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小脑肿瘤切除对执行功能、焦虑及疼痛恐惧的长期影响:一项混合方法的试点研究。

The long-term impact of cerebellar tumor resection on executive functioning, anxiety, and fear of pain: A mixed methodology pilot study.

作者信息

Lunde Claire E, Dudek Madison R, Talbert Cameron A, Sieberg Christine B, Silva Katie E, Papadelis Christos, Ullrich Nicole J, Manley Peter E, Moulton Eric A

机构信息

Biobehavioral Pain Innovations Lab, Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts, USA.

Pain and Affective Neuroscience Center, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

出版信息

Appl Neuropsychol Child. 2024 Apr 11:1-11. doi: 10.1080/21622965.2024.2337208.

Abstract

This pilot study investigated the long-term impact of a surgery-only treatment (no exposure to other treatments, such as chemotherapy and radiation) for pediatric cerebellar low-grade gliomas on executive function, anxiety, and fear of pain (FOP) beliefs. Twelve patients who underwent surgical glioma resection during childhood (surgery age was 4-16 years, study visit age was 10-28 years), and 12 pain-free controls matched for age, sex, race, and handedness were tested. The spatial extent of resection was precisely mapped using magnetic resonance imaging (MRI). Executive function, anxiety, and FOP were assessed using validated self-report age-appropriate questionnaires for children and adults. Structured clinical interviews at a post-surgery follow-up visit were completed (average: 89 months, range: 20-99). No significant differences in FOP (FOPQ-C t[14 = 1.81,  = 0.09; FOPQ-III t[4] = 0.29,  = 0.79), executive function scores (BRIEF t[20] = 0.30,  = 0.28), or anxiety scores (MASC t[16] = 0.19,  = 0.85; MAQ t[4] = 1.80,  = 0.15) were found in pediatric or adult patients compared to pain-free controls. Clinical interviews mainly categorized pediatric patients as not anxious. One participant reported mild/subclinical anxiety, and one had moderate clinical anxiety. Neither psychologists nor patients endorsed impairments to executive functioning, anxiety, or FOP. Our pilot results suggest that pediatric cerebellar tumor survivors treated with surgery-only have favorable long-term functioning related to these themes. While these results are promising, they will need to be replicated in a larger patient sample.

摘要

这项初步研究调查了仅采用手术治疗(未接受化疗和放疗等其他治疗)小儿小脑低级别胶质瘤对执行功能、焦虑及疼痛恐惧(FOP)信念的长期影响。研究测试了12名儿童期接受过胶质瘤手术切除的患者(手术年龄为4至16岁,研究访视年龄为10至28岁),以及12名在年龄、性别、种族和利手方面匹配的无疼痛对照者。使用磁共振成像(MRI)精确绘制切除的空间范围。采用经过验证的适合儿童和成人的自我报告问卷评估执行功能、焦虑和FOP。在术后随访时完成了结构化临床访谈(平均:89个月,范围:20至99个月)。与无疼痛对照者相比,小儿或成年患者在FOP(FOPQ-C t[14]=1.81,p=0.09;FOPQ-III t[4]=0.29,p=0.79)、执行功能评分(BRIEF t[20]=0.30,p=0.28)或焦虑评分(MASC t[16]=0.19,p=0.85;MAQ t[4]=1.80,p=0.15)方面均未发现显著差异。临床访谈主要将小儿患者归类为不焦虑。一名参与者报告有轻度/亚临床焦虑,一名有中度临床焦虑。心理学家和患者均未认可执行功能、焦虑或FOP存在损害。我们的初步结果表明,仅接受手术治疗的小儿小脑肿瘤幸存者在这些方面具有良好的长期功能。虽然这些结果很有前景,但需要在更大的患者样本中进行重复验证。

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