Performance and Symptom Validity Indicators among Children undergoing Cognitive Surveillance following Treatment for Craniopharyngioma

IF 2.4 Q2 CLINICAL NEUROLOGY

Neuro-oncology practice Pub Date : 2024-01-29 DOI:10.1093/nop/npae005

Brian S. Potter, Valerie Mc Laughlin Crabtree, J. Ashford, Yimei Li, Jia Liang, Yian Guo, Merrill S Wise, Evelyn S Skoda, T. Merchant, H. Conklin

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引用次数: 0

Abstract

Performance validity tests (PVTs) and symptom validity tests (SVTs) are essential to neuropsychological evaluations, helping ensure findings reflect true abilities or concerns. It is unclear how PVTs and SVTs perform in children who received radiotherapy for brain tumors. Accordingly, we investigated the rate of noncredible performance on validity indicators as well as associations with fatigue and lower intellectual functioning. Embedded PVTs and SVTs were investigated in 98 patients with pediatric craniopharyngioma undergoing proton radiotherapy (PRT). The contribution of fatigue, sleepiness, and lower intellectual functioning to embedded PVT performance was examined. Further, we investigated PVTs and SVTs in relation to cognitive performance at pre-PRT baseline and change over time. SVTs on parent measures were not an area of concern. PVTs identified 0-31% of the cohort as demonstrating possible noncredible performance at baseline, with stable findings one-year following PRT. Reliable Digit Span (RDS) noted highest PVT failure rate; RDS has been criticized for false positives in pediatric populations, especially children with neurological impairment. Objective sleepiness was strongly associated with PVT failure, stressing need to consider arousal level when interpreting cognitive performance in children with craniopharyngioma. Lower intellectual functioning also needs to be considered when interpreting task engagement indices as it was strongly associated with PVT failure. Embedded PVTs should be used with caution in pediatric craniopharyngioma patients who have received PRT. Future research should investigate different cut-off scores and validity indicator combinations to best differentiate noncredible performance due to task engagement versus variable arousal and/or lower intellectual functioning.

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颅咽管瘤治疗后接受认知监测的儿童的表现和症状有效性指标

表现效度测试（PVT）和症状效度测试（SVT）对神经心理评估至关重要，有助于确保评估结果反映真实的能力或问题。目前尚不清楚PVT和SVT在接受脑肿瘤放疗的儿童中的表现如何。因此，我们研究了有效性指标的不可信表现率以及与疲劳和智力功能低下的关联。我们对 98 名接受质子放疗（PRT）的小儿颅咽管瘤患者的嵌入式 PVT 和 SVT 进行了调查。我们研究了疲劳、嗜睡和智力功能低下对嵌入式 PVT 表现的影响。此外，我们还研究了 PVT 和 SVT 与放疗前基线认知能力的关系以及随时间的变化。家长测量中的 SVT 并不值得关注。PVTs发现0-31%的组群在基线时可能表现出不可置信的表现，PRT一年后结果稳定。可靠数字跨度（RDS）的 PVT 失败率最高；RDS 曾因在儿科人群中出现假阳性而受到批评，尤其是神经系统受损的儿童。客观嗜睡与 PVT 失败密切相关，这强调了在解释颅咽管瘤患儿的认知表现时需要考虑唤醒水平。在解释任务参与指数时，还需要考虑智力功能较低的情况，因为这与 PVT 失败密切相关。对于接受过 PRT 的小儿颅咽管瘤患者，应谨慎使用嵌入式 PVT。未来的研究应调查不同的临界分数和有效性指标组合，以最好地区分任务参与导致的不可信表现与可变唤醒和/或智力功能低下导致的不可信表现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuro-oncology practice CLINICAL NEUROLOGY-

CiteScore

5.30

自引率

11.10%

发文量

期刊介绍： Neuro-Oncology Practice focuses on the clinical aspects of the subspecialty for practicing clinicians and healthcare specialists from a variety of disciplines including physicians, nurses, physical/occupational therapists, neuropsychologists, and palliative care specialists, who have focused their careers on clinical patient care and who want to apply the latest treatment advances to their practice. These include: Applying new trial results to improve standards of patient care Translating scientific advances such as tumor molecular profiling and advanced imaging into clinical treatment decision making and personalized brain tumor therapies Raising awareness of basic, translational and clinical research in areas of symptom management, survivorship, neurocognitive function, end of life issues and caregiving