Lai Jin-Shei, Bregman Corey, Zelko Frank, Nowinski Cindy, Cella David, Beaumont Jennifer J, Goldman Stewart
Medical Social Sciences and Pediatrics, Feinberg School of Medicine at Northwestern University, 633 N St Clair, #19-039, Chicago, IL, 60611, USA.
Medical Imaging (Radiology), Ann & Robert H. Lurie Children's Hospital, Chicago, IL, 60611, USA.
Qual Life Res. 2017 Sep;26(9):2541-2550. doi: 10.1007/s11136-017-1583-8. Epub 2017 Apr 26.
Cognitive dysfunction is a major concern for children with brain tumors. A valid, user-friendly screening tool could facilitate prompt referral for comprehensive neuropsychological assessments and therefore early intervention. Applications of the pediatric perceived cognitive function item bank (pedsPCF) such as computerized adaptive testing can potentially serve as such a tool given its brevity and user-friendly nature. This study aimed to evaluate whether pedsPCF was a valid indicator of cerebral compromise using the criterion of structural brain changes indicated by leukoencephalopathy grades.
Data from 99 children (mean age = 12.6 years) with brain tumors and their parents were analyzed. Average time since diagnosis was 5.8 years; time since last treatment was 4.3 years. Leukoencephalopathy grade (range 0-4) was based on white matter damage and degree of deep white matter volume loss shown on MRI. Parents of patients completed the pedsPCF. Scores were based on the US general population-based T-score metric (mean = 50; SD = 10). Higher scores reflect better function.
Leukoencephalopathy grade distributions were as follows: 36 grade 0, 27 grade 1, 22 grade 2, 13 grade 3, and 1 grade 4. The mean pedsPCF T-score was 48.3 (SD = 8.3; range 30.5-63.7). The pedsPCF scores significantly discriminated patients with different leukoencephalopathy grades, F = 4.14, p = 0.0084. Effect sizes ranged from 0.09 (grade 0 vs. 1) to 1.22 (grade 0 vs. 3/4).
This study demonstrates that the pedsPCF is a valid indicator of leukoencephalopathy and provides support for its use as a screening tool for more comprehensive neurocognitive testing.
认知功能障碍是脑肿瘤患儿的一个主要问题。一个有效且用户友好的筛查工具可以促进及时转诊以进行全面的神经心理学评估，从而实现早期干预。鉴于其简短性和用户友好性，儿科感知认知功能题库（pedsPCF）的应用（如计算机自适应测试）有可能成为这样一种工具。本研究旨在使用白质脑病分级所指示的脑结构变化标准，评估pedsPCF是否是脑功能受损的有效指标。
对99名脑肿瘤患儿（平均年龄 = 12.6岁）及其父母的数据进行分析。自诊断以来的平均时间为5.8年；自上次治疗以来的时间为4.3年。白质脑病分级（范围0 - 4）基于MRI显示的白质损伤和深部白质体积丢失程度。患者的父母完成了pedsPCF。分数基于美国基于一般人群的T分数度量标准（均值 = 50；标准差 = 10）。分数越高反映功能越好。
白质脑病分级分布如下：36例0级，27例1级，22例2级，13例3级，1例4级。pedsPCF的平均T分数为48.3（标准差 = 8.3；范围30.5 - 63.7）。pedsPCF分数显著区分了不同白质脑病分级的患者，F = 4.14，p = 0.0084。效应大小范围从0.09（0级与1级）到1.22（0级与3/4级）。
本研究表明pedsPCF是白质脑病的有效指标，并为其作为更全面神经认知测试的筛查工具的使用提供了支持。
