Visual–Motor Functions and Associated Cognitive Outcomes in Pediatric Cancer Survivors

TL;DR

This study finds that visual-motor issues are more severe than cognitive problems in childhood cancer survivors and are linked to working memory.

Contribution

The study identifies a stronger link between visual-motor dysfunction and cognitive outcomes than previously understood.

Findings

Visual-motor impairments are more severe than cognitive impairments in cancer survivors.

Visual-motor function is a significant predictor of attention and working memory in survivors.

Age and visual-motor function together influence cognitive outcomes in specific cancer groups.

Abstract

Introduction: Pediatric cancer survivors are at high risk for visual–motor and cognitive deficits that persist throughout life. These domains are related to academic performance. The current study examined (i) whether both visuomotor and cognitive functions and (ii) whether visuomotor functions alone mediate the relationship between age and cognitive functions. Methods: In total, there were 210 participants (7–17 years): 70 posterior fossa tumors (Mage = 12.1  ±  3.2 years, 44% female) and 70 acute lymphoblastic leukemia (Mage = 12.3  ±  3.4 years, 45% female) survivors and 70 (Mage = 12.2 ± 3.3 years, 41% female) healthy controls. Visual motor integration, motor coordination and visual perception were assessed using the Beery VMI test. Working memory, attention and planning were assessed using CANTAB. Results: Impaired motor function is significantly more pronounced than cognitive impairment in both groups of cancer survivors (effect size from 25 to 30% for visual–motor and from 5 to 7% for cognitive functions). A multiple regression model revealed that age and visual motor functions are significant predictors of attention (in the ALL group β = −0.490, t = −4.88, p = 0.000) and working memory (in the PFT group β = 0.264, t = 2.72, p = 0.008; in the ALL group β = 0.215, t = 2.24, p = 0.028). Conclusions: In children who have experienced acute lymphoblastic leukemia and tumors of the posterior cranial fossa, visual–motor dysfunction is more pronounced than cognitive impairment. In addition, there is an association between visual–motor function disorders and working memory. These findings can be used to develop more specific rehabilitation protocols.