Systematic Light Exposure Intervention for Fatigue and Cognitive Efficiency in Pediatric Brain Tumor Survivors

项目概要/摘要 由于检测和治疗方面的进步，小儿麻痹症的幸存者人数迅速增加。 脑瘤随着生存率的提高，人们更加重视管理儿科疾病的晚期影响。 脑瘤认知症状在幸存者中普遍存在，并与学习成绩差有关。 成就，职业成功和整体生活质量。然而，很少有干预措施被试用， 减少认知症状。为此，疲劳是脑肿瘤及其治疗的常见晚期效应， 显著降低认知效率，包括注意力和处理信息的速度。之间 对于幸存者，低成本、非药物和适合自我管理的干预措施是 很受欢迎但很少见系统的强光照射已被证明对改善睡眠有效 并减少青少年和成年患者人群（包括青少年和年轻人）的疲劳 实体瘤和成年癌症幸存者。拟议研究的目的是评估可行性， 系统性强光照射对减轻疲劳和改善认知能力的初步效果 儿科脑肿瘤幸存者的效率。40名幸存者（10-18岁）将被要求佩戴 在六周的时间内，在醒来后系统地暴露于光眼镜30分钟，并在2- 干预后几周。将系统性强光暴露（干预）与暗光暴露进行比较 （安慰剂对照）。作为本研究的一部分，我们使用集成的应用程序记录， 光暴露的时间和持续时间;以及与光暴露相关的不良副作用。我们评估 与患者和父母代理报告的疲劳和认知效率相关的初步结果， 亲自和远程管理计算机化电池。这项研究的最终目标是 减轻认知迟发效应以改善儿童脑肿瘤幸存者生活质量的试验干预措施。 这项试点研究的结果将用于完善干预措施，并为一项更大的随机对照研究提供信息。 审判

PROJECT SUMMARY/ABSTRACT Due to advances in detection and treatment, there is a rapidly increasing population of survivors of pediatric brain tumor. With increased survival rates, there is greater emphasis on managing the late effects of pediatric brain tumor. Cognitive symptoms are prevalent among survivors and are associated with poor academic achievement, vocational success, and overall quality of life. However, few interventions have been trialed to reduce cognitive symptoms. To this end, fatigue is a common late effect of brain tumor and its treatment, and it significantly reduces cognitive efficiency, including attention and speed of processing information. Among survivors, interventions that are low cost, non-pharmacological, and appropriate for self-management are highly desired but rare. Systematic bright light exposure has been shown to be effective for improving sleep and reducing fatigue among adolescent and adult patient populations, including adolescent and young adult solid tumor, and adult cancer survivors. The purpose of the proposed study is to evaluate the feasibility and preliminary effectiveness of systematic bright light exposure for reducing fatigue and improving cognitive efficiency among pediatric brain tumor survivors. Forty survivors (ages 10-18 years) will be asked to wear systematic light exposure glasses for 30 minutes upon awakening for a six week period with follow-up at 2- weeks post-intervention. Systematic bright light exposure (intervention) will be compared to dim light exposure (placebo-control). As part of this study, we focus on intervention fidelity, using an integrated app recording timing and duration of light exposure; and adverse side effects associated with light exposure. We assess preliminary outcomes associated with patient and parent-proxy reports of fatigue and cognitive efficiency using in-person and remote administration of a computerized battery. The ultimate goal of this line of research is to trial interventions that mitigate cognitive late effects to improve quality of life in pediatric brain tumor survivors. Findings from this pilot study will be used to refine the intervention and inform a larger randomized controlled trial.