Pediatric brain tumors are the second most common cancer diagnosis in individuals under the age of 20 (Mulhern & Butler, 2004). Modifications in treatment protocols have resulted in an increase in the overall survival rate to approximately 72.5% (CBTRUS, 2011); however, research has documented significant late effects in the areas of neurocognitive functioning, psychosocial functioning, and emotional functioning. The associations among deficits in these areas have yet to be adequately considered, and the role of survivors’ coping responses in the manifestation of these deficits is unknown. Further, research has yet to examine the neurobiological underpinnings of neurocognitive, psychosocial and emotional difficulties in survivors of pediatric brain tumors through the use of neuroimaging techniques.
These two studies use neurocognitive assessment, questionnaire measures, and functional neuroimaging techniques to examine the neurocognitive, psychosocial, and emotional functioning, and coping responses, of survivors of pediatric brain tumors (age 8 to 16 years). Analyses included between-group comparisons of brain tumor survivors (n = 7) relative to healthy controls (n = 7), and within group examination of the associations among these areas of deficit in a sample of 17 brain tumor survivors. Between-group analyses suggest differences in neurocognitive functioning, identifiable through both assessment and working memory task completion during functional neuroimaging, as well as differences in patterns of brain activation between brain tumor survivors and controls. Within-group analyses suggest that survivors experience neurocognitive, psychosocial, and emotional difficulties, and that increases in brain activation in prefrontal, anterior cingulate, and parietal regions are associated with better psychosocial and emotional functioning, and use of engagement coping responses.
These studies replicate prior research documenting late effects in survivors of pediatric brain tumors, and extend this area of research by examining underlying neurobiological processes. These findings contribute to our understanding of these difficulties in survivors, and provide a foundation for research exploring these associations and mediators of the emergence of deficits, with the end goal of improving the post-treatment experience for survivors.