Identifying patterns of neurocognitive dysfunction through direct comparison of children with leukemia, central nervous system tumors, and sickle cell disease

Abstract

AbstractPurposeTo quantify and compare the magnitude and type of neurocognitive dysfunction in at‐risk children with central nervous system (CNS) tumors, acute lymphoblastic leukemia (ALL), and sickle cell disease (SCD) using a common instrument and metric to directly compare these groups with each other.MethodsFifty‐three participants between the ages of 7 and 12 years (n = 27 ALL, n = 11 CNS tumor, n = 15 SCD) were enrolled and assessed using the NIH Toolbox Cognition Battery (NIHTCB). Participants with ALL or CNS tumor were 0–18 months posttherapy, while participants with SCD possessed the SS or Sβ0 genotype, took hydroxyurea, and had no known history of stroke.ResultsIndependent sample t‐tests showed that participants with ALL and CNS tumor experienced greatest deficits in processing speed (ALL d = −0.96; CNS tumor d = −1.2) and inhibitory control and attention (ALL d = −0.53; CNS tumor d = −0.97) when compared with NIHTCB normative data. Participants with SCD experienced deficits in cognitive flexibility only (d = −0.53). Episodic memory was relatively spared in all groups (d = −0.03 to −0.32). There were no significant differences in function when groups were compared directly with each other by analysis of variance.ConclusionsUse of a common metric to quantify the magnitude and type of neurocognitive dysfunction across at‐risk groups of participants by disease shows that participants perform below age‐expected norms in multiple domains and experience dysfunction differently than one another. This approach highlights patterns of dysfunction that can inform disease‐ and domain‐specific interventions.