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Cognitive Performance, Aerobic Fitness, Motor Proficiency, and Brain Function Among Children Newly Diagnosed With Craniopharyngioma

Published online by Cambridge University Press:  03 May 2019

Heather M. Conklin ,
Kirsten K. Ness ,
Jason M. Ashford ,
Matthew A. Scoggins ,
Robert J. Ogg ,
Yuanyuan Han ,
Yimei Li ,
Julie A. Bradley ,
Frederick A. Boop  and
Thomas E. Merchant
Heather M. Conklin*
Affiliation:
Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
Kirsten K. Ness
Affiliation:
Department of Epidemiology/Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee
Jason M. Ashford
Affiliation:
Department of Psychology, St. Jude Children’s Research Hospital, Memphis, Tennessee
Matthew A. Scoggins
Affiliation:
Division of Translational Imaging, St. Jude Children’s Research Hospital, Memphis, Tennessee
Robert J. Ogg
Affiliation:
Division of Translational Imaging, St. Jude Children’s Research Hospital, Memphis, Tennessee
Yuanyuan Han
Affiliation:
Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
Yimei Li
Affiliation:
Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, Tennessee
Julie A. Bradley
Affiliation:
Department of Radiation Oncology, University of Florida Health Proton Therapy Institute, Jacksonville, Florida
Frederick A. Boop
Affiliation:
Department of Surgery, St. Jude Children’s Research Hospital, Memphis, Tennessee
Thomas E. Merchant
Affiliation:
Department of Radiation Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee
*
Correspondence and reprint requests to: Heather M. Conklin, Department of Psychology, Mail Stop #740, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105-2794. E-mail: heather.conklin@stjude.org
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Abstract

Objectives: Craniopharyngioma survivors experience cognitive deficits that negatively impact quality of life. Aerobic fitness is associated with cognitive benefits in typically developing children and physical exercise promotes recovery following brain injury. Accordingly, we investigated cognitive and neural correlates of aerobic fitness in a sample of craniopharyngioma patients. Methods: Patients treated for craniopharyngioma [N=104, 10.0±4.6 years, 48% male] participated in fitness, cognitive and fMRI (n=51) assessments following surgery but before proton radiation therapy. Results: Patients demonstrated impaired aerobic fitness [peak oxygen uptake (PKVO2)=23.9±7.1, 41% impaired (i.e., 1.5 SD<normative mean)], motor proficiency [Bruininks-Oseretsky (BOT2)=38.6±9.0, 28% impaired], and executive functions (e.g., WISC-IV Working Memory Index (WMI)=96.0±15.3, 11% impaired). PKVO2 correlated with better executive functions (e.g., WISC-IV WMI r=.27, p=.02) and academic performance (WJ-III Calculation r=.24, p=.04). BOT2 correlated with better attention (e.g., CPT-II omissions r=.26, p=.04) and executive functions (e.g., WISC-IV WMI r=.32, p=.01). Areas of robust neural activation during an n-back task included superior parietal lobule, dorsolateral prefrontal cortex, and middle and superior frontal gyri (p<.05, corrected). Higher network activation was associated with better working memory task performance and better BOT2 (p<.001). Conclusions: Before adjuvant therapy, children with craniopharyngioma demonstrate significantly reduced aerobic fitness, motor proficiency, and working memory. Better aerobic fitness and motor proficiency are associated with better attention and executive functions, as well as greater activation of a well-established working memory network. These findings may help explain differential risk/resiliency with respect to acute cognitive changes that may portend cognitive late effects. (JINS, 2019, 25, 413–425)

Keywords

PediatricBrain tumorCognitive late effectsfMRIAcquired brain injuryExercise
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 4 , April 2019 , pp. 413 - 425
Copyright
Copyright © The International Neuropsychological Society, 2019. 

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