Department of Psychiatry, University of Michigan , Ann Arbor, MI, USA.
Department of Psychology, Eastern Michigan University , Ypsilanti, MI, USA.
Child Neuropsychol. 2020 Jul;26(5):597-611. doi: 10.1080/09297049.2019.1676406. Epub 2019 Oct 9.
Pediatric acute lymphoblastic leukemia survivors are at risk for developing neurocognitive late effects following intensive medical treatment. Motor impairments have been highlighted as a common neurocognitive late effect, including fine-, gross-, and visual-motor skills. The severity of these motor deficits is variable in the existing literature, warranting additional investigations with more homogenous samples. In addition, there is an even greater paucity regarding the interrelations between motor deficits and the impact motor challenges may have on other domains of functioning, such as academics. Therefore, the present study aimed to characterize motor functioning in children who were treated for acute lymphoblastic leukemia with chemotherapy ( = 13) in comparison to healthy controls ( = 13). Additionally, this study investigated the relationship between primary (e.g., visual-spatial, fine-motor), secondary (e.g., visual-motor), and tertiary (e.g., academics) skills. The results revealed that oncology survivors had significantly lower fine- and gross-motor skills compared to healthy controls. No significant differences were observed between the groups on visual-perception and visual-motor tasks. Fine-motor functioning was significantly associated with visual-motor functioning in ALL survivors. Motor skills were not related to academic outcomes. The present findings provide evidence for motor impairments in pediatric ALL survivors, along with initial findings highlighting the cascading effect of primary motor impairments on other cognitive domains. This research sheds light on the need for clinical screening and intervention of motor skills in the survivorship population. Future research is warranted to examine the effect of motor deficits on cognitive and psychosocial functioning in pediatric oncology.
儿科急性淋巴细胞白血病幸存者在接受强化治疗后有发生神经认知晚期效应的风险。运动障碍已被强调为常见的神经认知晚期效应之一，包括精细运动、粗大运动和视动技能。这些运动缺陷的严重程度在现有文献中存在差异，需要更多同质样本的进一步研究。此外，关于运动缺陷与运动挑战对其他功能领域（如学业）的影响之间的相互关系，文献更是匮乏。因此，本研究旨在比较接受化疗治疗的急性淋巴细胞白血病儿童（n=13）和健康对照组（n=13）的运动功能特征。此外，本研究还调查了主要（如视空间、精细运动）、次要（如视动）和 tertiary（如学术）技能之间的关系。结果显示，肿瘤幸存者的精细运动和粗大运动技能明显低于健康对照组。两组在视觉感知和视动任务上无显著差异。精细运动功能与 ALL 幸存者的视动功能显著相关。运动技能与学业成绩无关。本研究结果为儿科 ALL 幸存者的运动障碍提供了证据，同时初步结果强调了原发性运动障碍对其他认知领域的级联效应。这项研究表明，在生存者人群中需要进行运动技能的临床筛查和干预。需要进一步的研究来检验运动缺陷对儿科肿瘤患者认知和心理社会功能的影响。
