: The late treatment outcomes of pediatric brain tumors and of hematopoietic and lymphoid tissue tumors are an important focus of both rehabilitation and research. Neurocognitive and motor disorders induce further learning problems impeding social-emotional adaptation throughout a whole lifespan. Core deficits in short-term and working memory, visuospatial constructional ability, verbal fluency, and fine motor skills underlie distorted intellectual and academic achievement. This study aimed to assess the individual differences in cognitive ability and fine motor skills of pediatric tumor survivors and the age-matched healthy controls. Methods: A total of 504 tumor survivors after treatment and 646 age-matched healthy controls underwent neurocognitive and fine motor assessments. Findings: The group of tumor survivors scored significantly worse in both neurocognitive and fine motor skill in compared with the healthy control group. The pediatric brain tumor survivors (PBT group) performed worse in cognitive (p < 0.001 for verbal fluency and p < 0.001 for visuospatial constructional ability) and motor tests (p < 0.001) compared to the healthy controls. Hematopoietic and Lymphoid Tissues tumors survivors (THL group) performed worse in verbal fluency (p < 0.01) and visuospatial constructional test (p < 0.001) compared to the control group. Furthermore, the PBT group had worse results in visuospatial constructional ability (p < 0.05) and fine motor (p < 0.001) ability than the THL group. Significant differences between females and males were found in fine motor test performance in the PBT group (p < 0.05), as well as in verbal fluency (p < 0.01) and visuospatial constructional ability (p < 0.01) in the control group. Neurocognitive and fine motor skill characteristics in the THL group did not correlate with age.

Keywords: fine motor skill; neurocognitive functioning; pediatric brain tumor; tumors of hematopoietic and lymphoid tissues.

Figure 1

Boxplots of Digit Span Forward for the healthy control group and the diagnosis groups. Control—healthy control group, PBT—pediatric brain tumor survivors, THL—hematopoietic and lymphoid tissues tumor survivors. Red dot—mean test score for each group.

Figure 2

Boxplots of Digit Span Backward for the healthy control group and the diagnosis groups. Control—healthy control group, PBT—pediatric brain tumor survivors, THL—hematopoietic and lymphoid tissues tumor survivors. Red dot—mean test score for each group.

Figure 3

Boxplots of COWAT for the healthy control group and the diagnosis groups. Control—healthy control group, PBT—pediatric brain tumor survivors, THL—hematopoietic and lymphoid tissues tumor survivors. COWAT—Controlled Oral Word Association Task. Red dot—mean test score for each group.

Figure 4

Boxplots of ROCF for the healthy control group and the diagnosis groups. Control—healthy control group, PBT—pediatric brain tumor survivors, THL—hematopoietic and lymphoid tissues tumor survivors. COWAT—Controlled Oral Word Association Task. ROCF—the Rey–Osterrieth Complex Figure. Red dot—mean test score for each group.

Figure 5

Boxplots of Grooved Pegboard for the healthy control group and the diagnosis groups. Control—healthy control group, PBT—pediatric brain tumors survivors, THL—tumors of hematopoietic and lymphoid tissues survivors. COWAT—Controlled Oral Word Association Task. Red dot—mean test score for each group.

Figure 6

Heatmap of neurocognitive test results and age relationship in the healthy control group showing Spearman’s correlation after the FDR correction. COWAT—Controlled Oral Word Association Task, ROCF—the Rey–Osterrieth Complex Figure.

Figure 7

Heatmap of neurocognitive test results and age relationship in Pediatric Brain tumor group showing Spearman’s correlation after FDR correction. COWAT—Controlled Oral Word Association Task, ROCF—the Rey–Osterrieth Complex Figure.

Figure 8

Heatmap of neurocognitive test results and age relationship in hematopoietic and lymphoid tissues tumor group showing Spearman’s correlation after FDR correction. COWAT—Controlled Oral Word Association Task, ROCF—the Rey–Osterrieth Complex Figure; THL—hematopoietic and lymphoid tissues tumor group.