Leiden University Student Repository

Tissing, Margriet (2025)

The course of executive functioning in pediatric non-CNS oncology patients in the first two years after diagnosis: And the role of peripheral neuropathy on this course

Master thesis | Psychology (MSc)

Pediatric oncology patients with tumors outside their central nervous system may be at risk for neuropsychological impairments, such as executive dysfunctions, which can manifest shortly after diagnosis. Oncology treatments can induce peripheral neuropathy, characterized by damaged nerves, which can result in sensory and motor complaints. Previously, peripheral neuropathy has been associated with cognitive impairments, including executive dysfunctions. Understanding the progression of executive dysfunctions and identifying associated risk factors, such as neuropathy, is crucial for early intervention. This longitudinal study investigated executive functioning in pediatric non-CNS oncology patients over the first two years post-diagnosis. Participants (N = 110), aged 6-18 years at diagnosis (M = 11.7; SD = 3.7), were assessed at three time-points (3-6, 6-12, and 12-18 months) post-diagnosis. 40 participants (36%) experienced peripheral neuropathy. Executive functions were measured...Show morePediatric oncology patients with tumors outside their central nervous system may be at risk for neuropsychological impairments, such as executive dysfunctions, which can manifest shortly after diagnosis. Oncology treatments can induce peripheral neuropathy, characterized by damaged nerves, which can result in sensory and motor complaints. Previously, peripheral neuropathy has been associated with cognitive impairments, including executive dysfunctions. Understanding the progression of executive dysfunctions and identifying associated risk factors, such as neuropathy, is crucial for early intervention. This longitudinal study investigated executive functioning in pediatric non-CNS oncology patients over the first two years post-diagnosis. Participants (N = 110), aged 6-18 years at diagnosis (M = 11.7; SD = 3.7), were assessed at three time-points (3-6, 6-12, and 12-18 months) post-diagnosis. 40 participants (36%) experienced peripheral neuropathy. Executive functions were measured using neuropsychological tests and a questionnaire. Linear Mixed Models, examining the change over time in executive functions, revealed significant improvements on the neuropsychological tests of working memory (p < .001) and the reaction times of planning (p < .001), inhibition (p = .010), and cognitive flexibility (p < .001) over the first years post-diagnosis. Older age at diagnosis was associated with better cognitive flexibility (p = .042). Males made fewer errors in cognitive flexibility (p = .016). After correcting for multiple testing, improvements over time in working memory and planning and flexibility reaction times remained significant. No significant interaction effects were found between peripheral neuropathy and time on executive functioning. Contrary to hypotheses, executive functioning did not deteriorate over time; instead, improvements were observed in some domains. The hypothesis that neuropathy would exacerbate declines in executive functioning was not supported. Although these findings contrasted with some previous long-term survivors’ studies, they aligned with research showing initial improvements post-diagnosis. Practice effects due to repeated exposure to the same tests may explain some of the observed improvements. The study's strengths include its longitudinal design and comprehensive assessment approach, but limitations such as potential sample heterogeneity were noted. Future research should consider factors such as socio-economic status and the severity and duration of treatments and neuropathy to better understand their impacts on executive functioning.Show less

Author

Tissing, Margriet

Faculty

Faculty of Social & Behavioural Sciences

Specialisation

Clinical Neuropsychology

Supervisors

Becker, J.M.

ECTS Credits

20

Language

en