LEARNING IMPAIRMENTS AMONG SURVIVORS OF CHILDHOOD CANCER

描述(改编自调查人员摘要)：一些幸存下来的儿童 癌症类型，特别是急性淋巴细胞白血病(ALL)和脑 肿瘤，学习障碍的发生率比他们的 一般人群中健康的同龄人。这些损伤是有原因的 没有已知的有效治疗方法，其严重程度足以抑制正常 学业成就、职业成就和生活质量。上一首 研究已经提出了一种模式，在这种模式下，治疗导致的病变 大脑，尤其是白质中的大脑，是学习的根本原因 经常表现为能力缺陷的困难 保持注意力。这项研究计划的目的是检验其有效性 通过定义问题的神经解剖学基础 注意力和学习，并通过评估这些人的行为反应 药物干预存在的问题。为了实现这一目标，量化 脑部磁共振成像(QMRI)与神经心理测试 将对625名接受ALL或恶性治疗的参与儿童进行调查 三个儿科癌症中心的脑瘤。据推测，有大量的 患者的正常脑白质将：a)与 健康的同龄人，b)直接与他们的中枢 神经系统治疗，以及c)与他们的表现呈正相关 关于持续关注和学习的衡量标准。第二个研究假设是 哌甲酸甲酯将有效地减少他们的问题 注意力和学习。这一假设将在200名儿童中进行检验。 根据客观问题从较大的筛选样本中选择 持续关注和学习以下方面：(A)立即(1-1/2小时) 我们实验室的行为优势和(B)短期(3周)优势 家庭和学校采用随机、安慰剂对照、交叉设计，然后 (C)家庭和学校的长期(12个月)赡养费。结果是 这些研究将对儿童癌症产生潜在的重要影响 通过减少癌症和癌症治疗的认知发病率，以及通过 进一步加深了我们对它们生物学基础的了解。

DESCRIPTION (adapted from investigator's abstract): Children surviving some types of cancer, particularly acute lymphoblastic leukemia (ALL) and brain tumors, have an increased incidence of learning impairments compared to their healthy peers in the general population. These impairments, for which there is no known effective treatment, are of sufficient severity to inhibit normal academic achievement, vocational attainment, and quality of life. Previous investigations have suggested a model in which treatment-induced lesions of the brain, especially in the white matter, are an underlying cause of learning difficulties that are frequently manifested as deficits in the ability to sustain attention. The goal of this research proposal is to test the validity of this model by defining the neuroanatomic substrates of problems with attention and learning and by assessing the behavioral response of these problems to pharmacological intervention. To accomplish this goal, quantitative magnetic resonance imaging (qMRI) of the brain and neuropsychological testing will be conducted on 625 participating children treated for ALL or malignant brain tumors at 3 pediatric cancer centers. It is hypothesized that volumes of normal white matter in patients will be: a) significantly reduced compared to healthy peers, b) directly associated with the intensity of their central nervous system treatment, and c) positively correlated with their performance on measures of sustained attention and learning. A second study hypothesis is that methylphenidate will be effective in reducing their problems with attention and learning. This hypothesis will be tested with 200 children selected from the larger screened sample on the basis of objective problems with sustained attention and learning with regard to: (a) immediate (1-1/2 hr) behavioral benefits in our laboratory and (b) short-term (3 week) benefits at home and school in randomized, placebo-controlled, crossover designs, and then (c) long-term (12 month) maintenance benefits at home and school. The results of these studies will have a potentially important impact on childhood cancer by reducing the cognitive morbidities of cancer and cancer treatment and by furthering our knowledge of their biological basis.