Cognitive performance and medical (traumatic) stress within one year after diagnosis in pediatric brain tumor patients

Background. Pediatric brain tumor patients are known to experience cognitive problems. It is important to recognize that pediatric cancer patients and their families face significant distress from the moment of diagnosis. The early screening and treatment of stress symptoms may help to reduce cognitive problems and improve the quality of life for pediatric brain tumor survivors. The main aim for this thesis was to evaluate whether there is an association between medical (traumatic) stress and cognition, within the first year of diagnosis in pediatric brain tumor patients. It was hypothesized that on average, cognitive performance and stress would improve and that patients with persistent stress or increased medical (traumatic) stress would experience more cognitive difficulties. Method. The longitudinal study included 74 pediatric brain tumor patients. Stress was measured with a questionnaire and cognition was measured with neuropsychological assessments on the cognitive domains of...Show moreBackground. Pediatric brain tumor patients are known to experience cognitive problems. It is important to recognize that pediatric cancer patients and their families face significant distress from the moment of diagnosis. The early screening and treatment of stress symptoms may help to reduce cognitive problems and improve the quality of life for pediatric brain tumor survivors. The main aim for this thesis was to evaluate whether there is an association between medical (traumatic) stress and cognition, within the first year of diagnosis in pediatric brain tumor patients. It was hypothesized that on average, cognitive performance and stress would improve and that patients with persistent stress or increased medical (traumatic) stress would experience more cognitive difficulties. Method. The longitudinal study included 74 pediatric brain tumor patients. Stress was measured with a questionnaire and cognition was measured with neuropsychological assessments on the cognitive domains of attention, executive functioning, processing speed, and memory. Patients participated at two time points, shortly after diagnosis and one year after diagnosis. One-sample t-tests were used to compare the z-scores of the cognitive domains at both time points. Paired t-tests were used to examine stress and cognition over one year. To examine an association a linear mixed model was performed, predictors included stress and time since diagnosis. Results. On average, medical (traumatic) stress improved over one year, with a subgroup of patients experiencing increased and/or persistent stress throughout the year. The cognitive domain of attention was mostly impaired with no improvement over one year. Executive functioning and processing were mostly impaired at the beginning of diagnosis, with improvements over one year. Memory was not impaired. Moreover, there was no association found between medical (traumatic) stress and cognition. Conclusion. This study showed that it is important to test for cognitive performance and medical (traumatic) stress shortly after diagnosis and over the course of one year. New insights from early testing could benefit clinical implications and interventions to improve the quality of life. For future research, objective measures of medical (traumatic) stress and a healthy matched control group should be added.Show less

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Cognitive performance and medical (traumatic) stress within one year after diagnosis in pediatric brain tumor patients