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儿童期被诊断为神经胶质神经元肿瘤的儿童和青年的认知、健康相关生活质量及情绪

Cognition, health-related quality of life, and mood in children and young adults diagnosed with a glioneuronal tumor in childhood.

作者信息

Ehrstedt Christoffer, Rydell Ann-Margret, Gabert Hallsten Marina, Strömberg Bo, Ahlsten Gunnar

机构信息

Department of Women's and Children's Health, Section for Pediatrics, Uppsala University, Sweden; Uppsala University Children's Hospital, Uppsala, Sweden.

Department of Psychology, Uppsala University, Uppsala, Sweden.

出版信息

Epilepsy Behav. 2018 Jun;83:59-66. doi: 10.1016/j.yebeh.2018.03.026. Epub 2018 Apr 11.

Abstract

AIMS

The aim of this study was to investigate long-term cognitive outcome, health-related quality of life (HRQoL), and psychiatric symptoms in children and young adults diagnosed with a glioneuronal tumor in childhood.

METHODS

Twenty-eight children and adolescents (0-17.99years) with a minimum postoperative follow-up time of five years were eligible for the study; four persons declined participation. A cross-sectional long-term follow-up evaluation was performed using the following study measures: Wechsler Intelligence Scale for Children (WISC-IV) or Wechsler Adult Intelligence Scale (WAIS-IV), Reys Complex Figure Test (RCFT), Short Form 36 version 2 (SF-36v2), Short Form 10 (SF-10), Quality of Life in Epilepsy 31 (QOLIE-31), Hospital Anxiety Depression Scale (HADS) or Beck Youth Inventory Scales (BYI), and Rosenberg Self-Esteem Scale. Historical WISC-III and RCFT data were used to compare cognitive longitudinal data.

RESULTS

Mean follow-up time after surgery was 12.1years. Sixty-three percent (15/24) were seizure-free. Despite a successive postoperative gain in cognitive function, a significant reduction relative to norms was seen in the seizure-free group with respect to perceptual reasoning index (PRI), working memory index (WMI), and full-scale intelligence quotient (FSIQ). Seizure freedom resulted in acceptable HRQoL. Thirty-two percent and 16% exceeded the threshold level of possible anxiety and depression, respectively, despite seizure freedom.

CONCLUSION

Although lower than in corresponding reference groups, cognitive outcome and HRQoL are good provided that seizure freedom or at least a low seizure severity can be achieved. There is a risk of elevated levels of psychiatric symptoms. Long-term clinical follow-up is advisable.

摘要

目的

本研究旨在调查童年期被诊断为神经胶质神经元肿瘤的儿童和青年的长期认知结果、健康相关生活质量(HRQoL)及精神症状。

方法

28名儿童和青少年(0至17.99岁)术后至少随访5年符合研究条件;4人拒绝参与。采用以下研究方法进行横断面长期随访评估:韦氏儿童智力量表(WISC-IV)或韦氏成人智力量表(WAIS-IV)、雷氏复杂图形测验(RCFT)、简明健康调查量表第2版(SF-36v2)、简明健康调查量表第10版(SF-10)、癫痫患者生活质量量表31项(QOLIE-31)、医院焦虑抑郁量表(HADS)或贝克青少年量表(BYI)以及罗森伯格自尊量表。使用历史WISC-III和RCFT数据比较认知纵向数据。

结果

术后平均随访时间为12.1年。63%(15/24)无癫痫发作。尽管术后认知功能持续改善,但在无癫痫发作组中,感知推理指数(PRI)、工作记忆指数(WMI)和全量表智商(FSIQ)相对于常模仍有显著降低。无癫痫发作带来了可接受的健康相关生活质量。尽管无癫痫发作,但分别有32%和16%超过了可能的焦虑和抑郁阈值水平。

结论

尽管低于相应参照组,但只要能实现无癫痫发作或至少癫痫严重程度较低,认知结果和健康相关生活质量就良好。存在精神症状水平升高的风险。建议进行长期临床随访。

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