Computerized Assessment of Cognitive Late Effects among Childhood Brain Tumor Survivors: An Alternative Use for the ImPACT Battery

J Int Neuropsychol Soc -


Conklin, H. M., J. M. Ashford, T. N. Skinner, M. McCool, T. E. Merchant, V. Santana, M. DiPinto, C. Vaughan, G. Gioia, S. Wu and X. Xiong.



Objective: Advantages to computerized assessment of neuropsychological functions include improved standardization, increased reliability of response time variables, and increased availability of alternate forms facilitating longitudinal assessment. ImPACT (Immediate PostConcussion Assessment and Cognitive Testing) is a computerized battery developed for monitoring recovery following mild brain injuries that assesses attention, memory and processing speed. Despite evidence that core areas of deficit in cancer survivors are among those assessed by ImPACT, it has not previously been used with this population. Participants and Methods: Twenty four childhood brain tumor (BT) survivors treated with conformal radiation therapy (mean age= 15.7±1.6; mean age at irradiation= 9.8±2.5), twenty solid tumor (ST) survivors treated without CNS-directed therapy (mean age= 16.2±1.8) and twenty healthy siblings (mean age= 15.1±1.6 years) were administered an age modified version of ImPACT. Additional computerized working memory and recognition memory measures were administered. Results: Univariate ANOVAs revealed group differences (p<.05) on measures of recognition memory (Word Memory, Design Memory), spatial working memory (Xs & Os), processing speed (Symbol Match) and reaction time (Speed Click, Color Match), with BT survivors performing significantly worse than ST survivors and siblings. Multiple surgical resections, hydrocephalus and CSF shunt placement predicted worse performance (p<.05). Pearson correlation coefficients revealed significant associations between ImPACT memory tasks and computerized forced choice recognition tasks (rs= .30-.33, p<.05). Conclusions: ImPACT demonstrated sensitivity to cognitive late effects experienced by some BT survivors with clinical predictors of performance consistent with the pediatric oncology literature. Correlations with measures of similar constructs provide evidence for criterion-oriented validity. Findings offer initial support for the utility of ImPACT for monitoring of cognitive late effects.

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