Raghubar Kimberly P, Mahone E Mark, Yeates Keith Owen, Cecil Kim M, Makola Monwabisi, Ris M Douglas
Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
Department of Neuropsychology, Kennedy Krieger Institute and Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Child Neuropsychol. 2017 Aug;23(6):642-654. doi: 10.1080/09297049.2016.1183608. Epub 2016 May 26.
Children are at risk for cognitive difficulties following the diagnosis and treatment of a brain tumor. Longitudinal studies have consistently demonstrated declines on measures of intellectual functioning, and recently it has been proposed that specific neurocognitive processes underlie these changes, including working memory, processing speed, and attention. However, a fine-grained examination of the affected neurocognitive processes is required to inform intervention efforts. Radiation therapy (RT) impacts white matter integrity, likely affecting those cognitive processes supported by distributed neural networks. This study examined working memory and attention in children during the early delayed stages of recovery following surgical resection and RT. The participants included 27 children diagnosed with pediatric brain tumor, treated with (n = 12) or without (n = 15) RT, who completed experimental and standardized measures of working memory and attention (n-back and digit span tasks). Children treated with radiation performed less well than those who did not receive radiation on the n-back measure, though performance at the 0-back level was considerably poorer than would be expected for both groups, perhaps suggesting difficulties with more basic processes such as vigilance. Along these lines, marginal differences were noted on digit span forward. The findings are discussed with respect to models of attention and working memory, and the interplay between the two.
儿童在被诊断患有脑肿瘤并接受治疗后有出现认知困难的风险。纵向研究一致表明,智力功能测量指标呈下降趋势,最近有人提出,特定的神经认知过程是这些变化的基础,包括工作记忆、处理速度和注意力。然而,需要对受影响的神经认知过程进行细致的检查,以便为干预措施提供依据。放射治疗(RT)会影响白质完整性,可能会影响由分布式神经网络支持的那些认知过程。本研究在手术切除和放射治疗后的早期恢复延迟阶段,对儿童的工作记忆和注意力进行了检查。参与者包括27名被诊断患有小儿脑肿瘤的儿童,其中12名接受了放射治疗,15名未接受放射治疗,他们完成了工作记忆和注意力的实验性及标准化测量(n-back和数字广度任务)。在n-back测量中,接受放射治疗的儿童表现不如未接受放射治疗的儿童,不过两组在0-back水平的表现都比预期差得多,这可能表明在诸如警觉等更基本的过程中存在困难。同样,在顺向数字广度方面也发现了微小差异。我们将根据注意力和工作记忆模型以及两者之间的相互作用来讨论这些发现。