Social Connectedness in Pediatric Brain Cancer Survivors

儿童脑癌幸存者的社会联系

• 批准号: 10543801
• 负责人: Matthew C. Hocking
• 金额: $ 62.5万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10543801
• 关键词: Acceleration; Address; Adult; Affect; Age; Behavior; Body Composition; Body mass index; Brain; Brain Injuries; Brain Neoplasms; Cancer Survivor; Cancer Survivorship; Cerebellar Pilocytic Astrocytoma; Childhood Brain Neoplasm; Childhood Malignant Brain Tumor; Clinical; Cognitive; Craniopharyngioma; Data; Development; Diagnosis; Endocrine; Exhibits; Face Processing; Family; Fatigue; Friends; Friendships; Goals; Health; Hearing; Hormones; Impairment; Intervention; Knowledge; Late Effects; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Childhood Neoplasm; Malignant Neoplasms; Malignant neoplasm of brain; Marriage; Measurement; Measures; Medical; Mental Health; Metabolic; Methods; Modeling; Morbidity - disease rate; Neurologic; Neurosecretory Systems; Non-Malignant; Operative Surgical Procedures; Outcome; Oxytocin; Participant; Pediatric Hospitals; Personal Satisfaction; Philadelphia; Physical therapy; Pilocytic Astrocytoma; Populations at Risk; Process; Radiation; Research; Rest; Risk; Risk Factors; Schools; Secondary to; Social Behavior; Social Functioning; Social isolation; Somatotropin; Survivors; Testing; Thyroid Gland; Time; Visit; Well in self; Youth; biopsychosocial; cancer therapy; cohort; effective intervention; experience; health related quality of life; improved; information processing; innovation; interest; irradiation; longitudinal design; medulloblastoma; neurobiological mechanism; neuroimaging marker; novel; peer; prospective; recruit; sex; side effect; social; social attention; social factors; social influence; tumor

PROJECT SUMMARY/ABSTRACT Survivors of pediatric brain tumors often experience significant problems with social connectedness during youth that have lasting effects as adults (e.g., reduced rates of marriage). However, the factors contributing to these difficulties are unclear and little is known about how domains of social connectedness influence health- related quality of life (HRQL) and psychological well-being over time in survivors of pediatric brain cancer. Further, intervention efforts to address these issues have been limited by a lack of research on the underlying risk and mechanistic factors of social connectedness. Candidate risk and mechanistic factors include age at diagnosis, treatment, and treatment-related morbidities across many domains (e.g., cognitive, neurologic, endocrine, metabolic). Additionally, brain cancer treatments disrupt neurodevelopmental processes that are essential to social behavior, such as brain connectivity, face processing, and social attention. Establishing the importance of social connectedness to overall health and the mechanistic processes contributing to social connectedness impairments in pediatric brain cancer survivors is important in order to develop appropriate interventions. The broad objectives of this proposal are to compare domains of social connectedness among survivors of malignant brain tumors to survivors of non-malignant brain tumors, evaluate the influence of social connectedness on HQRL and psychological well-being among survivors, and to evaluate risk and mechanistic factors for the trajectory of social connectedness. We propose an innovative study of youth treated for medulloblastoma (MB), cerebellar pilocytic astrocytoma (PA) or craniopharyngioma (CP) (N = 180; ages 8-16) using a 2-year accelerated longitudinal design with annual visits with cohorts stratified by time since diagnosis. Clinical differences between groups (e.g., malignant/non-malignant, use of craniospinal irradiation) allow for tests of their unique impacts on social connectedness and for identification of potential intervention targets. Participants will be recruited from the Children's Hospital of Philadelphia. At each study visit, participants will complete measures of social connectedness, HRQL, and psychological well-being, as well as assessments of body composition, neuroendocrine function, hearing, brain connectivity (e.g., MRI), social information processing (SIP) and social behavior. Neuroimaging markers of interest include structural connectivity, resting state functional connectivity, and functional connectivity in the social brain during social processing tasks. We hypothesize that social connectedness, and thus HRQL and psychological well-being, are uniquely impacted in MB survivors, and that risk (e.g., CSI) and mechanistic factors (e.g., hearing, social behavior) affect social connectedness over time. We expect to establish deficits in social connectedness as a notable late effect in survivors of medulloblastoma with significant impact on HRQL and well-being and to identify mechanisms of social connectedness. By identifying the mechanisms underlying social connectedness, we can then develop interventions that target key mechanistic factors and improve social connectedness, health, and well-being.

项目总结/摘要 儿童脑肿瘤的幸存者在治疗过程中经常会遇到社会联系方面的严重问题。 作为成年人具有持久影响的青年（例如，降低结婚率）。然而，促成 这些困难还不清楚，关于社会联系领域如何影响健康，人们知之甚少。 相关的生活质量（HRQL）和心理健康随着时间的推移在儿童脑癌幸存者。 此外，解决这些问题的干预努力受到了限制，因为缺乏对这些问题的根本原因的研究。 社会联系的风险和机械因素。候选人的风险和机械因素包括年龄 诊断、治疗和治疗相关的发病率跨越许多领域（例如，认知的，神经的， 内分泌、代谢）。此外，脑癌治疗会破坏神经发育过程， 这对社会行为至关重要，例如大脑连接，面部处理和社会注意力。建立 社会联系对整体健康的重要性以及促进社会联系的机械过程 儿童脑癌幸存者的连通性障碍是重要的，以便制定适当的 干预措施。这项建议的广泛目标是比较社会联系的领域， 恶性脑肿瘤的幸存者与非恶性脑肿瘤的幸存者，评估社会影响 HQRL和幸存者心理健康的联系，并评估风险和机制 社会联系轨迹的因素。我们提出了一个创新的研究青年治疗 髓母细胞瘤（MB）、小脑毛细胞星形细胞瘤（PA）或颅咽管瘤（CP）（N = 180;年龄8-16岁） 采用2年加速纵向设计，每年进行一次访视，队列按诊断后的时间分层。 组间的临床差异（例如，恶性/非恶性，使用颅脊髓照射）允许 测试其对社会联系的独特影响，并确定潜在的干预目标。 参与者将从费城儿童医院招募。在每次研究访视时，参与者将 社会联系，HRQL和心理健康的完整措施，以及评估 身体组成、神经内分泌功能、听力、大脑连接（例如，MRI）、社会信息 处理（SIP）和社会行为。感兴趣的神经影像学标记物包括结构连接、静息 状态功能连接，以及社会处理任务中社会大脑的功能连接。我们 假设社会联系，从而HRQL和心理健康，是唯一的影响， 甲基溴幸存者，以及风险（例如，CSI）和机械因素（例如，听力、社会行为）影响社会 随着时间的推移，我们预计，社会联系的赤字将成为一个显着的晚期效应， 对HRQL和健康有显著影响的髓母细胞瘤幸存者，并确定 社会联系通过识别社会联系的潜在机制， 针对关键机械因素的干预措施，改善社会联系、健康和福祉。