Executive Function After Childhood Cancer: Insights from Network Neuroscience

Abstract In this review, we examine the empirical literature on the cognitive late effects of childhood acute lymphoblastic leukemia (ALL) and brain tumors, with a focus on executive function and its neural underpinnings. Executive function is a critical domain, influencing survivors’ educational attainment, social relationships, and overall quality of life. We first examine behavioral evidence of executive function impairments observed after cancer diagnosis and treatment. We then explore neuroscientific insights, integrating findings from volumetric analyses, functional imaging, and network-based approaches to uncover neural mechanisms underlying these deficits. Special emphasis is placed on the value of network-based methods, including structural and functional connectivity as well as overall network organization. Finally, we identify promising directions for future research aimed at deepening our understanding of these cognitive late effects and developing effective strategies to mitigate them. This review seeks to bridge behavioral and neural perspectives, offering insights that can inform clinical practices and improve outcomes for childhood cancer survivors.