Neurocognitive and Family Functioning at End of Therapy in Pediatric Brain Tumor

描述（由申请人提供）：儿童脑肿瘤幸存者经历神经认知能力下降，可能影响家庭系统。对其他疾病人群（例如，创伤性脑损伤）的研究表明，神经认知功能和家庭功能可能相互影响。本应用程序的主要目的是检查幸存者神经认知功能和家庭功能（目的1）之间的并发关系，以及家庭功能（目的2）和医疗强度（目的3）对幸存者神经认知功能的预期影响。这项拟议的研究是已知的第一个前瞻性调查儿童脑肿瘤幸存者（N = 50）及其照顾者之间这些相互关系的研究。参与者将包括那些接受过颅脑或颅脑-脊柱放射治疗并正在过渡积极药物治疗的患者。参与者将完成一系列简短的神经心理学测试，评估儿童脑肿瘤幸存者在药物治疗结束时（T1）和6个月后（T2）普遍表现出缺陷的所有领域（工作记忆、处理速度、言语记忆和执行功能）。护理人员还将在两个时间点完成经过验证的生活质量和家庭功能测量。25名具有时间2数据的参与者也将在治疗后1年（T3）重复这些措施。假设：（1 & 2）更好的家庭功能将与T2时幸存者神经认知功能以及幸存者和照顾者的生活质量呈正相关；(3)T1时更好的家庭功能将与T2时幸存者神经认知功能下降较少相关。也有假设(4)，更大的治疗强度将与幸存者神经认知功能的更大下降有关。探索性分析将检验T1期的家庭功能是否会调节治疗强度与T2期神经认知功能下降之间的关系。这项研究的发现可以为儿童脑肿瘤患者的临床护理以及随后在更广泛的中枢神经系统疾病幸存者群体中的研究提供信息。这项研究的数据将用于未来的拨款申请，并将作为一个纲领性研究线的基础，该研究线将检查儿童癌症幸存者经历的神经认知晚期效应的心理社会影响。

DESCRIPTION (provided by applicant): Childhood brain tumor survivors experience neurocognitive declines that may impact the family system. Research with other illness populations (e.g., traumatic brain injury) illustrates the potential of neurocognitive functioning and family functioning to affect each other. The primary goals of this application are to examine the concurrent relations between survivor neurocognitive functioning and family functioning (Aim 1) and the prospective influences of family functioning (Aim 2) and medical treatment intensity (Aim 3) on survivor neurocognitive functioning. The proposed research is the first known study to investigate prospectively these interrelations in childhood brain tumor survivors (N = 50) and their caregivers. Participants will include those treated with either cranial or cranial-spinal radiation and transitioning off of active medical treatment. Participants will complete a brief battery of neuropsychological tests assessing all areas where childhood brain tumor survivors generally show deficits (working memory, processing speed, verbal memory and executive function) at the conclusion of medical treatment (T1) and again 6 months later (T2). Caregivers also will complete well-validated measures of quality of life and family functioning at both time points. Twenty-five participants with Time 2 data also will repeat these measures 1 year post-treatment (T3). It is hypothesized that (1 & 2) better family functioning will be positively associated with concurrent survivor neurocognitive functioning and survivor and caregiver quality of life at T2 and (3) better family functioning at T1 will be associated with fewer decline in survivor neurocognitive functioning at T2. It also is hypothesized (4) that greater treatment intensity will be associated with greater decline in survivor neurocognitive functioning. Exploratory analyses will examine whether family functioning at T1 moderates the relation between treatment intensity and decline in neurocognitive functioning seen at T2. Findings from this study could inform clinical care with childhood brain tumor patients and subsequent research among a broader group of survivors affected by central nervous system disease. Data from this study will be used for future grant submissions and will serve as the basis for a programmatic line of research that examines psychosocial influences on the neurocognitive late effects experienced by childhood cancer survivors.