Application of the CNS vital signs test and WISC-IV in the cognitive assessment of Chinese pediatric patients with intra-cranial space occupying lesion

A fast and reliable neurocognitive assessment tool is required for pediatric patients with an intracranial space-occupying lesion (ICSOL). A cross-sectional study was conducted on 41 pediatric patients having ICSOL. Cognitive abilities were assessed using both WISC-IV and CNS Vital Signs (CNS VS). All domains are compared to the normative data. Spearman’s correlation analysis is performed between domains in two batteries. In the WISC-IV, CPI, PSI, and WMI are significantly lower than the normative level. In the CNS VS, NCI, Memory domains, Reaction Time, Social Acuity, and Sustained Attention are significantly lower. Six domains in the CNS VS, including Complex Attention, Sustained Attention, Cognitive Flexibility, Executive Function, Processing Speed, and Social Acuity, positively correlate to the PSI or CPI in the WISC-IV. Sixty percent (9/15) of domains in the CNS VS negatively correlate to the size of ISCOL. The FSIQ in the WISC-IV is significantly associated with patients’ parent education level. Compared to the WISC-IV, CNS VS takes less time, but measures more domains. CNS VS is more sensitive to the size of ICSOL but is not affected by patients’ parent education level. A healthy control group is warranted for interpreting the results in Chinese participants.针对颅内占位性病变（intracranial space-occupying lesion, ICSOL）患儿，亟需一款快速可靠的神经认知评估工具。本研究纳入41例颅内占位性病变患儿开展横断面研究。采用韦氏儿童智力量表第四版（Wechsler Intelligence Scale for Children-Fourth Edition, WISC-IV）与中枢神经行为认知评估系统（CNS Vital Signs, CNS VS）对其认知能力进行评估，并将所有认知域与常模数据进行对比。随后对两套评估工具的各认知域开展斯皮尔曼相关分析。在WISC-IV中，综合表现指数（CPI）、加工速度指数（PSI）与工作记忆指数（WMI）得分显著低于常模水平；在CNS VS中，神经认知综合指数（NCI）、记忆域、反应时、社交敏锐度及持续注意力得分显著低于常模。CNS VS包含的6项认知域，包括复杂注意力、持续注意力、认知灵活性、执行功能、加工速度及社交敏锐度，与WISC-IV中的PSI或CPI呈显著正相关。CNS VS中有60%（9/15）的认知域与ICSOL体积呈负相关。WISC-IV中的全量表智商（Full Scale Intelligence Quotient, FSIQ）与患儿父母的受教育水平显著相关。相较于WISC-IV，CNS VS耗时更短但覆盖的认知域更多，对ICSOL体积变化更为敏感，但不受患儿父母受教育水平的影响。针对中国受试者的结果解读需设置健康对照组。