Working Memory Performance Among Childhood Brain Tumor Survivors

This is a cross-sectional controlled study of brain tumor survivors treated at St. Jude with
conformal radiation therapy. Brain tumor survivors (n= 50, solid tumor survivors (n=40), and
healthy sibling controls (n= 40) are evaluated once only with laboratory measures of
cognitive skills (working memory, episodic memory and estimated IQ) and parental
questionnaires (executive and adaptive functions). We also use buccal (cheek) swabs to
gather samples for DNA extraction. We hypothesize: brain tumor survivors will perform
significantly worse than solid tumor and healthy controls on measures of working memory,
working memory will correlate significantly with IQ, working memory will be associated with
parent report of executive functions and a specified genotype related to dopamine metabolism
will be associated with working memory impairment.

Inclusion Criteria:

Brain Tumor Patients

- Treated for a primary central nervous system (CNS) tumor with conformal radiation
therapy and enrolled on the institutional protocol RT-1

- Initiated radiation therapy at least 2 years prior to enrollment with no evidence of
recurrent disease

- Age 8-18 years inclusive at the time of enrollment, with sampling to obtain a broad
cross-section of participants in terms of age, tumor location and time since RT
initiation

- English as the primary language

- Research participant and one parent willing to participate and provide consent/assent
according to institutional guidelines

Solid Tumor Patient Controls

- Treated for a solid tumor (i.e., Ewing's sarcoma, osteosarcoma, soft
tissue/rhabdomyosarcoma, neuroblastoma or Wilms tumor) at St. Jude without CNS
directed therapy - Diagnosed at least 2 years prior to enrollment

- Age 8-18 inclusive at the time of enrollment, with age, gender and race sampling to
broadly match the brain tumor group

- English as the primary language

- Research participant and one parent willing to participate and provide consent/assent
according to institutional guidelines

Sibling Controls

- Healthy sibling controls- siblings of St. Jude patients treated for a brain tumor
(not necessarily on RT-1)

- Age 8-18 inclusive, with age and gender sampling to broadly match the patient group

- English as a primary language

- Research participant and one parent willing to participate and provide consent/assent
according to institutional guidelines

Exclusion Criteria:

Brain Tumor Patients

- Significant impairment in global intellectual functioning (operationalized as an
estimated IQ less than 70 as indicated by most recent RT-1 testing)

- History of documented CNS injury or disease predating cancer diagnosis

- History of documented Attention Deficit Hyperactivity Disorder (ADHD) predating
cancer diagnosis by at least one year (must have been diagnosed by a physician with
medication prescribed)

- Treatment with psychostimulant or psychotropic medication within two weeks of study
enrollment

- Sensory or motor impairment that would preclude valid cognitive testing

Solid Tumor and Sibling Controls

- Significant impairment in global intellectual functioning (operationalized as a
history of special education in a self-contained classroom)

- History of documented CNS injury or disease

- History of documented Attention Deficit Hyperactivity Disorder (ADHD) (must have been
diagnosed by a physician with medication prescribed)

- Treatment with psychostimulant or psychotropic medication within two weeks of study
enrollment

- Sensory or motor impairment that would preclude valid cognitive testing