A systematic review and meta-analysis of executive function outcomes in pediatric central nervous system tumor survivors

Background: This review aimed to determine whether executive dysfunction is a characteristic of survivors of central nervous system tumors in children and adolescents, including Astrocytoma, Neurofibromatosis-1, Medulloblastoma, and Pilocytic Astrocytoma. Methods: A review and meta-analysis of execu...

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Detalhes bibliográficos
Autor: Bausela Herreras, Esperanza
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Recursos:Universidad Pública de Navarra
Repositorio:Academica-e. Repositorio Institucional de la Universidad Pública de Navarra
OAI Identifier:oai:academica-e.unavarra.es:2454/56422
Acesso em linha:https://hdl.handle.net/2454/56422
Access Level:acceso abierto
Palavra-chave:Astrocytoma
BRIEF
Executive function
Neurofibromatosis-1
Medulloblastoma
Pilocytic astrocytoma
Descrição
Resumo:Background: This review aimed to determine whether executive dysfunction is a characteristic of survivors of central nervous system tumors in children and adolescents, including Astrocytoma, Neurofibromatosis-1, Medulloblastoma, and Pilocytic Astrocytoma. Methods: A review and meta-analysis of executive function assessed with Behavior Rating Inventory of Executive Function (BRIEF) in individuals with these tumor types. Results: The main findings of the meta-analyses can be summarized as follows: (i) Neurofibromatosis type 1(NF1) – BRIEF (parents): Children with NF1 show significant deficits in executive functions according to the parent-rated BRIEF, with an overall model effect size of d = 0.81(p<0.001). The most affected areas are working memory, monitoring, and metacognition, indicating that these deficits are consistent and clinically relevant. (ii) NF1 –BRIEF-P (parents and teachers): In this meta-analysis, theoverall model effect size was d = 0.37 (p<0.001), showing moderate but significant difficulties in executive functions. Both parents and teachers report problems in working memory and emerging metacognition, reflecting a consistent pattern across different observational contexts. (iii)Medulloblastoma vs. other tumors: Patients with medulloblastoma exhibit marked deficits in executive functions compared to other brain tumors, with an overall model effect size of d = –0.74 (p<0.001). The most affected areas include inhibition, initiation, regulation, and metacognition, with consistent findings across the included studies. Conclusions: Executive deficits are observed in individuals with brain tumors or survivors, significantly affecting their academic, social, and emotional lives. Early identification, along with educational and neuropsychological support, is essential to preventing these deficits from interfering with academic, personal, and professional functioning.