Ramjan Sameera, Levitch Cara, Sands Stephen, Kim Soo Young, Barnett Marie, Bledsoe Jesse, Holland Alice Ann
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Neurooncol Pract. 2022 Nov 7;10(2):152-161. doi: 10.1093/nop/npac090. eCollection 2023 Apr.
Executive and social functioning difficulty is well established in pediatric brain tumor survivors. Few studies have compared posterior fossa (PF) tumor survivors in comparison to their peers. The relationship between attention, processing speed, working memory, fatigue, and executive and social functioning was investigated to better understand the factors that impact executive and social functioning in PF tumor populations.
Sixteen medulloblastomas, 9 low-grade astrocytomas (LGAs), and 17 healthy controls recruited from 4 sites completed measures of working memory and processing speed, and self-reported fatigue. One parent completed questionnaires on executive and social functioning.
There were no significant differences among all 3 groups on parent-reported executive and social functioning; of note, parents of LGA survivors expressed greater concerns regarding behavioral and cognitive regulation than did parents of medulloblastoma survivors and healthy controls. Parent-reported attention was related to parent-reported emotion, behavior, and cognitive regulation. Worse self-reported fatigue was associated with greater emotional dysregulation for the 2 PF tumor groups.
Parents of PF tumor survivors described their children as performing similarly to their peers in most facets of executive and social functioning. While LGA survivors are traditionally thought to have more favorable outcomes, our finding of parent-reported executive functioning concerns to be worse for this group highlights the importance of long-term follow-up for all PF tumor survivors. Additionally, significant effects of attention on aspects of executive functioning in PF tumor survivors may inform current clinical practice and the future development of more effective interventions.
小儿脑肿瘤幸存者存在执行功能和社交功能障碍已得到充分证实。很少有研究将后颅窝（PF）肿瘤幸存者与其同龄人进行比较。研究了注意力、处理速度、工作记忆、疲劳与执行功能和社交功能之间的关系，以更好地了解影响PF肿瘤人群执行功能和社交功能的因素。
从4个地点招募的16名髓母细胞瘤患者、9名低级别星形细胞瘤（LGA）患者和17名健康对照者完成了工作记忆和处理速度测量以及自我报告的疲劳情况。一名家长完成了关于执行功能和社交功能的问卷调查。
在家长报告的执行功能和社交功能方面，所有3组之间没有显著差异；值得注意的是，LGA幸存者的家长比髓母细胞瘤幸存者的家长和健康对照者对行为和认知调节表达了更大的担忧。家长报告的注意力与家长报告的情绪、行为和认知调节有关。对于2个PF肿瘤组，自我报告的疲劳越严重，情绪失调越严重。
PF肿瘤幸存者的家长表示，他们的孩子在执行功能和社交功能的大多数方面表现与同龄人相似。虽然传统上认为LGA幸存者的预后更好，但我们发现家长报告的该组执行功能问题更严重，这凸显了对所有PF肿瘤幸存者进行长期随访的重要性。此外，注意力对PF肿瘤幸存者执行功能方面的显著影响可能为当前临床实践和未来更有效干预措施的开发提供参考。
