Effects of cognitive-motor intervention for pediatric posterior fossa tumor survivors: results of a pilot study.

The purpose of this prospective pilot study was to evaluate the feasibility and effects of cognitive-motor intervention on the cognitive and motor abilities of pediatric survivors of posterior fossa tumors. The study involved patients aged 7 to 18 years with cognitive deficits who had completed primary treatment for posterior fossa tumors. 25 participants (Mage=11.3 ± 2.93, 64% male; 17 medulloblastoma, 1 ependymoma, 1 desmoplastic medulloblastoma, 6 piloid astrocytoma; 22 in remission (Mmonths =45), 3 in stabilization (Mmonths=49)) were recruited from the Research Institute for Brain Development and Peak Performance. The intervention consisted of two phases with a 3-month break for home training, and a total duration of 6 months. Each phase lasted 7 weeks and included two assessment procedures (pre- and post-intervention) and 10 training sessions over a period of 5 weeks (two 3-hour sessions per week). At baseline and pre- and post-intervention, all participants underwent a battery of cognitive and motor tests. Each training session included gross motor training (GMT), graphomotor training (GT), and cognitive-motor training (CMT). Statistical analysis was performed using the Friedman test for repeated measures and post-hoc Durbin-Conover test. The results indicated significant improvements in visuospatial working memory, visual attention, eye-hand coordination, semantic verbal fluency, auditory-motor synchronization, reaction time, and a decrease in the rate of ataxia. These improvements remained stable even in the absence of direct intervention. The findings demonstrate positive effects and feasibility of the intervention and suggest the need for further research in this area including randomized controlled feasibility studies with a larger sample.

The Role of the Cerebellum in Visual-Spatial Memory in Pediatric Posterior Fossa Tumor Survivors.

The cerebellum is involved in motor and non-motor functions. Cerebellar lesions can underlie the disruption of various executive functions. The violation of executive functions in cerebellar lesions is a serious problem, since children, after completing treatment, must return to school, finish their education, and get a profession. One of the important executive functions is working memory, which contributes to academic success. Deficits of verbal working memory in cerebellar tumors have been studied, in contrast to visual-spatial working memory. To assess this issue, 101 patients who survived cerebellar tumors and 100 healthy control subjects performed a visual-spatial working memory test. As a result, in children who survived cerebellar tumors, visual-spatial working memory is impaired compared to the control group. Moreover, with age, and hence the time since the end of treatment, the number of elements that children can retain in visual-spatial working memory increases, but still remains smaller compared to the control group. Our findings complement the idea of cerebellar involvement in visual-spatial working memory and suggest that it is disrupted by cerebellar lesions in children.

Phonological Verbal Fluency Test for Russian-Speaking Children.

INTRODUCTION: Verbal fluency tasks are mainly used for assessment of verbal fluency and have proven useful for differential diagnosis. The first objective of the study was to provide normative data on phonemic verbal fluency (for letters "Π" [p], "O" [o], "C" [s]) in children population. The second objective of the study was to establish diagnostic validity of the present task and to collect normative data on participants who survived posterior fossa tumor (PFT) and participants with treated hemoblastosis. METHOD: For diagnostics, we used verbal fluency test. The normative sample consisted of 746 participants aged 7-16 years. A linear multiple regression analysis was implemented for each dependent variable with age, gender, disease for all participants and academic achievement as predictors in normative sample. The performance of 746 healthy participants was compared to the performance of 118 participants who survived PFT and 492 participants who survived hemoblastosis using one-way ANOVA analysis. RESULTS: Healthy children have better verbal fluency than their peers who survived cancer. In the group of healthy children, we assessed the relationship between verbal fluency and school performance. A significant correlation with the "Russian language" subject (r = 0.127; p < 0.001) emerged. In all three groups of children, age and gender turned out to be significant factors that affected the characteristics of verbal fluency. CONCLUSION: Our data will contribute to increasing the accuracy of verbal fluency deficit detection in Russian speakers and will be useful for differential diagnosis of cognitive impairment for children who have survived oncological diseases of various geneses.

Comparison of Neurocognitive Functioning and Fine Motor Skills in Pediatric Cancer Survivors and Healthy Children.

Background: The late treatment outcomes of pediatric brain tumors and of hematopoietic and lymphoid tissue tumors are an important focus of both rehabilitation and research. Neurocognitive and motor disorders induce further learning problems impeding social-emotional adaptation throughout a whole lifespan. Core deficits in short-term and working memory, visuospatial constructional ability, verbal fluency, and fine motor skills underlie distorted intellectual and academic achievement. This study aimed to assess the individual differences in cognitive ability and fine motor skills of pediatric tumor survivors and the age-matched healthy controls. Methods: A total of 504 tumor survivors after treatment and 646 age-matched healthy controls underwent neurocognitive and fine motor assessments. Findings: The group of tumor survivors scored significantly worse in both neurocognitive and fine motor skill in compared with the healthy control group. The pediatric brain tumor survivors (PBT group) performed worse in cognitive (p < 0.001 for verbal fluency and p < 0.001 for visuospatial constructional ability) and motor tests (p < 0.001) compared to the healthy controls. Hematopoietic and Lymphoid Tissues tumors survivors (THL group) performed worse in verbal fluency (p < 0.01) and visuospatial constructional test (p < 0.001) compared to the control group. Furthermore, the PBT group had worse results in visuospatial constructional ability (p < 0.05) and fine motor (p < 0.001) ability than the THL group. Significant differences between females and males were found in fine motor test performance in the PBT group (p < 0.05), as well as in verbal fluency (p < 0.01) and visuospatial constructional ability (p < 0.01) in the control group. Neurocognitive and fine motor skill characteristics in the THL group did not correlate with age.

