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Characterizing neurocognitive late effects in childhood leukemia survivors using a combination of neuropsychological and cognitive neuroscience measures |
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| Authors: | Ellen Van Der Plas Lauren Erdman Brian J Nieman Rosanna Weksberg Darci T Butcher Deborah L O’connor |
| Institution: | 1. Translational Medicine, The Hospital for Sick Children Research Institute, Toronto, Canada;2. Psychiatry Research, The Hospital for Sick Children, Toronto, Canada;3. Genetics and Genome Biology, The Hospital for Sick Children Research Institute, Toronto, Canada;4. Department of Computer Science, The University of Toronto, Toronto, Canada;5. Mouse Imaging Centre, The Hospital for Sick Children, Toronto, Canada;6. Ontario Institute for Cancer Research, Toronto, Canada;7. Department of Medical Biophysics, The University of Toronto, Toronto, Canada;8. Department of Pediatrics, Faculty of Medicine, The University of Toronto, Toronto, Canada;9. Institutes of Medical Science, The University of Toronto, Toronto, Canada;10. Nutritional Sciences, The University of Toronto, Toronto, Canada |
| Abstract: | Knowledge about cognitive late effects in survivors of childhood acute lymphoblastic leukemia (ALL) is largely based on standardized neuropsychological measures and parent reports. To examine whether cognitive neuroscience paradigms provided additional insights into neurocognitive and behavioral late effects in ALL survivors, we assessed cognition and behavior using a selection of cognitive neuroscience tasks and standardized measures probing domains previously demonstrated to be affected by chemotherapy. 130 ALL survivors and 158 control subjects, between 8 and 18 years old at time of testing, completed the n-back (working memory) and stop-signal (response inhibition) tasks. ALL survivors also completed standardized measures of intelligence (Wechsler Intelligence Scales WISC-IV]), motor skills (Grooved Pegboard), math abilities (WIAT-III), and executive functions (Delis–Kaplan Executive Function System). Parents completed behavioral measures of executive functions (Behavior Rating Inventory of Executive Function BRIEF]) and attention (Conners-3). ALL survivors exhibited deficiencies in working memory and response inhibition compared with controls. ALL survivors also exhibited deficits on WISC-IV working memory and processing speed, Grooved Pegboard, WIAT-III addition and subtraction fluency, and numerical operations, as well as DKEFS number-letter switching. Parent reports suggested more attention deficits (Conners-3) and behavioral difficulties (BRIEF) in ALL survivors compared with referenced norms. Low correspondence between standardized and experimental measures of working memory and response inhibition was noted. The use of cognitive neuroscience paradigms complements our understanding of the cognitive deficits evident after treatment of ALL. These measures could further delineate cognitive processes involved in neurocognitive late effects, providing opportunities to explore their underlying mechanisms. |
| Keywords: | Childhood cancer survivor neuropsychology working memory responseinhibition cognitive neuroscience |