AS2-2 NEUROCOGNITIVE AND PSYCHOSOCIAL DISORDERS IN CHILDREN WITH BRAIN TUMORS

Abstract

The survival rate of children with brain tumors has been improving in the recent times. However, treatment outcomes should also include improved functional prognosis, considering motor dysfunction and sensory disorders, such as vision, and neurocognitive and psychosocial disorders, such as impaired intelligence, memory disorders, impaired attention, and impaired social behavior. In children with brain tumors, neurocognitive and psychosocial disorders easily occur due to various factors such as effect of the tumor, complications such as hydrocephalus, and impact of surgical treatment or radiotherapy. In addition, neurocognitive and psychosocial disorders are associated with decreasing quality of life (QoL) of pediatric patients with brain tumors.When assessing neurocognitive and psychosocial disorders, objective assessments such as a neuropsychological assessment that includes an academic achievement test and an intelligence test, and subjective assessments such as observing behaviors need to be included. However, limited pediatric neuropsychological tests available in Japan.Little evidence is available on the direct intervention methods that aim to improve neurocognitive and psychosocial disorders. Medical management for epilepsy, hydrocephalus, and endocrine disorders is performed while carefully considering cognitive function even in patients with neurocognitive and psychosocial disorders. Patients’ symptoms and QoL can be improved through cognitive rehabilitation, environmental adjustments such as an intervention in their educational environment, and family support. To integrate these medical and social models, a multidisciplinary team approach is required.There is limited data on the assessment and intervention methods available for neurocognitive and psychosocial disorders of children with brain tumors. Currently, only a few facilities are equipped to provide expert treatment. The Neuropsychological Assessment Subcommittee (Brain Tumor Committee, the Japanese Children’s Cancer Group (JCCG)) aims to standardize the evaluation of neurocognitive and psychosocial disorders and intervention methods. These will be presented in line with the medical care provided at our hospital.