The Impact of Mild COVID-19 on Executive Functioning and Mental Health Outcomes in Young Adults.

COVID-19 is associated with a range of long-lasting symptoms related to cognitive and psycho-emotional spheres. Even mild cases of the disease can lead to persistent cognitive deficits and deterioration of the psycho-emotional state. The purpose of our study was to examine the presence and frequency of psycho-emotional disorders and cognitive deficits in students who recovered from mild form of COVID-19. A total of 40 COVID-19 survivors and 25 healthy controls participated in our study. We assessed three core cognitive functions (inhibition, working memory, task-switching), reaction time and motor speed. We also assessed depression, anxiety and fatigue with self-report questionnaires. The COVID-19 group manifested increased depression and decreased inhibition in comparison with the controls. Our results show that even in young adults who have recovered from mild COVID-19, there are persisting cognitive and psycho-emotional deficits.

The feasibility and efficacy of short-term visual-motor training in pediatric posterior fossa tumor survivors.

BACKGROUND: Pediatric posterior fossa tumor (PFT) survivors experience a range of cognitive and motor impairments that require timely rehabilitation of these functions. In Russia, rehabilitation services are only just beginning to be formed; therefore, it is necessary to test rehabilitation protocols for children surviving cancer. AIM: To evaluate the efficacy of short-term cognitive and motor training (CMT) aimed on visual-motor integration in PFT survivors using training devices. DESIGN: "Single center" quasi randomized controlled experiment. SETTING: Outpatients of the Russkoe Pole Rehabilitation Center. POPULATION: The 63 children cancer survivors between the ages of 6 and 17 years. METHODS: The baseline level of cognitive and motor functions was assessed in all participants. Then the sample of patients split into two subgroups of equal sex, age, and diagnosis. The intervention subgroup received six sessions of CMT for two weeks, and the other subgroup underwent 'empty' two weeks with no intervention. Reassessment of motor and cognitive functions was conducted in all participants. Then the subgroups changed: the first subgroup underwent 'empty' two weeks, and the second subgroup completed the CMT, and further reassessment was provided. RESULTS: The primary results demonstrate an increase in gross and fine motor skills, motor coordination, visual-motor integration, and visual processing after CMT. Secondary results show that the age at onset is an important factor in the subsequent decline in cognitive, motor functions, and eye movements. Children with medulloblastoma perform worse on motor tests than children with astrocytoma. A tumor in the IV ventricle is the most harmful, and a tumor in the cerebellar hemispheres is the least harmful to a child's cognitive and motor development. CONCLUSIONS: This study shows the effectiveness of a short-term CMT program for children who survived PFT. The study also found that cognitive, motor, and visual-motor functions are affected by the tumor's localization, malignancy, and the child's age at onset. CLINICAL REHABILITATION IMPACT: Short-term rehabilitation methods can be useful in pediatric oncological practice. Reconstruction of cognitive functions can occur during the training of more "simple" functions, such as hand-eye integration. The study makes a significant contribution to the methods of short-term rehabilitation in children who survived cancer.

The Validity and Reliability of the Turkish Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 7-18 in Russia.

Background: Fatigue is the most common complaint by children both during and after cancer treatment, but in Russia, there is no reliable method for assessing fatigue. Objective: To develop a Russian version of the Turkish Scale for the Assessment of Fatigue in Pediatric Oncology Patients Ages 7-18. Design: Our first step was to translate all the items of the Turkish questionnaire into Russian. Then, through discussion, we created a single proposition for each item. The next step was obtaining expert opinions to assess the validity. Once the expert estimates agreed, a pilot version of the questionnaire was formed. The next step was to collect a large sample of patients to study the reliability and validity of the questionnaire. Results: As a result of factor analysis, three factors were identified. The first factor was "fatigue associated with actions;" the second was "fatigue as feeling;" and the third was "fatigue associated with sleep difficulties." The children's and parents' versions had the same factor structure. Conclusions: This study showed the possibility of using the questionnaire in a Russian sample. That's why it is necessary to continue collecting and analyzing data in this direction. The reliability of the test was also assessed. The reliability of the parent version scored a Cronbach's alpha of 0.91. The reliability of the children's version showed a Cronbach's alpha of 0.93.