Abstract

Research shows promise for cognitive interventions for children diagnosed with brain tumors. Interventions have been delivered approximately 5 years postdiagnosis on average, yet recent evidence shows cognitive deficits may appear near diagnosis. The present study assessed the feasibility and initial effects of working memory training in children with brain tumors delivered soon after diagnosis and followed 2 years postdiagnosis. Children completed baseline assessments 10 months postdiagnosis and were randomized to complete adaptive or nonadaptive (i.e., control) Cogmed Working Memory Training. Children were administered the WISC-IV Working Memory Index (WMI) and NIH Toolbox Cognitive Battery (NTCB), and parents completed attentional and executive function measures at four time points. On average, participants completed half of prescribed Cogmed sessions. Retention for the three follow-up assessments proved difficult. For both Cogmed groups, WMI and NTCB scores significantly improved immediately postintervention compared to baseline scores. Significant differences were not maintained at the remaining follow-ups. There was preliminary evidence for improved executive function at the final follow-up on parent-reported measures. Working memory training closer to diagnosis proved difficult, though results suggest evidence of cognitive improvement. Future studies should continue to examine potentially efficacious interventions for children with brain tumors and optimal delivery windows to maximize impact.

摘要

研究表明，对被诊断患有脑肿瘤的儿童进行认知干预很有希望。干预措施平均在诊断后约 5 年进行，但最近的证据表明认知缺陷可能出现在诊断附近。本研究评估了在诊断后不久进行的脑肿瘤患儿工作记忆训练的可行性和初步效果，并在诊断后 2 年随访。儿童在诊断后 10 个月完成基线评估，并被随机分配到完成自适应或非自适应（即控制）Cogmed 工作记忆训练。儿童接受了 WISC-IV 工作记忆指数 (WMI) 和 NIH 工具箱认知电池 (NTCB)，父母在四个时间点完成了注意力和执行功能测量。一般，参与者完成了规定的 Cogmed 会话的一半。三项后续评估的保留证明是困难的。对于 Cogmed 组，WMI 和 NTCB 评分与基线评分相比，干预后立即显着提高。在其余的随访中没有保持显着差异。在对家长报告的措施进行最终随访时，初步证据表明执行功能有所改善。更接近诊断的工作记忆训练被证明是困难的，尽管结果表明认知改善的证据。未来的研究应继续检查对脑肿瘤儿童的潜在有效干预措施和最佳分娩窗口，以最大限度地发挥影响。与基线评分相比，WMI 和 NTCB 评分在干预后立即显着提高。在其余的随访中没有保持显着差异。在对家长报告的措施进行最终随访时，初步证据表明执行功能有所改善。更接近诊断的工作记忆训练被证明是困难的，尽管结果表明认知改善的证据。未来的研究应继续检查对脑肿瘤儿童的潜在有效干预措施和最佳分娩窗口，以最大限度地发挥影响。与基线评分相比，WMI 和 NTCB 评分在干预后立即显着提高。在其余的随访中没有保持显着差异。在对家长报告的措施进行最终随访时，初步证据表明执行功能有所改善。更接近诊断的工作记忆训练被证明是困难的，尽管结果表明认知改善的证据。未来的研究应继续检查对脑肿瘤儿童的潜在有效干预措施和最佳分娩窗口，以最大限度地发挥影响。更接近诊断的工作记忆训练被证明是困难的，尽管结果表明认知改善的证据。未来的研究应继续检查对脑肿瘤儿童的潜在有效干预措施和最佳分娩窗口，以最大限度地发挥影响。更接近诊断的工作记忆训练被证明是困难的，尽管结果表明认知改善的证据。未来的研究应继续检查对脑肿瘤儿童的潜在有效干预措施和最佳分娩窗口，以最大限度地发挥影响。