Long-Term Neuropsychological Effects in Survivors of Pediatric Low-Grade Gliomas

Statement of the problem: Survival rates of low-grade gliomas (diagnosed and treated during childhood) have improved resulting in a population of long-term survivors, albeit with limited knowledge of their neurocognitive function, quality of life, and adaptive function.

Methods: Patients treated at The Childrens Hospital at Westmead, Sydney, Australia during childhood (ages 6-18), and a minimum of five years post diagnosis (n = 20) participated in a neuropsychological evaluation. Demographic and tumour related variables were independently analyzed.

Results: The majority of the participants demonstrated average ability on most cognitive tasks, although we found some variability resulting in three subgroups ranging from mild to severe functioning. The lower cognitive functioning subgroup demonstrated challenges on tasks of memory, processing speed, and executive function. In addition, they self-reported sub-clinical to clinical ranges in internalizing and externalizing symptoms as well as difficulties in physical health, and social and emotional well-being. Medication consumption and less education were moderators of biological risk. None of the tumour related factors were identified as moderators, in part due to the small sample size. Positive associations between challenges in adaptive function (internalizing and externalizing symptoms) and difficulties in perceived cognitive abilities and health related quality of life were identified in the sample.

Conclusions: This study highlighted the variability in long-term outcomes of low-grade gliomas and the necessity for routine follow-up care over the course of recovery and survivorship.