A systematic review of cognitive interventions for adult patients with brain tumours.

BACKGROUND: Neurocognitive impairments are common in patients with current or previously treated brain tumours, and such impairments can negatively affect patient outcomes including quality of life and survival. This systematic review aimed to identify and describe interventions used to ameliorate (improve) or prevent cognitive impairments in adults with brain tumours. METHODS: We performed a literature search of the Ovid MEDLINE, PsychINFO and PsycTESTS databases from commencement until September 2021. RESULTS: In total, 9998 articles were identified by the search strategy; an additional 14 articles were identified through other sources. Of these, 35 randomised and nonrandomised studies were deemed to meet the inclusion/exclusion criteria of our review and were subsequently included for evaluation. A range of interventions were associated with positive effects on cognition, including pharmacological agents such as memantine, donepezil, methylphenidate, modafinil, ginkgo biloba and shenqi fuzheng, and nonpharmacological interventions such as general and cognitive rehabilitation, working memory training, Goal Management Training, aerobic exercise, virtual reality training combined with computer-assisted cognitive rehabilitation, hyperbaric oxygen therapy and semantic strategy training. However, most identified studies had a number of methodological limitations and were judged to be at moderate-to-high risk of bias. In addition, it remains unclear whether and to what extent the identified interventions lead to durable cognitive benefits after cessation of the intervention. CONCLUSION: The 35 studies identified in this systematic review have indicated potential cognitive benefits for a number of pharmacological and nonpharmacological interventions in patients with brain tumours. Study limitations were identified and further studies should focus on improved study reporting, methods to reduce bias and minimise participant drop-out and withdrawal where possible, and consider standardisation of methods and interventions across studies. Greater collaboration between centres could result in larger studies with standardised methods and outcome measures, and should be a focus of future research in the field.

Influences on cognitive outcomes in adult patients with gliomas: A systematic review.

People with brain tumors, including those previously treated, are commonly affected by a range of neurocognitive impairments involving executive function, memory, attention, and social/emotional functioning. Several factors are postulated to underlie this relationship, but evidence relating to many of these factors is conflicting and does not fully explain the variation in cognitive outcomes seen in the literature and in clinical practice. To address this, we performed a systematic literature review to identify and describe the range of factors that can influence cognitive outcomes in adult patients with gliomas. A literature search was performed of Ovid MEDLINE, PsychINFO, and PsycTESTS from commencement until September 2021. Of 9,998 articles identified through the search strategy, and an additional 39 articles identified through other sources, 142 were included in our review. The results confirmed that multiple factors influence cognitive outcomes in patients with gliomas. The effects of tumor characteristics (including location) and treatments administered are some of the most studied variables but the evidence for these is conflicting, which may be the result of methodological and study population differences. Tumor location and laterality overall appear to influence cognitive outcomes, and detection of such an effect is contingent upon administration of appropriate cognitive tests. Surgery appears to have an overall initial deleterious effect on cognition with a recovery in most cases over several months. A large body of evidence supports the adverse effects of radiotherapy on cognition, but the role of chemotherapy is less clear. To contrast, baseline cognitive status appears to be a consistent factor that influences cognitive outcomes, with worse baseline cognition at diagnosis/pre-treatment correlated with worse long-term outcomes. Similarly, much evidence indicates that anti-epileptic drugs have a negative effect on cognition and genetics also appear to have a role. Evidence regarding the effect of age on cognitive outcomes in glioma patients is conflicting, and there is insufficient evidence for gender and fatigue. Cognitive reserve, brain reserve, socioeconomic status, and several other variables discussed in this review, and their influence on cognition and recovery, have not been well-studied in the context of gliomas and are areas for focus in future research. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42017072976.

Neural and Cognitive Underpinnings of Counterintuitive Science and Math Reasoning in Adolescence.

Reasoning about counterintuitive concepts in science and math is thought to require suppressing naive theories, prior knowledge, or misleading perceptual cues through inhibitory control. Neuroimaging research has shown recruitment of pFC regions during counterintuitive reasoning, which has been interpreted as evidence of inhibitory control processes. However, the results are inconsistent across studies and have not been directly compared with behavior or brain activity during inhibitory control tasks. In this fMRI study, 34 adolescents (aged 11-15 years) answered science and math problems and completed response inhibition tasks (simple and complex go/no-go) and an interference control task (numerical Stroop). Increased BOLD signal was observed in parietal (Brodmann's area 40) and prefrontal (Brodmann's area 8, 45/47) cortex regions in counterintuitive problems compared with control problems, where no counterintuitive reasoning was required, and in two parietal clusters when comparing correct counterintuitive reasoning to giving the incorrect intuitive response. There was partial overlap between increases in BOLD signal in the complex response inhibition and interference control tasks and the science and math contrasts. However, multivariate analyses suggested overlapping neural substrates in the parietal cortex only, in regions typically associated with working memory and visuospatial attentional demands rather than specific to inhibitory control. These results highlight the importance of using localizer tasks and a range of analytic approach to investigate to what extent common neural networks underlie performance of different cognitive tasks and suggests visuospatial attentional skills may support counterintuitive reasoning in science and math.

The developmental trajectories of spatial skills in middle childhood.

The multidimensional structure of spatial ability remains a debated issue. However, the developmental trajectories of spatial skills have yet to be investigated as a source of evidence within this debate. We tested the intrinsic versus extrinsic and static versus dynamic dimensions of the Uttal et al. (2013, Psychol. Bull., 139, 352) typology in relation to spatial development. Participants (N = 184) aged 6-11 completed spatial tasks chosen to measure these spatial dimensions. The results indicated that the developmental trajectories of intrinsic versus extrinsic skills differed significantly. Intrinsic skills improved more between 6 and 8 years, and 7 and 8 years, than extrinsic skills. Extrinsic skills increased more between 8 and 10 years than intrinsic skills. The trajectories of static versus dynamic skills did not differ significantly. The findings support the intrinsic versus extrinsic, but not the static versus dynamic dimension, of the Uttal et al. (2013, Psychol. Bull., 139, 352) typology.

