Computerized Addenbrooke’s Cognitive Examination for Neurocognitive Monitoring of Children with Benign and Malignant Brain Cerebellar Tumor

Brain tumors in the cerebellum site, especially in the cranial nuclei, are most commonly associated with cognitive impairment in children, but the differences in dimensions of cognitive impairments in pediatric benign and malignant tumors are rarely studied. Meanwhile, cognitive impairments in this area are required to be widely studied. This study aimed at using Computerized Addenbrooke's Cognitive Examination Revised (CACE-R) as an effective and new neurocognitive monitoring tool to diagnose children with benign brain tumors (BBT) and malignant brain tumors (MBT) after surgery.

In the present causal-comparative study, 83 children aged 10 to 14 years old with BBT and MBT, who were treated in Mahak (a pediatric oncology support center in Tehran, Iran) during 6 months, participated. They underwent surgery and fractionated radiotherapy (at a dose of 53 Gy). After meeting the inclusion criteria, they were evaluated by a computerized version of ACE-R.

In this study, 33.33% of children with MBT vs 28.89% of BBT used shunts and 28.89% of them experienced relapse and 22.82% dropped out of school. About 17.77% of mothers were not graduated from high school. These factors predicted the memory, fluency, and language of these children. Furthermore, the results of this study showed a significant difference between children with BBT and MBT in terms of attention/orientation, memory, fluency, language, and visual-spatial abilities in ACE-R (P<0.001).

Children with BBT compared with those with MBT experienced more problems in attention-orientation function, short- and long-term memory, fluency, language, and spatial-visual ability. These results emphasized that only leisure induced by tumor growth did not cause cognitive impairment, but the nature and function of the tumor also contribute to damage of the brain activity.