Neurocognitive Assessment Strategies
Historically, the BSC was primarily tasked with assessment and data
collection in trials examining neurocognitive outcomes in response to
treatment modifications. Our first concerted effort was the development
of a free-standing protocol, ALTE07C1, designed to streamline and
standardize neurocognitive data collection across COG trials. ALTE07C1
included a brief, direct assessment of cognitive domains commonly
affected by cancer and its treatment and predictive of
educational/occupational outcomes. A total of 945 children were enrolled
on this protocol across COG trials over a span of 14 years, representing
significantly improved data collection rates compared to prior COG
trials. ALTE07C1 has been renamed the COG Standardized Neurocognitive
Assessment Battery and is now embedded in relevant clinical trials.
After the development of ALTE07C1, BSC members began investigating the
utility of a briefer, computerized assessment battery
(Cogstate)6 that can be administered without a
psychologist or neuropsychologist. These computerized assessments have
the potential to characterize neurocognitive functioning with less cost,
time, practice effects, and patient burden than traditional measures.
However, there are minimal data linking these measures to functional
(educational/occupational) outcomes. With this in mind, BSC members
obtained R01 grant funding to develop a comprehensive model of
neurocognitive development in children with high-risk acute
lymphoblastic leukemia to guide prediction of individual risk for
cognitive declines and inform intervention development and timing.
Relying on an early detection model of frequent neurocognitive
monitoring, this initiative uses a multi-method approach of Cogstate
(embedded in protocol AALL1131) and traditional measures (ALTE07C1) to
understand neurocognitive function during and after treatment. Data
collection is ongoing, and analysis is pending.