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Dissertation

Decreased Generalized Performance Ability in Pediatric Brain Tumor Survivors: Localization and Specific Contributions of Neurocognitive Functions

1 January 2017

Abstract

Below average generalized performance ability is among the most frequently observed sequelae in pediatric brain tumor survivors (PBTS). The purpose of the current study was to investigate the role of localization of tumor, and to explore which visual-motor neurocognitive measures in a neuropsychological battery were correlated with, and predictive of, generalized performance ability while controlling for the covariate age at time of diagnosis. The current study involved 58 patients diagnosed with brain tumor before age 18. Two subgroups were classified by tumor localization, supratentorial (i.e., above the tentorium) and infratentorial (i.e., below the tentorium). All patients received a standardized battery of neurocognitive measures. Results reflected the overall sample had below average generalized performance ability; however, there was no significant difference between subgroups based on tumor localization. All neurocognitive measures were significantly correlated with generalized performance ability. An exploratory regression analysis reflected visual-motor integration, visual organization, and visual construction neurocognitive functions were uniquely predictive of generalized performance ability while controlling for age at time of diagnosis. Both tumor subgroups had below average generalized performance ability, implicating a more diffuse and less localized effect. Cranial radiation therapy, and associated diffuse white matter loss, was suspected and is a topic worthy of future investigation. Determining whether basic visual, motor, and visual-motor integration skills are intact in the neurocognitive assessment of PBTS is strongly recommended for accurate assessment of generalized performance ability in this population.


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