LEARNING IMPAIRMENTS AMONG SURVIVORS OF CHILDHOOD CANCER

儿童癌症幸存者的学习障碍

• 批准号: 6513180
• 负责人: RAYMOND K MULHERN
• 金额: $ 56.72万
• 依托单位: ST. JUDE CHILDREN'S RESEARCH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-07-12 至 2004-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6513180
• 关键词: attention; brain disorder chemotherapy; brain imaging /visualization /scanning; brain neoplasms; child (0-11); clinical research; cognition; human subject; human therapy evaluation; learning disorders; lymphocytic leukemia; magnetic resonance imaging; methylphenidate; neuroanatomy; neuropsychological tests; pediatric neoplasm /cancer; performance; psychological models

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.

描述（改编自研究者摘要）：儿童存活一些 癌症类型，特别是急性淋巴细胞白血病（ALL）和脑 肿瘤，有学习障碍的发病率增加相比， 健康的同龄人。这些损伤， 没有已知的有效治疗，严重程度足以抑制正常的 学业成绩、职业成就和生活质量。先前 研究已经提出了一种模型，其中治疗诱导的 大脑，特别是白色物质，是学习的潜在原因 这些困难经常表现为缺乏能力， 保持注意力。这项研究的目的是测试有效性 通过定义问题的神经解剖学基础， 注意力和学习，并通过评估这些行为反应， 药物干预的问题。为了实现这一目标，量化 大脑磁共振成像（qMRI）和神经心理学测试 将在625名接受ALL或恶性肿瘤治疗的参与儿童中进行 三个儿科癌症中心的脑肿瘤据推测， 患者中的正常白色物质将：a）与 健康的同龄人，B）直接与他们的中央强度相关 神经系统治疗，以及c）与他们的表现正相关 持续关注和学习的措施。第二个研究假设是 哌醋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出 持续关注和学习：（a）立即（1-1/2小时） 在我们的实验室中的行为益处和（B）在以下条件下的短期（3周）益处： 采用随机、安慰剂对照、交叉设计在家庭和学校进行，然后 (c)家庭和学校的长期（12个月）抚养津贴。结果 这些研究将对儿童癌症产生潜在的重要影响， 通过降低癌症和癌症治疗的认知发病率， 加深了我们对它们生物学基础的了解。