Department of Psychology, St Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
J Int Neuropsychol Soc. 2012 Nov;18(6):996-1005. doi: 10.1017/S1355617712000793. Epub 2012 Jun 13.
While longitudinal studies of children treated for brain tumors have consistently revealed declines on measures of intellectual functioning, greater specification of cognitive changes following treatment is imperative for isolating vulnerable neural systems and developing targeted interventions. Accordingly, this cross-sectional study evaluated the performance of childhood brain tumor survivors (n = 50) treated with conformal radiation therapy, solid tumor survivors (n = 40) who had not received central nervous system (CNS) -directed therapy, and healthy sibling controls (n = 40) on measures of working memory [Digit Span and computerized self-ordered search (SOS) tasks]. Findings revealed childhood brain tumor survivors were impaired on both traditional [Digit Span Backward- F(2,127) = 5.98; p < .01] and experimental [SOS-Verbal- F(2,124) = 4.18; p < .05; SOS-Object- F(2,126) = 5.29; p < .01] measures of working memory, and performance on working memory measures correlated with intellectual functioning (Digit Span Backward- r = .45; p < .0001; SOS- r = -.32 to -.26; p < .01). Comparison of performance on working memory tasks to recognition memory tasks (computerized delayed match-to-sample) offered some support for greater working memory impairment. This pattern of findings is consistent with vulnerability in functional networks that include prefrontal brain regions and has implications for the clinical management of children with brain tumors.
虽然对接受脑瘤治疗的儿童进行的纵向研究一致表明,他们的智力功能会出现下降,但为了确定易受影响的神经系统并开发有针对性的干预措施,更具体地描述治疗后认知变化至关重要。因此,这项横断面研究评估了接受适形放射治疗的儿童脑瘤幸存者(n = 50)、未接受中枢神经系统(CNS)定向治疗的实体瘤幸存者(n = 40)和健康兄弟姐妹对照组(n = 40)在工作记忆[数字跨度和计算机自我有序搜索(SOS)任务]方面的表现。研究结果显示,脑瘤儿童在传统[数字跨度倒背- F(2,127)= 5.98;p <.01]和实验[SOS-语言- F(2,124)= 4.18;p <.05;SOS-物体- F(2,126)= 5.29;p <.01]工作记忆测量方面都存在障碍,并且工作记忆测量的表现与智力功能相关(数字跨度倒背- r =.45;p <.0001;SOS- r = -.32 至 -.26;p <.01)。将工作记忆任务的表现与识别记忆任务(计算机延迟匹配样本)进行比较,为工作记忆障碍提供了一些支持。这一发现模式与包括前额叶脑区在内的功能网络的脆弱性一致,对脑瘤儿童的临床管理具有重要意义。