Computerized assessment of cognitive late effects among adolescent brain tumor survivors.
Computerized assessment of cognitive late effects among adolescent brain tumor survivors.
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DOI：
10.1007/s11060-013-1123-5
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发表时间：
2013-06
影响因子：
3.9
通讯作者：
Wu, Shengjie
中科院分区：
文献类型：
--
作者：
Conklin, Heather M.;Ashford, Jason M.;Di Pinto, Marcos;Vaughan, Christopher G.;Gioia, Gerard A.;Merchant, Thomas E.;Ogg, Robert J.;Santana, Victor;Wu, Shengjie
神经心理功能的计算机化评估的优势包括提高了反应时间变量的标准化和可靠性。Impact(脑震荡后即刻评估和认知测试)是一种计算机化的电池，用于监测轻度脑损伤后的恢复情况，评估注意力、记忆力和处理速度。尽管有证据表明癌症幸存者的核心缺陷领域是那些通过影响评估的领域，但它以前从未在这一人群中使用过。24名接受适形放射治疗的儿童脑瘤(BT)幸存者(平均年龄15.7±1.6岁；照射时平均年龄=9.8±2.5岁)、20名未接受中枢神经系统定向治疗的实体肿瘤(ST)幸存者(平均年龄16.2±1.8岁)和20名健康兄弟姐妹(平均年龄15.1±1.6岁)接受了年龄修正版本的IMPACT。另外还进行了工作记忆和再认记忆的计算机化测量。单因素方差分析显示，在再认记忆、空间工作记忆、处理速度和反应时方面，两组间存在差异(p<；0.05)，BT幸存者的表现明显逊于ST幸存者和兄弟姐妹。皮尔逊相关系数揭示了影响记忆任务和计算机化强迫选择再认任务之间的显著关联(rS=0.30-0.33，p<；0.05)。使用线性混合模型(p<；0.05)，多次手术切除、脑积水和脑脊液分流术最一致地预测了较差的冲击性能。冲击试验组显示了对一些BT幸存者经历的认知迟发效应的敏感性，其临床预测指标与儿科肿瘤学文献一致。与相似结构测量的相关性为收敛效度提供了证据。研究结果初步支持了IMPACT用于监测认知迟发效应的效用。
Advantages of computerized assessment of neuropsychological functions include improved standardization and increased reliability of response time variables. ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is a computerized battery developed for monitoring recovery following mild brain injuries that assesses attention, memory and processing speed. Despite evidence that core areas of deficit among cancer survivors are those assessed by ImPACT, it has not previously been used with this population. Twenty four childhood brain tumor (BT) survivors treated with conformal radiation therapy (mean age= 15.7±1.6; mean age at irradiation= 9.8±2.5), twenty solid tumor (ST) survivors treated without CNS-directed therapy (mean age= 16.2±1.8) and twenty healthy siblings (mean age= 15.1± 1.6 years) were administered an age modified version of ImPACT. Additional computerized measures of working memory and recognition memory were administered. Univariate ANOVAs revealed group differences (p< .05) on measures of recognition memory, spatial working memory, processing speed and reaction time, with BT survivors performing significantly worse than ST survivors and siblings. Pearson correlation coefficients revealed significant associations between ImPACT memory tasks and computerized forced choice recognition tasks (rs= .30-.33, p< .05). Multiple surgical resections, hydrocephalus and CSF shunt placement most consistently predicted worse ImPACT performance using linear mixed models (p< .05). The ImPACT test battery demonstrated sensitivity to cognitive late effects experienced by some BT survivors with clinical predictors of performance consistent with the pediatric oncology literature. Correlations with measures of similar constructs provide evidence for convergent validity. Findings offer initial support for the utility of ImPACT for monitoring of cognitive late effects.
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