Cognitive disorders and correction options in children, who survived posterior fossa tumors: Analytical review

Abstract

This work presents the analytical review, which systematizes literature on the problems of pediatric neuro-oncology, cognitive deficits, and rehabilitation possibilities of cognitive functions in children, who survived brain tumors. Oncology remains one of the leading causes of child mortality all over the world. The most common oncological diagnoses among children are malignant tumors of the brain, in particular the tumor appearing in the posterior fossa, which is called medulloblastoma. Treatment of medulloblastoma includes surgery, as well as radiation therapy (craniospinal irradiation) and polychemotherapy. Current methods of treating oncological diseases led to significant increase of survival rates. However, patients often have negative consequences and late side-effects in cognitive, motor, personality and social spheres. Negative effects can be caused both by the tumor itself and the treatment. The most important and maladaptive consequence of the disease is the decrease of cognitive functions: attention, working memory, speech, executive control functions. In particular, there are observed such impairments as the decrease of the volume of working memory and information processing speed; deficiency in the visuospatial function, metacognitive functions, speech, planning and executive control. Due to the obvious cognitive deficiency in children, who survived posterior fossa tumors, the level of academic performance, social adaptation and quality of life in general are influenced negatively and remain impaired for a long period of time. Taking into account the potential impact of these disorders on the children’s everyday performance, the urgent issue in the fields of neuro-oncology and clinical psychology is to develop programs for rehabilitation of the impaired functions. The literature demonstrates the effectiveness and feasibility of training of such cognitive functions as working memory, short-term memory, attention, information processing speed, cognitive flexibility. Rehabilitation programs aimed at cognitive functions can use digital technologies, physical exercises, biological feedback, an interdisciplinary approach, providing positive academic environment. The results reported in the papers show the effectiveness of individual rehabilitation programs for the recovery and development of cognitive functions. However, further studies are necessary to develop comprehensive rehabilitation programs and evaluate their applicability in children, who survived posterior fossa tumors.