J Neurosci Nurs. 2024 Dec 1;56(6):229-235. doi: 10.1097/JNN.0000000000000793. Epub 2024 Oct 24.
Brain tumor survivors who received radiotherapy (RT) are at a disproportionately increased risk of accelerated aging and symptom burden. We aim to examine the association between environmental enrichment (EE) and health outcomes among low-grade glioma survivors who received brain RT. METHODS: The study used a cross-sectional cohort design, enrolling participants approximately 5 years from diagnosis. The construct of EE consisted of social network, physical activity, employment status, and financial stability. Berkman-Syme Social Network Index, International Physical Activity Questionnaire, Vocational Index Scale, and a Socioeconomic Questionnaire were used to measure the construct of EE. Health outcome measures included the Montreal Cognitive Assessment, Symbol Digit Modality Test, clinical brain magnetic resonance images (pre-RT, approximately 2-3 years after RT, and approximately 5 years after RT), Karnofsky Performance Status Scale, and the MD Anderson Symptom Inventory Brain Tumor Module. Ordinal logistic regression estimated the association between levels of EE and health outcomes. RESULTS: Thirty-nine participants completed the study and experienced varying levels of EE. The median age was 44 years old, ranging from 26 to 78 years old. Nineteen individuals were diagnosed with oligodendroglioma, and 18 were diagnosed with astrocytoma. Thirteen participants had low EE, 17 had moderate EE, and 9 had high EE. Although not statistically significant, we observed patterns of increasing health outcomes (Montreal Cognitive Assessment, Symbol Digit Modality Test, and Karnofsky Performance Status Scale) related to increasing levels of EE. CONCLUSION: This study is an initial exploration into the role of EE in health outcomes and survivorship programs for persons with glioma. Future research should assess EE before treatment or at the time of diagnosis and be longitudinal to accurately ascertain the association between EE and health outcomes. Comprehensive neuro-oncology survivorship programs structured to facilitate EE may reduce symptom burden, promote neuroplasticity, and improve cognitive and functional outcomes after brain radiation.
接受放疗 (RT) 的脑肿瘤幸存者面临加速衰老和症状负担增加的不成比例风险。我们旨在研究环境强化 (EE) 与接受脑部 RT 的低级别胶质瘤幸存者健康结果之间的关系。
该研究采用横断面队列设计，招募接近诊断后 5 年的参与者。EE 的结构包括社会网络、身体活动、就业状况和财务稳定性。使用 Berkman-Syme 社会网络指数、国际体力活动问卷、职业指数量表和社会经济问卷来衡量 EE 的结构。健康结果测量包括蒙特利尔认知评估、符号数字模态测试、临床脑部磁共振图像（RT 前、RT 后约 2-3 年和 RT 后约 5 年）、卡诺夫斯基表现状态量表和 MD 安德森症状量表脑肿瘤模块。有序逻辑回归估计 EE 水平与健康结果之间的关联。
39 名参与者完成了研究，经历了不同程度的 EE。中位年龄为 44 岁，范围为 26-78 岁。19 名患者被诊断为少突胶质细胞瘤，18 名被诊断为星形细胞瘤。13 名参与者的 EE 较低，17 名参与者的 EE 中等，9 名参与者的 EE 较高。尽管没有统计学意义，但我们观察到健康结果（蒙特利尔认知评估、符号数字模态测试和卡诺夫斯基表现状态量表）与 EE 水平增加相关的模式。
这项研究是对 EE 在神经胶质瘤患者健康结果和生存计划中的作用的初步探索。未来的研究应该在治疗前或诊断时评估 EE，并进行纵向研究，以准确确定 EE 与健康结果之间的关系。旨在促进 EE 的综合性神经肿瘤学生存计划可能会减轻症状负担、促进神经可塑性并改善脑部放疗后的认知和功能结果。
