Impact of a pediatric brain tumor: Research into neurocognitive late effects and psychosocial consequences and the evaluation of a potential intervention

This thesis describes neurocognitive and psychosocial functioning of pediatric brain tumor survivors (PBTS) with neurocognitive complaints, as well as the results of the first double-blind randomized placebo-controlled trial (RCT) investigating the efficacy of neurofeedback (NF) training in PBTS, as compared to a placebo feedback (PF) training (clinicaltrials.gov NCT00961922).
Firstly, we conducted a meta-analysis (Chapter 2) to establish the magnitude of the neurocognitive problems in PBTS. In Chapter 3 we describe the design of the PRISMA study, an RCT to investigate the efficacy of NF training in PBTS with neurocognitive complaints compared to PF training. In Chapters 4&5, respectively, the baseline neurocognitive and psychosocial functioning of the participating PBTS are presented. Chapter 6 describes the relationship between neurocognitive tasks and a potential screener questionnaire of executive functions in PBTS, the BRIEF-Parent and BRIEF-Teacher. Finally, the results of the RCT are presented in Chapter 7. Chapter 8, is the general discussion of the results of the studies described in this thesis.
The results of this study show that PBTS have neurocognitive and psychosocial late effects as a result of the treatment. It is important to monitor these deficits in order to timely refer PBTS to proper care if indicated. The BRIEF-Teacher could be useful but other options should be explored. The NF training does not have a favorable effect on neurocognitive and psychosocial functioning in PBTS above and beyond PF training. New interventions that might be effective to decrease neurocognitive problems in PBTS should be developed and studied.