Auditory Attention Decay Noted Post-Treatment in Pediatric Cerebellar Tumors

Within 30 months of surgery, about half of all patients with cerebellar tumors had a below-average Digit Span subtest on the Weschler Intelligence Scale for Children (WISC), and within 6 years, two-thirds had below-average scores post-surgery.

Understanding auditory attention difficulties in pediatric patients with cerebellar tumors will help to improve the information surrounding cognitive late effects, psychosocial intervention, and pharmacological intervention, according to a poster presented at the 2025 American Psychosocial Oncology Society Meeting.

Within 30 months of surgery, about half of all patients with cerebellar tumors had a below-average Digit Span subtest on the Weschler Intelligence Scale for Children (WISC), and within 6 years, two-thirds had below-average scores post-surgery. Abnormality on the Digit Span test was described as less than 8.

Abnormalities identified in the Digit Span Total were observed between 2 and 6 months from surgery, 17 patients had a 40.6% prevalence of abnormal rate on a Digit Span Total test (95% CI, 21.4%-63.1%). Between 9 and 18 months, 10 patients had an estimated rate of 40.6% (95% CI, 16.8%-69.8%); at 19 to 36 months, 9 patients had an estimated rate of 37.2% (95% CI, 13.4%-69.4%); at 37 to 72 months, 9 patients had an estimated rate of 69.3% (95% CI, 35.8%-90.1%); and at 72 months or more, 6 patients had an estimated rate of 19.2% (95% CI, 3.3%-62.7%).

“The results support the idea that cerebellar tumors are associated with below-average auditory attention, as measured by performance on the WISC Digit Span Total, regardless of the pathology of the tumor,” Julia Wendland, a research assistant in the Pediatrics Department at the University of Iowa, stated in the poster. “The frequency of abnormality on this measure varies over time, with 40% to 70% of individuals performing below average up to 72 months post-surgery.”

Overall, 37 patients with a history of cerebellar tumors who underwent neuropsychological evaluation during, and after, cancer treatment were evaluated for this study. Patients had a mean standard score of 105.5 for verbal intellect, with verbal IQ scores normally distributed. After surgery, nonparametric analyses were used to determine the probability of failure, defined as a Digit Span test score less than 8, at different interval time points.

The distribution of pathology included medulloblastoma (n = 17), pilocytic astrocytoma (n = 14), anaplastic ependymoma (n = 1), cerebellar vermis tumor (n = 1), ependymoma (n = 2), high-grade glioma (n = 1), and pilomyxoid astrocytoma (n = 1).

Regarding Digit Span Forward, with a time from surgery of 2 to 6 months, 16 patients had an abnormal estimated rate of 18.6% (95% CI, 5.2%-49.2%); at 9 to 18 months, 9 patients had an estimated rate of 43.6% (95% CI, 19.4%-71.2%); at 19 to 36 months, 8 patients had an estimated rate of 36.6% (95% CI, 10.0%-75.0%); at 37 to 72 months, 7 patients had an estimated rate of 61.0% (95% CI, 32.3%-83.7%); and at 72 months or more, 6 patients had an estimated rate of 44.6% (95% CI, 25.9%-65.0%).

For Digit Span Backward, with a time from surgery of 2 to 6 months, 16 patients had an abnormal estimated rate of 30.1% (95% CI, 13.6%-54.0%); at 9 to 18 months, 9 patients had an estimated rate of 22.6% (95% CI, 10.0%-43.2%); at 19 to 36 months, 8 patients had an estimated rate of 50.5% (95% CI, 23.2%-77.5%); at 37 to 72 months, 7 patients had an estimated rate of 67.1% (95% CI, 37.9%-87.2%); and at 72 months or more, 6 patients had an estimated rate of 37.7% (95% CI, 13.4%-70.2%).

“Future analyses will investigate potential contributing factors (e.g., IQ, gender, radiation, lesion location) and include additional working memory measures (e.g., [Wide Range Assessment of Memory and Learning], BRIEF) to further elucidate the patterns of auditory deficits in this population,” Wendland concluded.

Reference

Wendland J, Sadler B, Joslyn K, et al. Timing of auditory attention decay following cancer treatment in childhood cerebellar tumors. Presented at the 2025 American Psychosocial Oncology Society Meeting; March 5-7, 2025, Pittsburgh, PA. Poster W90.