Neuropsychological outcomes of children with Optic Pathway Glioma

Chiara Papini,David A Walker,Shery Thomas,Robert A Dineen,Nicola J Pitchford

doi:10.1038/s41598-020-59896-2

Abstract

Optic Pathway Glioma (OPG) is a relatively common brain tumour in childhood; however, there is scarce understanding of neuropsychological sequelae in these survivors. In this study, 12 children with diagnosis of OPG before 6 years of age received a comprehensive standardised assessment of visual perception, general intelligence and academic achievement, using adjustments to visual materials of the tests, to examine the extent of concurrent impairment in these functional domains. Information about vision, clinical and socio-demographic factors were extracted from medical records to assess the associations of neuropsychological outcomes with clinical and socio-demographic factors. Children with OPG exhibited high within-patient variability and moderate group-level impairment compared to test norms. Visual perception was the most impaired domain, while scholastic progression was age-appropriate overall. For cognition, core verbal and visuo-spatial reasoning skills were intact, whereas deficits were found in working memory and processing speed. Visual function was associated with tasks that rely on visual input. Children with OPG are at moderate risk of neuropsychological impairment, especially for visual perception and cognitive proficiency. Future research should elucidate further the relative contribution of vision loss and neurofibromatosis type 1 co-diagnosis within a large sample.

Highlights

Optic Pathway Glioma (OPG) is a relatively common brain tumour in childhood; there is scarce understanding of neuropsychological sequelae in these survivors
Half or more OPGs are associated with Neurofibromatosis type 1 (NF1)[3,4], a multisystem genetic disorder that is associated with neuropsychological sequelae, including mild intellectual impairment, inattention, visuospatial deficits and learning disability[5,6,7,8,9]
Within the NF1 literature, children with diagnosed or treated OPG have typically been excluded from neuropsychology studies[5,6,19], whereas the very few studies that attempted to disentangle the relative contribution of NF1 and brain tumour did not always focus on OPG20–22

Summary

Introduction

Optic Pathway Glioma (OPG) is a relatively common brain tumour in childhood; there is scarce understanding of neuropsychological sequelae in these survivors. One prospective study[14] documented the neuropsychological profile of 21 school-aged children with OPG initially treated with chemotherapy integrating an IQ test for cognitive function with a collection of subtests from different batteries for individual perceptual and scholastic skills.

Results

Conclusion