Cognitive deficits in long-term survivors of childhood medulloblastoma and other noncortical tumors: Age-dependent effects of whole brain radiation

Jerilynn Radcliffe, Greta R. Bunin, Leslie N. Sutton, Joel W. Goldwein, Peter C. Phillips

Research output: Contribution to journalArticlepeer-review

127 Scopus citations

Abstract

Twenty-four children, aged 1.5-20 yr at diagnosis, with noncortical brain tumors, primarily medulloblastoma, have been followed for 3-4 yr for intellectual status. All the children received craniospinal irradiation, and 19 of 24 received chemotherapy as well. For the group as a whole, Full Scale IQ fell from 104 at baseline to 91 at final follow-up. Children younger than 7 yr at diagnosis showed a significant decrease in IQ as early as year 1, and all changes from baseline to years 3 and 4 were significant. In contrast, children older than 7 yr at diagnosis did not show a significant IQ change from baseline to year 3 or 4. The Spearman correlation coefficient between IQ change and age at diagnosis from baseline to year 4 was 0.57 (P=0.003). This study supports the hypothesis that children treated with whole brain radiation at a younger age have more severe cognitive impairment than those treated at a later age. Limitations in sample size and duration of observations do not permit us to identify whether a true plateau occurs 2-4 yr after irradiation versus a continued progressive decline in intellectual performance. Moreover, we cannot at this time distinguish between a true dementing process versus failure to acquire new cognitive skills at a rate comparable to age-matched peers.

Original languageEnglish
Pages (from-to)327-334
Number of pages8
JournalInternational Journal of Developmental Neuroscience
Volume12
Issue number4
DOIs
StatePublished - Jun 1994
Externally publishedYes

Keywords

  • children
  • medulloblastoma
  • noncortical tumors
  • radiation injury

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