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The Neurological Predictor Scale Predicts Adaptive Functioning via Executive Dysfunction in Young Adult Survivors of Childhood Brain Tumor

Published online by Cambridge University Press:  09 July 2020

Rella J. Kautiainen Open the ORCID record for Rella J. Kautiainen [Opens in a new window] ,
Michelle E. Fox Open the ORCID record for Michelle E. Fox [Opens in a new window]  and
Tricia Z. King Open the ORCID record for Tricia Z. King [Opens in a new window]
Rella J. Kautiainen
Affiliation:
Department of Psychology, Georgia State University, Atlanta, GA30303, USA
Michelle E. Fox
Affiliation:
Department of Psychology, Georgia State University, Atlanta, GA30303, USA
Tricia Z. King*
Affiliation:
Department of Psychology, Neuroscience Institute, Georgia State University, Atlanta, GA30303, USA
*
*Correspondence and reprint requests to: Dr. Tricia Z. King, Department of Psychology, Georgia State University, Atlanta, GA30303, USA. E-mail: tzking@gsu.edu
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Abstract

Objectives:

Survivors of childhood brain tumors experience neurological sequelae that disrupt everyday adaptive functioning (AF) skills. The Neurological Predictor Scale (NPS), a cumulative measure of tumor treatments and sequelae, predicts cognitive outcomes, but findings on its relation to informant-reported executive dysfunction (ED) and AF are mixed. Given known effects of frontal-subcortical system disruptions on AF, this study assessed the NPS’ relationship with AF as mediated by frontal systems dysfunction, measured by the Frontal Systems Behavior Scale (FrSBe).

Methods:

75 participants (Mage = 23.5, SDage = 4.5) were young adult survivors of childhood brain tumors at least 5 years past diagnosis. FrSBe and Scales of Independent Behavior-Revised (SIB-R), a measure of AF, were administered to informants. Parallel multiple mediator models included Apathy and ED as mediators, and age at diagnosis and time between diagnosis and assessment as covariates.

Results:

More complex treatment and sequelae were correlated with poorer functioning. Mediation models were significant for all subscales: Motor Skills (MS), p = .0001; Social Communication (SC), p = .002; Personal Living (PL), p = .004; Community Living (CL), p = .007. The indirect effect of ED on SC and CL was significant; the indirect effect of Apathy was not significant for any subscales.

Conclusions:

More complex tumor treatment and sequelae were associated with poorer long-term AF via increased ED. Cognitive rehabilitation programs may focus on the role of executive function and initiation that contribute to AF, particularly SC and CL skills, to help survivors achieve comparable levels of independence in everyday function as their peers.

Keywords

Brain tumor survivorsAdaptive skillsFrontal systemsNeurological sequelaeLong-term outcomesApathyCognition
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 27 , Issue 1 , January 2021 , pp. 1 - 11
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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