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Journal of Pediatric Psychology Advance Access originally published online on February 28, 2007
Journal of Pediatric Psychology 2007 32(9):1040-1049; doi:10.1093/jpepsy/jsl056
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Understanding the Cognitive Impact on Children Who are Treated for Medulloblastoma

Shawna L. Palmer, PhD, Wilburn E. Reddick, PhD and Amar Gajjar, MD

St. Jude Children's Research Hospital, Memphis, TN

All correspondence concerning this article should be addressed to Shawna L. Palmer, Division of Behavioral Medicine, St. Jude Children's Research Hospital, 332 North Lauderdale Street, Memphis, TN, 38105. E-mail: shawna.palmer{at}stjude.org.


  Abstract

Objective Risk-adapted treatment approaches employed within contemporary medulloblastoma treatment protocols aim to reduce the neurotoxicity directed at the central nervous system. Despite these important steps to reduce radiation dose exposure, an overwhelming majority of medulloblastoma survivors continue to experience academic failure and significant learning delays. Methods A review of the current literature is presented. Results Deficits in intellectual function, academic achievement, memory, attention, and processing speed are reported. Finally, intervention programs, including pharmacotherapy and experimental cognitive intervention studies, are discussed. A review of neuroimaging studies shows changes in brain tissue following chemotherapy and radiation treatment. Conclusions Declining IQ and academic struggles may be predated by difficulties with attention, memory, and processing speed. More clinical trials directed at treating and preventing neurocognitive late effects through cognitive rehabilitation are needed.

Key words: brain tumor; cognitive deficits; late effects; medulloblastoma.

Received November 20, 2006; accepted December 26, 2006


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