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

小儿脑肿瘤治疗结束时的神经认知和家庭功能

• 批准号: 8320598
• 负责人: Matthew C. Hocking
• 金额: $ 8.38万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-07 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8320598
• 关键词: Affect; Aftercare; Age; Area; Caregivers; Caring; Central Nervous System Diseases; Cephalic; Child; Childhood; Childhood Brain Neoplasm; Data; Disease; Family; Family Caregiver; Future; Goals; Grant; Intervention; Investigation; Late Effects; Literature; Measures; Medical; Memory; Modeling; Neurocognitive; Neurocognitive Deficit; Neuropsychological Tests; Outcome; Parents; Participant; Pathway interactions; Patients; Pediatric Hospitals; Philadelphia; Population; Psychosocial Factor; Psychosocial Influences; Quality of life; Radiation; Recruitment Activity; Research; Short-Term Memory; Spinal; Survivors; System; Time; Traumatic Brain Injury; base; childhood cancer survivor; clinical care; contextual factors; executive function; experience; family influence; family management; functional outcomes; health related quality of life; indexing; memory process; neglect; neuro-oncology; oncology program; processing speed; prospective; psychosocial; social; survivorship; tumor

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. PUBLIC HEALTH RELEVANCE: Childhood brain tumor survivors experience significant neurocognitive declines that impact psychosocial and family outcomes. Family functioning has the potential to influence neurocognitive functioning in survivors but these relations have not been explored. The proposed research will explore the concurrent and prospective influences of family functioning at the end of tumor-directed therapy on survivor neurocognitive functioning and quality of life and potentially highlight family functioning as an intervention target in orderto ameliorate the impact of intense medical treatments on neurocognitive functioning.

描述（由申请人提供）：儿童脑肿瘤幸存者会经历神经认知能力下降，这可能会影响家庭系统。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。该应用程序的主要目标是检查幸存者神经认知功能和家庭功能（目标 1）之间的并发关系，以及家庭功能（目标 2）和医疗强度（目标 3）对幸存者神经认知功能的预期影响。拟议的研究是第一个已知的前瞻性研究儿童脑肿瘤幸存者（N = 50）及其照顾者的这些相互关系的研究。参与者将包括接受颅脑或颅脊髓放射治疗以及正在停止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治疗结束时 (T1​​) 和 6 个月后 (T2) 通常表现出缺陷的所有领域（工作记忆、处理速度、语言记忆和执行功能）。护理人员还将在这两个时间点完成经过充分验证的生活质量和家庭功能测量。拥有第 2 次数据的 25 名参与者也将在治疗后 1 年（T3）重复这些措施。据推测，(1 和 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护理人员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。还假设 (4) 治疗强度越大，幸存者神经认知功能的下降幅度越大。探索性分析将检查 T1 时的家庭功能是否调节治疗强度与 T2 时神经认知功能下降之间的关系。这项研究的结果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参考。这项研究的数据将用于未来的拨款申请，并将作为一系列研究的基础，该研究检查心理社会对儿童癌症幸存者经历的神经认知后期影响的影响。 公共卫生相关性：儿童脑肿瘤幸存者会经历显着的神经认知下降，影响社会心理和家庭结果。家庭功能有可能影响幸存者的神经认知功能，但这些关系尚未得到探索。拟议的研究将探讨肿瘤定向治疗结束时家庭功能对幸存者神经认知功能和生活质量的同时和前瞻性影响，并可能强调家庭功能作为干预目标，以减轻强化医疗对神经认知功能的影响。