Neuropsychological consequences of childhood medulloblastoma and possible interventions: A review - 17/02/21

Doi : 10.1016/j.neuchi.2018.03.002

E. Doger de Spéville ^a,^b,^c, V. Kieffer ^c,^d, C. Dufour ^c, J. Grill ^c, M. Noulhiane ^a,^b, L. Hertz-Pannier ^a,^b, M. Chevignard ^d,^e,^f,^g,^⁎
^a Inserm U1129, CEA, Paris Descartes university, 75005 Paris, France
^b UNIACT, institut Joliot, DRF, Neurospin, CEA, Paris Saclay university, 91190 Gif-sur-Yvette, France
^c Department of pediatric and adolescent oncology, Gustave-Roussy, 94800 Villejuif, France
^d CSI (Outreach team for children and adolescents with acquired brain injury), department for children with acquired brain injury, hôpitaux de Saint-Maurice, 94410 Saint-Maurice, France
^e Rehabilitation department for children with acquired neurological injury, and outreach team for children and adolescents with acquired brain injury, Saint-Maurice hospitals, 14, rue du Val-d’Osne, 94410 Saint-Maurice, France
^f Sorbonne université, laboratoire d’imagerie biomédicale, LIB, 75006 Paris, France
^g GRC n^o 18, handicap cognitif et réadaptation (HanCRe)– Sorbonne université, 75013 Paris, France

^⁎Corresponding author at: Service de rééducation des pathologies neurologiques de l’enfant, pôle de rééducation et réadaptation de l’enfant, hôpitaux de Saint-Maurice, 14, rue du Val-d’Osne, 94410 Saint-Maurice, France.Service de rééducation des pathologies neurologiques de l’enfant, pôle de rééducation et réadaptation de l’enfant, hôpitaux de Saint-Maurice, 14, rue du Val-d’Osne, 94410 Saint-Maurice, France.

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Abstract

Background

Children who have been treated for a medulloblastoma often suffer long-term cognitive impairments that often negatively affect their academic performance and quality of life. In this article, we will review the neuropsychological consequences of childhood medulloblastoma and discuss the risk factors known to influence the presence and severity of these cognitive impairments and possible interventions to improve their quality of life.

Methods

This narrative review was based on electronic searches of PubMed to identify all relevant studies.

Results

Although many types of cognitive impairments often emerge during a child's subsequent development, the core cognitive domains that are most often affected in children treated for a medulloblastoma are processing speed, attention and working memory. The emergence and magnitude of these deficits varies greatly among patients. They are influenced by demographic (age at diagnosis, parental education), medical and treatment-related factors (perioperative complications, including posterior fossa syndrome, radiation therapy dose, etc.), and the quality of interventions such as school adaptations provided to the child or rehabilitation programs that focus on cognitive skills, behavior and psychosocial functioning.

Conclusion

These patients require specialized and coordinated multidisciplinary rehabilitation follow-up that provides timely and adapted assessments and culminates in personalized intervention goals being set with the patient and the family. Follow-up should be continued until referral to adult services.

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Keywords : Childhood, Medulloblastoma, Cognitive impairments, Risk factors, Interventions