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Doger de Spéville E, Kieffer V, Dufour C, Grill J, Noulhiane M, Hertz-Pannier L, Chevignard M. Neuropsychological consequences of childhood medulloblastoma and possible interventions: A review. Neurochirurgie 2018; 67:90-98. [PMID: 29716738 DOI: 10.1016/j.neuchi.2018.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/11/2018] [Accepted: 03/03/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Children who have been treated for a medulloblastoma often suffer long-term cognitive impairments that often negatively affect their academic performance and quality of life. In this article, we will review the neuropsychological consequences of childhood medulloblastoma and discuss the risk factors known to influence the presence and severity of these cognitive impairments and possible interventions to improve their quality of life. METHODS This narrative review was based on electronic searches of PubMed to identify all relevant studies. RESULTS Although many types of cognitive impairments often emerge during a child's subsequent development, the core cognitive domains that are most often affected in children treated for a medulloblastoma are processing speed, attention and working memory. The emergence and magnitude of these deficits varies greatly among patients. They are influenced by demographic (age at diagnosis, parental education), medical and treatment-related factors (perioperative complications, including posterior fossa syndrome, radiation therapy dose, etc.), and the quality of interventions such as school adaptations provided to the child or rehabilitation programs that focus on cognitive skills, behavior and psychosocial functioning. CONCLUSION These patients require specialized and coordinated multidisciplinary rehabilitation follow-up that provides timely and adapted assessments and culminates in personalized intervention goals being set with the patient and the family. Follow-up should be continued until referral to adult services.
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Affiliation(s)
- E Doger de Spéville
- Inserm U1129, CEA, Paris Descartes university, 75005 Paris, France; UNIACT, institut Joliot, DRF, Neurospin, CEA, Paris Saclay university, 91190 Gif-sur-Yvette, France; Department of pediatric and adolescent oncology, Gustave-Roussy, 94800 Villejuif, France
| | - V Kieffer
- Department of pediatric and adolescent oncology, Gustave-Roussy, 94800 Villejuif, France; CSI (Outreach team for children and adolescents with acquired brain injury), department for children with acquired brain injury, hôpitaux de Saint-Maurice, 94410 Saint-Maurice, France
| | - C Dufour
- Department of pediatric and adolescent oncology, Gustave-Roussy, 94800 Villejuif, France
| | - J Grill
- Department of pediatric and adolescent oncology, Gustave-Roussy, 94800 Villejuif, France
| | - M Noulhiane
- Inserm U1129, CEA, Paris Descartes university, 75005 Paris, France; UNIACT, institut Joliot, DRF, Neurospin, CEA, Paris Saclay university, 91190 Gif-sur-Yvette, France
| | - L Hertz-Pannier
- Inserm U1129, CEA, Paris Descartes university, 75005 Paris, France; UNIACT, institut Joliot, DRF, Neurospin, CEA, Paris Saclay university, 91190 Gif-sur-Yvette, France
| | - M Chevignard
- CSI (Outreach team for children and adolescents with acquired brain injury), department for children with acquired brain injury, hôpitaux de Saint-Maurice, 94410 Saint-Maurice, France; Rehabilitation department for children with acquired neurological injury, and outreach team for children and adolescents with acquired brain injury, Saint-Maurice hospitals, 14, rue du Val-d'Osne, 94410 Saint-Maurice, France; Sorbonne université, laboratoire d'imagerie biomédicale, LIB, 75006 Paris, France; GRC n(o) 18, handicap cognitif et réadaptation (HanCRe)- Sorbonne université, 75013 Paris, France.
