Neuropsychological Outcome following Cranio-spinal Radiation in Medulloblastoma Patients: A Longitudinal Analysis of Predictors

• Main Author: Moxon-Emre, Iska
• Other Authors: Mabbott, Donald
• Language: en_ca
• Published: 2013
• Subjects: Medulloblastoma; Neuropsychology; Pediatric; 0621; 0633
• Online Access: http://hdl.handle.net/1807/35649

Medulloblastoma is the most common malignant central nervous system (CNS) tumor in childhood. The cranio-spinal radiation (CSR) required to treat this disease results in long-term cognitive and neurologic impairments. Medulloblastoma was recently categorized into four genetic subgroups (WNT, SHH, Group 3, and Group 4). This study examined neuropsychological and intellectual functioning in 91 medulloblastoma patients (41 Group 4; 20 Group 3; 18 SHH; 12 WNT) following treatment, and examined the impact of several medical, treatment and demographic factors on functioning over time. Longitudinal growth curve analyses revealed hydrocephalus most clearly predisposes to poor neuropsychological functioning. Results also indicate medulloblastoma subgroups have heterogeneous intellectual outcomes following treatment. All subgroups experience intellectual declines following treatment; however, comparing between subgroups revealed Group 4 performs most poorly, and Group 3 has the best overall intellectual outcome. Lastly, qualitative analyses suggest treatment with a larger CSR dose may contribute to poor intellectual functioning.