Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA.
Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA.
Appl Neuropsychol Child. 2022 Jul-Sep;11(3):412-421. doi: 10.1080/21622965.2021.1875226. Epub 2021 Jan 27.
Research shows promise for cognitive interventions for children diagnosed with brain tumors. Interventions have been delivered approximately 5 years postdiagnosis on average, yet recent evidence shows cognitive deficits may appear near diagnosis. The present study assessed the feasibility and initial effects of working memory training in children with brain tumors delivered soon after diagnosis and followed 2 years postdiagnosis. Children completed baseline assessments 10 months postdiagnosis and were randomized to complete adaptive or nonadaptive (i.e., control) Cogmed Working Memory Training. Children were administered the WISC-IV Working Memory Index (WMI) and NIH Toolbox Cognitive Battery (NTCB), and parents completed attentional and executive function measures at four time points. On average, participants completed half of prescribed Cogmed sessions. Retention for the three follow-up assessments proved difficult. For both Cogmed groups, WMI and NTCB scores significantly improved immediately postintervention compared to baseline scores. Significant differences were not maintained at the remaining follow-ups. There was preliminary evidence for improved executive function at the final follow-up on parent-reported measures. Working memory training closer to diagnosis proved difficult, though results suggest evidence of cognitive improvement. Future studies should continue to examine potentially efficacious interventions for children with brain tumors and optimal delivery windows to maximize impact.
研究表明,认知干预对诊断出脑肿瘤的儿童有一定效果。干预措施平均在诊断后约 5 年进行,但最近的证据表明,认知缺陷可能在诊断时就已经出现。本研究评估了在诊断后不久即开始并在诊断后 2 年进行随访的脑肿瘤儿童进行工作记忆训练的可行性和初步效果。儿童在诊断后 10 个月完成基线评估,并随机分为自适应或非自适应(即对照)Cogmed 工作记忆训练组。对儿童进行 WISC-IV 工作记忆指数(WMI)和 NIH 工具包认知电池(NTCB)测试,家长在四个时间点完成注意力和执行功能测试。平均而言,参与者完成了规定的 Cogmed 课程的一半。三次随访的保留率证明很困难。对于 Cogmed 两组,WMI 和 NTCB 评分在干预后立即与基线评分相比显著提高。在其余随访中没有保持显著差异。在最后一次随访时,根据家长报告的指标,有初步证据表明执行功能有所改善。更接近诊断时进行工作记忆训练证明很困难,但结果表明认知有改善的迹象。未来的研究应继续探索对脑肿瘤儿童有效的干预措施,以及最佳的干预时间窗,以最大限度地提高效果。