Presurgical assessment of cognitive function in pediatric brain tumor patients: feasibility and initial findings.
BACKGROUND
Establishing a presurgical baseline of neurocognitive functioning for pediatric brain tumor patients is a high priority to identify level of functioning prior to medical interventions. However, few studies have obtained adequate samples of presurgery assessments.


METHODS
This study examines the feasibility of completing tests to assess pre-surgical neurocognitive functioning in 59 identified pediatric brain tumor patients.


RESULTS
Eighty-five percent of patients (n= 50) were referred by the neurosurgery team before surgery and 83% of patients (n= 49) enrolled in the study. A full battery, includingbothperformance-based and parent-report measures of neurocognitive function, was completed for 54% (n= 32) of patients. Rates of completion foreitherparent-report or performance-based measures were 68% (n= 40) and 69% (n= 41), respectively. While the performance-based assessment fell within the average range (M = 95.4, SD = 14.7, 95% CI, 90.7-100.0), 32% of participants had scores one or more standard deviations below the mean, or twice the expected rate. Parent-reports indicated higher level of concern than the general population (M = 55.4, SD = 11.3, 95% CI, 51.8-59.0) and found that 35% fell one or more standard deviations above the mean, or more than twice the expected rate.


CONCLUSIONS
Results suggest it is feasible to conduct pre-surgical assessments with a portion of pediatric brain tumor patients upon diagnosis and these results compare favorably with prior research. However, nearly half of identified patients did not receive a full test battery. Identifying barriers to enrollment and participation in research are discussed as well as recommendations for future research.
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Jennifer C
JC
Thigpen
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Matthew
M
Pearson
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Kristen E
KE
Robinson
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Charissa
C
Andreotti
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Jennifer P
JP
Dunbar
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Kelly H
KH
Watson
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Leandra
L
Dejardins
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Lindsay
L
Holmes
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Rebecca
R
Byram
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Claire
C
Fraley
Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN (J.C.T., B.E.C); Department of Neurosurgery , Vanderbilt University Medical Center , Nashville, TN (M.P.); Department of Psychology & Human Development , Vanderbilt University , Nashville, TN (K.E.R., C.A., J.P.D., K.H.W., L.D., L.H., R.B., C.F., B.E.C).
Bruce E
BE
Compas
neurocognitive function; pediatric brain tumors; presurgical assessment