Predictors of neurocognition outcomes in children and young people with primary brain tumor presenting to tertiary care hospitals of Karachi, Pakistan: a prospective cohort study

• DOI: 10.1007/s00381-024-06306-x
• Publication Date: 2024-02-16T12:04:20Z
• Authors: Nida Zahid; S. Ather Enam; Thomas Mårtensson; Iqbal Azam; Naureen Mushtaq; Mariya Moochhala; Farrukh Javed; Faiza Kausar; Aneesa Hasan; Lal Rehman; M. Nouman Mughal; Sadaf Altaf; Salman Kirmani; Nick Brown
• Keywords: Neurocognitive; Gee; Raven's Progressive Matrices; Brain tumor

Abstract Introduction Primary brain tumors are a common cause of morbidity and mortality in children young people (CYP) globally. Impaired neurocognitive function is potential severe consequence primary tumor (PBT) survivors. There no in-depth studies from low- middle-income countries (LMICs) to inform management follow-up. The research questions this study were as follows: Are the sociodemographic factors (lower age CYP, female gender, low socioeconomic status, parental education), disease-related (high grade tumor, presence seizures, hydrocephalous), treatment-related (adjuvant therapy, surgical intervention, post-treatment placement shunts) associated with decline neurcognition outcomes 12 months CYP PBTs? Methods A prospective cohort was conducted November 2020 July 2023 at Aga Khan University Hospital Jinnah Postgraduate Medical Centre, tertiary care hospitals Karachi, Pakistan. All aged 5 21 years newly diagnosed PBTs eligible. neurocognition assessment undertaken by psychologist two points, i.e., pre-treatment using validated tools. verbal intelligence assessed Slosson Intelligence tool, revised 3rd edition (SIT-R3), perceptual reasoning Raven’s Progressive Matrices (RPM), Processing Speed Index Wechsler Scale (WISC V) Adult (WAIS-IV). data analyzed STATA version software. Generalized estimating equation (GEE) used determine mean change non-verbal scores. Unadjusted adjusted beta coefficients their 95% confidence intervals reported. Results total 48 CYPs enrolled, 23 (48%) them lost follow-up 10 (21%) died. remaining 25 (52%) reassessed after treatment. On multivariable analysis, significant scores predicted seizures = − 20.8 (95% CI, 38.2, 3.4), mothers having formal educational status lower household monthly income. Similarly, also 10.7 20.6, 0.8), education Worsening processing speed histology, 33.9 47.7, 20.0), mother, monthly. However, an improvement seen resection. Conclusion In novel study, sociodemographic, treatment factors. These findings may have implications for targeted early psychological screening higher risk PBTs. Identification these predictors serve foundation developing more cost-effective thereby alleviating burden morbidity. However establish generalizability, future should prioritize larger-scale, multicountry studies. (Trial registration: ClinicalTrials.gov Identifier: NCT05709522)