title: Cognitive dysfunction in children with brain tumors at diagnosis.
abstract: BACKGROUND
  Survivors of brain tumors have a high risk for a wide range of cognitive problems. These dysfunctions are caused by the lesion itself and its surgical removal, as well as subsequent treatments (chemo- and/or radiation therapy). Multiple recent studies have indicated that children with brain tumors (BT) might already exhibit cognitive problems at diagnosis, i.e., before the start of any medical treatment. The aim of the present study was to investigate the baseline neuropsychological profile in children with BT compared to children with an oncological diagnosis not involving the central nervous system (CNS).
  
  
  METHODS
  Twenty children with BT and 27 children with an oncological disease without involvement of the CNS (age range: 6.1-16.9 years) were evaluated with an extensive battery of neuropsychological tests tailored to the patient's age. Furthermore, the child and his/her parent(s) completed self-report questionnaires about emotional functioning and quality of life. In both groups, tests were administered before any therapeutic intervention such as surgery, chemotherapy, or irradiation. Groups were comparable with regard to age, gender, and socioeconomic status.
  
  
  RESULTS
  Compared to the control group, patients with BTs performed significantly worse in tests of working memory, verbal memory, and attention (effect sizes between 0.28 and 0.47). In contrast, the areas of perceptual reasoning, processing speed, and verbal comprehension were preserved at the time of measurement.
  
  
  CONCLUSIONS
  Our results highlight the need for cognitive interventions early in the treatment process in order to minimize or prevent academic difficulties as patients return to school.
authors.affiliation: Department of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Bern, Switzerland.|Center of Cognition, Learning and Memory, University of Berne, Bern, Switzerland.
authors.forename: Katja
authors.initials: K
authors.lastname: Margelisch
authors.affiliation: Department of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Bern, Switzerland.|Center of Cognition, Learning and Memory, University of Berne, Bern, Switzerland.
authors.forename: Martina
authors.initials: M
authors.lastname: Studer
authors.affiliation: Department of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Bern, Switzerland.|Center of Cognition, Learning and Memory, University of Berne, Bern, Switzerland.
authors.forename: Barbara Catherine
authors.initials: BC
authors.lastname: Ritter
authors.affiliation: Department of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Bern, Switzerland.|Center of Cognition, Learning and Memory, University of Berne, Bern, Switzerland.
authors.forename: Maja
authors.initials: M
authors.lastname: Steinlin
authors.affiliation: Department of Pediatric Hematology/Oncology, Children's University Hospital, Bern, Switzerland.
authors.forename: Kurt
authors.initials: K
authors.lastname: Leibundgut
authors.affiliation: Department of Neuropediatrics, Development and Rehabilitation, Children's University Hospital, Bern, Switzerland.|Center of Cognition, Learning and Memory, University of Berne, Bern, Switzerland.
authors.forename: Theda
authors.initials: T
authors.lastname: Heinks
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests
keywords: at diagnosis; attention; cognitive problems; memory; pediatric brain tumor