The Unique Contributions of Verbal Analogical Reasoning and Nonverbal Matrix Reasoning to Science and Maths Problem-Solving in Adolescence.

Relational reasoning, the ability to detect meaningful patterns, matures through adolescence. The unique contributions of verbal analogical and nonverbal matrix relational reasoning to science and maths are not well understood. Functional magnetic resonance imaging data were collected during science and maths problem-solving, and participants (N = 36, 11-15 years) also completed relational reasoning and executive function tasks. Higher verbal analogical reasoning associated with higher accuracy and faster reaction times in science and maths, and higher activation in the left anterior temporal cortex during maths problem-solving. Higher nonverbal matrix reasoning associated with higher science accuracy, higher science activation in regions across the brain, and lower maths activation in the right middle temporal gyrus. Science associations mostly remained significant when individual differences in executive functions and verbal IQ were taken into account, while maths associations typically did not. The findings indicate the potential importance of supporting relational reasoning in adolescent science and maths learning.

Inhibitory control and counterintuitive science and maths reasoning in adolescence.

Existing concepts can be a major barrier to learning new counterintuitive concepts that contradict pre-existing experience-based beliefs or misleading perceptual cues. When reasoning about counterintuitive concepts, inhibitory control is thought to enable the suppression of incorrect concepts. This study investigated the association between inhibitory control and counterintuitive science and maths reasoning in adolescents (N = 90, 11-15 years). Both response and semantic inhibition were associated with counterintuitive science and maths reasoning, when controlling for age, general cognitive ability, and performance in control science and maths trials. Better response inhibition was associated with longer reaction times in counterintuitive trials, while better semantic inhibition was associated with higher accuracy in counterintuitive trials. This novel finding suggests that different aspects of inhibitory control may offer unique contributions to counterintuitive reasoning during adolescence and provides further support for the hypothesis that inhibitory control plays a role in science and maths reasoning.

Spatial cognition and science achievement: The contribution of intrinsic and extrinsic spatial skills from 7 to 11 years.

BACKGROUND: Prior longitudinal and correlational research with adults and adolescents indicates that spatial ability is a predictor of science learning and achievement. However, there is little research to date with primary-school aged children that addresses this relationship. Understanding this association has the potential to inform curriculum design and support the development of early interventions. AIMS: This study examined the relationship between primary-school children's spatial skills and their science achievement. METHOD: Children aged 7-11 years (N = 123) completed a battery of five spatial tasks, based on a model of spatial ability in which skills fall along two dimensions: intrinsic-extrinsic; static-dynamic. Participants also completed a curriculum-based science assessment. RESULTS: Controlling for verbal ability and age, mental folding (intrinsic-dynamic spatial ability), and spatial scaling (extrinsic-static spatial ability) each emerged as unique predictors of overall science scores, with mental folding a stronger predictor than spatial scaling. These spatial skills combined accounted for 8% of the variance in science scores. When considered by scientific discipline, mental folding uniquely predicted both physics and biology scores, and spatial scaling accounted for additional variance in biology and variance in chemistry scores. The children's embedded figures task (intrinsic-static spatial ability) only accounted for variance in chemistry scores. The patterns of association were consistent across the age range. CONCLUSION: Spatial skills, particularly mental folding, spatial scaling, and disembedding, are predictive of 7- to 11-year-olds' science achievement. These skills make a similar contribution to performance for each age group.

Children's science learning: A core skills approach.

BACKGROUND: Research has identified the core skills that predict success during primary school in reading and arithmetic, and this knowledge increasingly informs teaching. However, there has been no comparable work that pinpoints the core skills that underlie success in science. AIMS AND METHOD: The present paper attempts to redress this by examining candidate skills and considering what is known about the way in which they emerge, how they relate to each other and to other abilities, how they change with age, and how their growth may vary between topic areas. RESULTS: There is growing evidence that early-emerging tacit awareness of causal associations is initially separated from language-based causal knowledge, which is acquired in part from everyday conversation and shows inaccuracies not evident in tacit knowledge. Mapping of descriptive and explanatory language onto causal awareness appears therefore to be a key development, which promotes unified conceptual and procedural understanding. CONCLUSIONS: This account suggests that the core components of initial science learning are (1) accurate observation, (2) the ability to extract and reason explicitly about causal connections, and (3) knowledge of mechanisms that explain these connections. Observational ability is educationally inaccessible until integrated with verbal description and explanation, for instance, via collaborative group work tasks that require explicit reasoning with respect to joint observations. Descriptive ability and explanatory ability are further promoted by managed exposure to scientific vocabulary and use of scientific language. Scientific reasoning and hypothesis testing are later acquisitions that depend on this integration of systems and improved executive control.

Influence of virtual reality training on the roadside crossing judgments of child pedestrians.

The roadside crossing judgments of children aged 7, 9, and 11 years were assessed relative to controls before and after training with a computer-simulated traffic environment. Trained children crossed more quickly, and their estimated crossing times became better aligned with actual crossing times. They crossed more promptly, missed fewer safe opportunities to cross, accepted smaller traffic gaps without increasing the number of risky crossings, and showed better conceptual understanding of the factors to be considered when making crossing judgments. All age groups improved to the same extent, and there was no deterioration when children were retested 8 months later. The results are discussed in relation to theoretical arguments concerning the extent to which children's pedestrian judgments are amenable to training.