title: Slower processing speed after treatment for pediatric brain tumor and acute lymphoblastic leukemia.
abstract: BACKGROUND
  Acute lymphoblastic leukemia (ALL) and brain tumor (BT) survivors are at risk for post-treatment IQ declines. The extent to which lower scores represent global cognitive decline versus domain-specific impairment remains unclear. This study examined discrepancies between processing speed and estimated IQ (EIQ) scores and identified clinical characteristics associated with score discrepancies in a sample of pediatric cancer survivors.
  
  
  METHODS
  Survivors (50 ALL, 50 BT) ages 12-17 years completed cognitive testing. The Wechsler Abbreviated Scale of Intelligence provided an untimed measure of general reasoning ability (EIQ). The age-appropriate Wechsler Intelligence Scale provided a Processing Speed Index (PSI) score. Scores were examined and compared.
  
  
  RESULTS
  Survivors' PSI scores were lower than their EIQ scores (BT t(45) =6.3, p<0.001; ALL t(49) =6.9, p<0.001). For BT survivors, lower PSI scores were associated with history of craniospinal irradiation, t(44) =3.3, p<0.01. For ALL survivors, lower PSI scores were associated with male gender, grade retention, and time since diagnosis, F(3, 46) =10.1, p<0.001. Clinically significant EIQ-PSI score discrepancies were identified in 41.3% of BT and 14.0% of ALL survivors.
  
  
  CONCLUSIONS
  Many pediatric BT and ALL survivors exhibit slower processing speed than expected for age, whereas general reasoning ability remains largely intact. Risk factors associated with larger EIQ-PSI discrepancies include the following: BT diagnosis, craniospinal irradiation (BT only), male gender, and younger age at diagnosis (ALL only). Grade retention was frequent and associated with lower EIQ scores (both groups) and PSI scores (ALL only). Describing post-treatment cognitive declines using global measures of intellectual ability may underestimate dysfunction or fail to isolate specific underlying deficits contributing to impairment.
authors: Department of Pediatrics, Section of Psychology, Baylor College of Medicine, Houston, TX, USA. Lskahall@texaschildrens.org
authors: Lisa S
authors: LS
authors: Kahalley
authors: Heather M
authors: HM
authors: Conklin
authors: Vida L
authors: VL
authors: Tyc
authors: Melissa M
authors: MM
authors: Hudson
authors: Stephanie J
authors: SJ
authors: Wilson
authors: Shengjie
authors: S
authors: Wu
authors: Xiaoping
authors: X
authors: Xiong
authors: Pamela S
authors: PS
authors: Hinds
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000970:Antineoplastic Agents / Q000009:adverse effects; D001932:Brain Neoplasms / Q000150:complications / Q000523:psychology* / Q000628:therapy; D002648:Child; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000523:psychology* / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects; D012737:Sex Factors; D017741:Survivors / Q000523:psychology*; D013997:Time Factors; D014888:Wechsler Scales
chemical_list: D000970:Antineoplastic Agents
keywords: intelligence; late effects of cancer treatment; pediatric hematology/oncology; processing speed