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儿童脑肿瘤患者神经心理功能的计算机化评估

Computerized assessment of neuropsychological functioning in pediatric brain tumor patients.

作者信息

Huang Jia-Yun, Yeh Ting-Chi, Liu Hsi-Che, Hou Jen-Yin, Yen Tsung-Yu, Huang Chun-Chao, Lao Hsuan-Chih, Ho Che-Sheng, Liang Muh-Lii

机构信息

Division of Pediatric Neurology, Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan.

Division of Pediatric Hematology-Oncology, Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan.

出版信息

J Neurooncol. 2025 May;172(3):633-644. doi: 10.1007/s11060-025-04945-x. Epub 2025 Jan 31.

Abstract

PURPOSE

Advances in multidisciplinary treatment of childhood brain tumors have significantly prolonged survival and reduced treatment-related complications. This makes the accessibility of digital neurocognitive assessment an important issue in the post-pandemic era.

METHODS

Twenty pediatric brain tumor patients were recruited between August 2023 and August 2024, and a total of eight standardized Cambridge Neuropsychological Test Automated Battery (CANTAB) tests targeting executive function, memory, and attention were applied on a digital system. Subjects with test data exceeding the 5th and 95th percentile ranges were defined as outlier in this context. Three domains (DMS, PAL, SWM) of the normative data for adult patients provided by CANTAB test were used for comparison. Mann-Whitney U test was used to compare differences in treatment modalities and age groups.

RESULTS

Four patients (4/20, 20%) exhibited impairments across four to six cognitive domains, with more than 14 sub-items falling outside the 5th and 95th percentiles.Another 7 patients (7/20, 35%) had impairments confined to a single domain, even though 4 out of 7 (57%) had a total IQ above 100. The subtle neurocognitive impairment of different domains can be effectively identified by automatic digital threshold analysis and reasonably associated with clinical characteristics. The normative data provided by the CANTAB battery for adult populations further enhances the accuracy of detecting neurofunctional impairments.

CONCLUSION

The CANTAB test was shown to be an evaluable and user-friendly neurocognitive assessment tool for post-treatment follow-up in pediatric patients with brain tumors.

摘要

目的

儿童脑肿瘤多学科治疗的进展显著延长了生存期并减少了治疗相关并发症。这使得数字神经认知评估的可及性成为大流行后时代的一个重要问题。

方法

2023年8月至2024年8月招募了20名儿童脑肿瘤患者,在数字系统上总共应用了八项针对执行功能、记忆和注意力的标准化剑桥神经心理测试自动成套测验(CANTAB)。在此背景下,测试数据超出第5和第95百分位数范围的受试者被定义为异常值。使用CANTAB测试提供的成年患者规范数据的三个领域(DMS、PAL、SWM)进行比较。采用曼-惠特尼U检验比较治疗方式和年龄组的差异。

结果

4名患者(4/20,20%)在四至六个认知领域表现出损伤,超过14个子项目落在第5和第95百分位数之外。另外7名患者(7/20,35%)的损伤局限于单个领域,尽管7名中有4名(57%)的总智商高于100。通过自动数字阈值分析可以有效识别不同领域的细微神经认知损伤,并合理地将其与临床特征相关联。CANTAB成套测验为成年人群提供的规范数据进一步提高了检测神经功能损伤的准确性。

结论

CANTAB测试被证明是一种可评估且用户友好的神经认知评估工具,用于脑肿瘤儿童患者治疗后的随访。

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