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Abstract
BACKGROUND There is an increasing need to assess the evidence of a multidisciplinary approach for both short-term and long-term management of neurological sequelae arising from the diagnosis and treatment of brain tumors in childhood. METHODS We performed a systematic review of the evidence base for multidisciplinary paediatric brain tumor rehabilitation using seven databases. PRISMA guidelines were adhered to and the review was registered with the PROSPERO international prospective register of systematic reviews (registration number CRD42014015070). RESULTS The literature search identified 3,061 results. Three service evaluations were included. The review identified limited evidence in favor of multidisciplinary rehabilitation for children with brain tumors. Due to the lack of controlled trial data and heterogeneity of the interventions and outcome measures, no meta-analysis could be performed. CONCLUSIONS Studies utilising a coordinated multi-centre approach with standardized outcome measures are recommended in order to enable robust assessment of the efficacy of multidisciplinary rehabilitation services.
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Affiliation(s)
- Daniel M Fountain
- a Brainbow Neurorehabilitation Service, Department of Paediatric Haematology , Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK and.,b Clinical School, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK
| | - G A Amos Burke
- a Brainbow Neurorehabilitation Service, Department of Paediatric Haematology , Oncology and Palliative Care, Cambridge University Hospitals NHS Foundation Trust , Cambridge , UK and
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Chevignard M. Children with brain tumours need long-term multidisciplinary psychosocial, neurocognitive, academic and rehabilitation follow-up programmes. Acta Paediatr 2016; 105:574-5. [PMID: 27153366 DOI: 10.1111/apa.13245] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury; Saint Maurice Hospitals; Saint Maurice France
- Sorbonne Universités; UPMC Univ Paris 06; CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB); Paris France
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Bonneau J, Dugas K, Louis A, Morel L, Toughza J, Frappaz D. [Educational and social outcome after childhood cancer]. Bull Cancer 2015; 102:691-7. [PMID: 25917346 DOI: 10.1016/j.bulcan.2015.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 03/22/2015] [Indexed: 11/26/2022]
Abstract
The survival rate improvement of childhood cancer survivors lead to question about their educational and social outcome. Authors suggest an international review in order to find risk factors of school or social failure after cancer experience. Principal cohort is studied in USA (the Children Cancer Survivor Study). Nevertheless, European studies are also published. The results vary, depending on subpopulation studied and on control choice (siblings or general population). Treatment improvement and supportive care make difficult to compare studies with current situations. Moreover, there are not international standard of education or social outcome. School and social behaviour are influenced by: types of tumor (cerebral tumor but also sometimes hemopathy and osteosarcoma), age at diagnosis (very young children and adolescent), treatments (neurotoxical treatments, hematopoietic stem cell transplant), and social or educational status of the parents.
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Affiliation(s)
- Jacinthe Bonneau
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France.
| | - Karyn Dugas
- CHU de Pellegrin, maison Aquitaine ressources pour les adolescents et jeunes adultes (MARADJA), 33000 Bordeaux, France
| | - Aurélien Louis
- Centre hospitalier de Chalon-sur-Saône, unité de Pédiatrie, 71321 Chalon-sur-Saone, France
| | - Laëtitia Morel
- CHU, hôpital Sud, unité d'hématologie oncologie pédiatrique, 35203 Rennes, France
| | - Jihane Toughza
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
| | - Didier Frappaz
- Institut hématologie oncologie pédiatrique (IHOP), oncologie pédiatrique, 69008 Lyon, France
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Guichardet K, Kieffer V, Lyard G, Pagnier A, Dufour C. [Neurocognitive outcome in childhood brain tumor survivors]. Bull Cancer 2015; 102:636-41. [PMID: 25866371 DOI: 10.1016/j.bulcan.2015.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/18/2015] [Indexed: 10/23/2022]
Abstract
Advances in treatment have significantly improved the survival rate of children with brain tumour. This review describes risk factors of late neurocognitive effect, the different type of neurocognitive side effect according to the type of tumour and the rehabilitation. The best knowledge of cognitive sequelae allowed to propose supported appropriate and specific disorders including school facilities for younger and adaptation of professional situation for adults. Furthermore, this understanding allows to link with the patient's quality of life and to approach the person in its specificity and overall.
