Cognitive functioning of pediatric patients with brain tumor: an investigation of the role of gender

PURPOSE: The female gender has been considered a risk factor for cognitive impairment in pediatric brain tumor survivors. However, it is still unknown which specific cognitive domains are at greater risk of impairment in females. The aim of this study was to explore differences between male and female children in distinct domains of cognitive functioning, in order to deepen knowledge on the topic. METHODS: The cognitive performance of 100 males and 71 females aged 6-16 years was assessed by Wechsler Intelligence Scales for Children-Third Edition (WISC-III). Differences between males and females were tested not only on intellectual quotients, but also on WISC-III subtests, which allow the evaluation of different cognitive domains. Analyses were performed in the whole sample and dividing children based on the supratentorial vs. infratentorial location of the tumor. RESULTS: Gender was the only predictor of VIQ in the whole group and in children with supratentorial tumor. Female children with supratentorial tumor performed significantly worse than males in four out of six verbal subtests. However, even among children with infratentorial tumor, females performed worse than males on two verbal subtests. CONCLUSIONS: Overall, findings of this study suggest that females may have more difficulties than males at manipulating verbal oral material. A possible explanation of these findings could be that females present a greater vulnerability to white matter damage due to the illness and post-adjuvant therapies, in line with reports of the literature on female children with lymphoblastic leukemia.