{
    "abstract": "Brain tumor treatment can result in sensorineural hearing loss (SNHL) that is associated with cognitive declines in school-age children. Young children treated for brain tumors are at heightened cognitive risk. This study examines the unique contribution of treatment-related ototoxicity to cognitive outcomes in young children treated for brain tumors.\n135 young children (mean age= 1.7 years) with a newly diagnosed malignant brain tumor were treated with chemotherapy, with or without focal proton or photon radiation therapy. Serial audiology and neurocognitive assessments were conducted for five years as part of a prospective, multisite, longitudinal trial (SJYC07; NCT00602667). SNHL was dichotomized as present versus not present (Chang grade \u22651a vs. 0). Neurocognitive assessments included intellectual functioning and parent ratings of adaptive functioning and attention.\n67% of patients experienced mild-to-severe SNHL, which was associated with younger age at diagnosis (p<. 001) but not sex, treatment, or study risk arm (p> .10). Pre-treatment, higher IQ was associated with older age and higher socioeconomic status (p< .01), with a negative change in IQ trajectory after SNHL that was worse for children with supratentorial tumors. Pre-treatment, higher adaptive functioning was associated with older age (p= .0001), with a negative change in adaptive functioning trajectory after SNHL that was worse for those treated at a younger age. Attention problems increased after SNHL for the entire group (p= .0099).\nSNHL is associated with IQ decline and worsening adaptive functioning and attention in young children treated for brain tumors. These findings have important implications for treatment modifications, interventions, and caregiver education.",
    "authors": [
        {
            "affiliation": "Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital.",
            "firstname": "Heather M",
            "initials": "HM",
            "lastname": "Conklin"
        },
        {
            "affiliation": "Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital.",
            "firstname": "Nicole A",
            "initials": "NA",
            "lastname": "Salman"
        },
        {
            "affiliation": "Rehabilitation Services, St. Jude Children's Research Hospital.",
            "firstname": "Johnnie K",
            "initials": "JK",
            "lastname": "Bass"
        },
        {
            "affiliation": "Department of Biostatistics, St. Jude Children's Research Hospital.",
            "firstname": "Jie",
            "initials": "J",
            "lastname": "Huang"
        },
        {
            "affiliation": "Department of Biostatistics, St. Jude Children's Research Hospital.",
            "firstname": "Arzu",
            "initials": "A",
            "lastname": "Onar-Thomas"
        },
        {
            "affiliation": "Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital.",
            "firstname": "Jason M",
            "initials": "JM",
            "lastname": "Ashford"
        },
        {
            "affiliation": "Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital.",
            "firstname": "Jennifer",
            "initials": "J",
            "lastname": "Harman"
        },
        {
            "affiliation": "Department of Psychology & Biobehavioral Sciences, St. Jude Children's Research Hospital.",
            "firstname": "Jeanelle S",
            "initials": "JS",
            "lastname": "Ali"
        },
        {
            "affiliation": "Oncology Services Group, Queensland Children's Hospital.",
            "firstname": "Michelle A",
            "initials": "MA",
            "lastname": "Swain"
        },
        {
            "affiliation": "Department of Pediatric Psychiatry and Psychology, Children's Medical Center Dallas.",
            "firstname": "Lana L",
            "initials": "LL",
            "lastname": "Harder"
        },
        {
            "affiliation": "Department of Pediatric Neuropsychology, Children's Minnesota.",
            "firstname": "Bonnie L",
            "initials": "BL",
            "lastname": "Carlson-Green"
        },
        {
            "affiliation": "Department of Pediatric Neuropsychology, Children's Minnesota.",
            "firstname": "Jonathan M",
            "initials": "JM",
            "lastname": "Miller"
        },
        {
            "affiliation": "Department of Child Neurology, Lucile Packard Children's Hospital Stanford.",
            "firstname": "Joanna",
            "initials": "J",
            "lastname": "Wallace"
        },
        {
            "affiliation": "Cancer and Blood Disorders, Rady Children's Hospital San Diego.",
            "firstname": "Ryan J",
            "initials": "RJ",
            "lastname": "Kaner"
        },
        {
            "affiliation": "Department of Radiation Oncology, St. Jude Children's Research Hospital.",
            "firstname": "Thomas E",
            "initials": "TE",
            "lastname": "Merchant"
        },
        {
            "affiliation": "Department of Pediatric Medicine, Neuro-Oncology Division, St. Jude Children's Research Hospital.",
            "firstname": "Giles W",
            "initials": "GW",
            "lastname": "Robinson"
        },
        {
            "affiliation": "Department of Pediatric Medicine, Neuro-Oncology Division, St. Jude Children's Research Hospital.",
            "firstname": "Amar",
            "initials": "A",
            "lastname": "Gajjar"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 The Author(s) 2025. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site\u2014for further information please contact journals.permissions@oup.com.",
    "doi": "10.1093/neuonc/noaf073",
    "journal": "Neuro-oncology",
    "keywords": [
        "brain tumor",
        "cognitive outcomes",
        "ototoxicity",
        "pediatric oncology",
        "young child"
    ],
    "methods": null,
    "publication_date": "2025-03-23",
    "pubmed_id": "40120120",
    "results": "67% of patients experienced mild-to-severe SNHL, which was associated with younger age at diagnosis (p<. 001) but not sex, treatment, or study risk arm (p> .10). Pre-treatment, higher IQ was associated with older age and higher socioeconomic status (p< .01), with a negative change in IQ trajectory after SNHL that was worse for children with supratentorial tumors. Pre-treatment, higher adaptive functioning was associated with older age (p= .0001), with a negative change in adaptive functioning trajectory after SNHL that was worse for those treated at a younger age. Attention problems increased after SNHL for the entire group (p= .0099).",
    "title": "Ototoxicity and Cognitive Outcomes among Very Young Children Treated for Brain Tumors: Findings from a Multisite, Prospective, Longitudinal Trial.",
    "xml": "<Element 'PubmedArticle' at 0x7885030ac1d0>"
}