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

项目摘要/摘要 由于检测和治疗的进步，儿科疾病幸存者的人数迅速增加。 脑瘤。随着存活率的提高，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很普遍，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验为 减少认知症状。为此，疲劳是脑肿瘤及其治疗的常见后遗症，而它 显著降低认知效率，包括注意力和处理信息的速度。其中 幸存者，低成本、非药物和适合自我管理的干预措施 非常想要，但很少见。系统的强光暴露已被证明对改善睡眠有效 以及减少青少年和成人患者群体中的疲劳，包括青少年和年轻人 实体瘤和成年癌症幸存者。拟议研究的目的是评估可行性和 系统性强光暴露对缓解疲劳和改善认知功能的初步效果 儿童脑肿瘤存活者的有效率。40名幸存者(10-18岁)将被要求穿着 清醒后对眼镜进行系统性光照30分钟，为期六周，随访时间为2- 干预后几周。系统性强光暴露(干预)将与弱光暴露进行比较 (安慰剂对照组)。作为这项研究的一部分，我们使用集成的应用程序录音，重点关注干预保真度 光照的时间和持续时间；以及与光照有关的不良副作用。我们评估 与患者和家长代理报告疲劳和认知效率相关的初步结果 计算机化电池的面对面和远程管理。这一系列研究的最终目标是 缓解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。 这项先导研究的结果将被用来改进干预措施，并为更大规模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.