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Affiliation(s)
- Karine Guichardet
- CHU de Grenoble, unité d'immuno-onco-hématologie pédiatre, 38043 Grenoble cedex 09, France.
| | - Virginie Kieffer
- Gustave-Roussy, département de cancérologie de l'enfant et de l'adolescent, 114, avenue Édouard-Vaillant, 94805 Villejuif, France; Hôpitaux de Saint-Maurice, centre de suivi et d'insertion pour enfants et adolescents avec lésions cérébrales acquises, 14-19, rue du val d'Osne, 94415 Saint-Maurice, France
| | - Geneviève Lyard
- CHU de Bordeaux Pellegrin, service d'oncologie pédiatrique, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - Anne Pagnier
- CHU de Grenoble, unité d'immuno-onco-hématologie pédiatre, 38043 Grenoble cedex 09, France
| | - Christelle Dufour
- Gustave-Roussy, département de cancérologie de l'enfant et de l'adolescent, 114, avenue Édouard-Vaillant, 94805 Villejuif, France
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Kieffer V, Longaud A, Callu D, Laroussinie F, Viguier D, Grill J, Dellatolas G. Teachers’ report of learning and behavioural difficulties in children treated for cerebellar tumours. Brain Inj 2012; 26:1014-20. [DOI: 10.3109/02699052.2012.661116] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chevignard M, Toure H, Brugel DG, Poirier J, Laurent-Vannier A. A comprehensive model of care for rehabilitation of children with acquired brain injuries. Child Care Health Dev 2010; 36:31-43. [PMID: 19438875 DOI: 10.1111/j.1365-2214.2009.00949.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acquired brain injury (ABI) is a leading cause of death and lifelong acquired disability in children and remains a significant public health issue. Deficits may only become fully apparent when developmental demands increase and once cognitive processes are expected to be fully developed. It is therefore necessary to provide organized long-term follow-up for children post ABI. Despite these recommendations, it has been shown that only a small proportion of children received specialized rehabilitation and adequate follow-up after ABI. AIMS The aims are: (i) to describe a comprehensive model of care devoted to children with acquired brain injuries; and (ii) to provide descriptive data analysing the characteristics of children followed up, the type/amount of services provided and general outcomes. PROGRAMME DESCRIPTION The programme features an in- and outpatient rehabilitation facility, where multidisciplinary rehabilitation and specialized schooling are provided. The ultimate goal of the programme is to promote each child's successful reintegration in school and in the community. Adequate preparation of discharge is essential, long-term follow-up is organized, and an outreach programme has been developed to deal with the complex delayed psychosocial issues. RESULTS Overall outcome, as measured by the Glasgow Outcome Scale, improved dramatically between admission (3.3; SD = 0.45) and discharge (2.15; SD = 0.74). Most of the children were discharged home with an adequate personalized plan for ongoing rehabilitation and school adaptations. Analysis of the outreach programme underlines the more challenging issues arising in late adolescence-early adulthood. CONCLUSION Given the specificities of childhood ABI, long-term specific care must be organized and co-ordinated, regardless of injury severity.
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Affiliation(s)
- M Chevignard
- Physical Medicine and Rehabilitation Department for children with acquired neurological injuries, Hôpital National de Saint Maurice, 14, rue du Val d'Osne, 94415 Saint Maurice, France.
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Cognitive and Academic Outcome After Benign or Malignant Cerebellar Tumor in Children. Cogn Behav Neurol 2009; 22:270-8. [DOI: 10.1097/wnn.0b013e3181bf2d4c] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Grill J, Puget S, De Carli E, Amoroso L, Taylor M, Brauner R, Leblond P, Kieffer V, Laurent-Vannier A, Dufour C, Bourgeois M, Wicart P, Dhermain F, Oppenheim D, Sainte-Rose C, Kalifa C. Tumeurs cérébrales de l’enfant : morbidité et suivi à l’âge adulte. Neurochirurgie 2008; 54:623-41. [DOI: 10.1016/j.neuchi.2008.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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