title: Processing speed, attention, and working memory after treatment for medulloblastoma: an international, prospective, and longitudinal study.
abstract: OBJECTIVE
  The current study prospectively examined processing speed (PS), broad attention (BA), and working memory (WM) ability of patients diagnosed with medulloblastoma over a 5-year period.
  
  
  METHODS
  The study included 126 patients, ages 3 to 21 years at diagnosis, enrolled onto a collaborative protocol for medulloblastoma. Patients were treated with postsurgical risk-adapted craniospinal irradiation (n = 36 high risk [HR]; n = 90 average risk) followed by four cycles of high-dose chemotherapy with stem-cell support. Patients completed 509 neuropsychological evaluations using the Woodcock-Johnson Tests of Cognitive Abilities Third Edition (median of three observations per patient).
  
  
  RESULTS
  Linear mixed effects models revealed that younger age at diagnosis, HR classification, and higher baseline scores were significantly associated with poorer outcomes in PS. Patients treated as HR and those with higher baseline scores are estimated to have less favorable outcomes in WM and BA over time. Parent education and marital status were significantly associated with BA and WM baseline scores but not change over time.
  
  
  CONCLUSIONS
  Of the three key domains, PS was estimated to have the lowest scores at 5 years after diagnosis. Identifying cognitive domains most vulnerable to decline should guide researchers who are aiming to develop efficacious cognitive intervention and rehabilitation programs, thereby improving the quality of survivorship for the pediatric medulloblastoma population.
authors: Shawna L. Palmer, Arzu Onar-Thomas, Shengjie Wu, Dana Wallace, Jane Schreiber, and Amar Gajjar, St Jude Children's Research Hospital, Memphis, TN; Carol Armstrong, Children's Hospital of Philadelphia, Philadelphia, PA; Melanie J. Bonner, Duke University Medical Center, Durham, NC; Lynn Chapieski, Texas Children's Hospital, Houston, TX; Michelle Swain, Royal Children's Hospital of Brisbane, Queensland; Sarah Knight, Royal Children's Hospital of Melbourne, Melbourne, Victoria; Robyn Boyle, Sydney Children's Hospital, Sydney, New South Wales, Australia; and Donald Mabbott, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Shawna L
authors: SL
authors: Palmer
authors: Carol
authors: C
authors: Armstrong
authors: Arzu
authors: A
authors: Onar-Thomas
authors: Shengjie
authors: S
authors: Wu
authors: Dana
authors: D
authors: Wallace
authors: Melanie J
authors: MJ
authors: Bonner
authors: Jane
authors: J
authors: Schreiber
authors: Michelle
authors: M
authors: Swain
authors: Lynn
authors: L
authors: Chapieski
authors: Donald
authors: D
authors: Mabbott
authors: Sarah
authors: S
authors: Knight
authors: Robyn
authors: R
authors: Boyle
authors: Amar
authors: A
authors: Gajjar
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001288:Attention / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects; D002528:Cerebellar Neoplasms / Q000150:complications* / Q000523:psychology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007390:International Agencies; D008137:Longitudinal Studies; D008297:Male; D008527:Medulloblastoma / Q000150:complications* / Q000523:psychology / Q000628:therapy; D008570:Memory, Short-Term / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects; D009483:Neuropsychological Tests; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult
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