Pituitary disorders as a predictor of apathy and executive dysfunction in adult survivors of childhood brain tumors
Pituitary disorders as a predictor of apathy and executive dysfunction in adult survivors of childhood brain tumors
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DOI：
10.1002/pbc.26144
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发表时间：
2016-11-01
影响因子：
3.2
通讯作者：
King, Tricia Z.
中科院分区：
文献类型：
--
作者：
Fox, Michelle E.;King, Tricia Z.
背景：冷漠和内分泌功能障碍这两种神经损伤的常见结果之间的关系尚未在脑肿瘤幸存者中得到研究。本研究旨在评估儿童脑肿瘤长期成年幸存者的垂体疾病与冷漠和其他方面执行功能之间的关系，并区分这一人群的冷漠和抑郁。程序：76名儿童期脑肿瘤至少5年的成年幸存者参与了研究。一名参与者完成了额叶系统行为量表（FrSBe）， 76名参与者中的75名完成了DSM-IV-TR （SCID）的结构化临床访谈。通过病历复习获得神经内分泌功能障碍的信息。结果：在41%的幸存者中发现了具有临床意义的FrSBe冷漠水平。垂体功能障碍显著解释了9%的冷漠评分差异，并影响个体是否表现出临床冷漠水平。垂体功能障碍预示着更高水平的执行功能障碍，但并不影响参与者是否达到临床水平的执行功能障碍。过去的重度抑郁发作（MDE）显著预测当前的冷漠，但与垂体疾病没有关系。放射治疗预测垂体功能障碍，但不能预测冷漠或执行功能的差异。结论：儿童脑肿瘤幸存者的冷漠和执行功能障碍与垂体功能障碍有很强的相关性，垂体功能障碍的个体更有可能在成年后表现出临床水平的冷漠。冷漠的临床水平可能没有当前的抑郁，垂体功能障碍对冷漠的影响是独特的。
Background: The relationship between apathy and endocrine dysfunction, both frequent outcomes of neurological insult, has not yet been investigated in brain tumor survivors. The present study aimed to assess the relationship between pituitary disorders and apathy and other facets of executive function in long-term adult survivors of childhood brain tumors and to differentiate between apathy and depression in this population.Procedure: Seventy-six adult survivors of childhood brain tumors at least 5 years past diagnosis participated. An informant completed the Frontal Systems Behavior Scale (FrSBe), and 75 of the 76 participants completed a Structured Clinical Interview for the DSM-IV-TR (SCID). Information on neuroendocrine dysfunction was obtained through medical chart review.Results: Clinically significant levels of apathy on the FrSBe were identified in 41% of survivors. Pituitary dysfunction significantly explained 9% of the variance in apathy scores and affected whether an individual presented with clinical levels of apathy. Pituitary dysfunction predicted higher levels of executive dysfunction but did not impact whether a participant reached clinical levels of executive dysfunction. A past major depressive episode (MDE) significantly predicted current apathy but showed no relationship with pituitary disorders. Radiation treatment predicted pituitary dysfunction but not the differences in apathy or executive functions.Conclusions: Apathy and executive dysfunction in survivors of childhood brain tumors are strongly predicted by pituitary dysfunction, and individuals with pituitary dysfunction are more likely to present with clinical levels of apathy as adults. Clinical levels of apathy may present absent of current depression, and pituitary dysfunction impacts apathy uniquely.