NCOG-11. COMPARISON OF NEUROCOGNITIVE FUNCTIONING IN PEDIATRIC BRAIN TUMOR SURVIVORS AND CHILDREN WITH NEURODEVELOPMENTAL ADHD

Abstract

BACKGROUND: Attention and working memory symptoms are among the most common late effects in survivors of pediatric brain tumors (BT). These difficulties lead to declines in academic and social functioning, as well as quality of life. In order to facilitate identification of these deficits and development of treatments, an ADHD framework has frequently been applied to the pediatric BT population, but it is unclear the extent to which the cognitive phenotypes overlap between these groups. The present study is the first to directly compare neurocognition in BT survivors and children with neurodevelopmental ADHD. METHOD(S): Neuropsychological data from clinically-referred samples of BT survivors (n=109, Mage=11.89, 51.4% male) and children with ADHD (n=184, Mage=11.08, 64.1% male) were abstracted. Data consists of a battery of parent-report questionnaires and performance-based measures of attention and executive functioning. RESULT(S): Survivors averaged 5.98 years (SD=3.91) at diagnosis, and were evaluated 5.63 (SD=3.29) years later. Tumor types varied, with the most common being medulloblastoma (18.5%), ependymoma (16.7%), and lowgrade glioma (13.9%); 63.1% received radiation therapy and 77.6% underwent surgical resection. Twenty-six survivors (23.9%) met symptom criteria for ADHD. Participants with neurodevelopmental ADHD and survivors who met ADHD criteria had significantly greater parent- (p<0.001) and teacherreported (p<0.001) working memory and behavior regulation difficulties than survivors who did not meet criteria. Children with ADHD and survivors with ADHD symptoms also performed worse on measures of sustained attention than survivors without ADHD symptoms (p<0.001). Additionally, survivors with ADHD symptoms had greater performance-based working memory difficulties than survivors without attention problems and children with neurodevelopmental ADHD (p=0.002). CONCLUSION(S): While some neurocognitive deficits are pervasive among survivors, a subset have attention and working memory problems that are similar to those observed in children with ADHD. Screening for ADHD symptoms could potentially help providers and investigators better identify and intervene with this at-risk group.