Prevalence of attention-deficit/hyperactivity disorder in pediatric brain tumor survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10572-10572
Author(s):  
Emily Kauvar Shabason ◽  
Cole Brodsky ◽  
Julie Baran ◽  
Wendy Hobbie ◽  
Jane E. Minturn ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Radiation Therapy ◽  
Brain Tumor ◽  
Attention Deficit ◽  
Pediatric Brain Tumor ◽  
Tumor Diagnosis ◽  
Adhd Diagnosis ◽  
Hyperactivity Disorder ◽  
Brain Tumor Diagnosis ◽  
Pediatric Brain

10572 Background: Pediatric brain tumor survivors (PBTS) often have neurodevelopmental late effects, including attention and concentration deficits, which may impact cognitive and academic functioning. Such symptoms are also seen in attention-deficit/hyperactivity disorder (ADHD), which affects ~5-8% of children and adolescents. This study examined the prevalence of ADHD diagnosis and ADHD medication use in PBTS and identified higher risk subsets of patients. Methods: A retrospective chart review was completed of PBTS (n = 106), diagnosed from 1999-2013, who were at least 2 years from the end of tumor-directed therapy (surgery, chemotherapy and/or radiation therapy) and without a multi-system genetic disorder or severe developmental delay prior to brain tumor diagnosis. Subjects were already screened for or enrolled in 3 other studies of PBTS late effects. Statistical analysis involved chi-squared analysis. Results: Among the 106 patients, 55.7% were male, with an average age at time of brain tumor diagnosis of 5.9 years (0-12.2 years). The most common tumor types were glioma (51.9% with 47.2% low grade, 4.7% high grade), medulloblastoma (13.2%) and ependymoma (11.3%), with 50% of tumors supratentorial, 46.2% infratentorial and 3.8% either extending or multifocal across the tentorium. Of the patients, 42.5% received radiation therapy, 38.7% chemotherapy and 86.8% surgery. Nineteen patients (17.9%) had ADHD diagnoses, and 20 (18.9%) had been on ADHD medications. Clinical factors associated with an ADHD diagnosis were supratentorial vs. infratentorial tumors (28.3% vs. 6.1%, p = 0.013), no radiation therapy vs. radiation therapy (27.9% vs. 4.4%, p = 0.002) and no chemotherapy vs. chemotherapy (24.6% vs. 7.3%, p = 0.024). ADHD diagnosis was not associated with age of brain tumor diagnosis or surgical treatment. Conclusions: Our study suggests that PBTS have over twice the ADHD prevalence as the general population, most notably in patients with supratentorial tumors or without a history of radiation therapy or chemotherapy. The results suggest that a closer look at this population is warranted and that select patients may benefit from behavioral or pharmacologic ADHD treatments to optimize functioning.

scholarly journals The Many Roles of the Rock: A Qualitative Inquiry into the Roles and Responsibilities of Fathers of Children with Brain Tumors

Children ◽  
2019 ◽  
Vol 6 (10) ◽  
pp. 113 ◽  
Author(s):  
Jacob E. Robinson ◽  
David Huskey ◽  
Jonathan Schwartz ◽  
Meaghann S. Weaver
Keyword(s):  
Palliative Care ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Personal Growth ◽  
Pediatric Brain Tumor ◽  
Qualitative Inquiry ◽  
Tumor Diagnosis ◽  
Support Needs ◽  
Brain Tumor Diagnosis ◽  
Pediatric Brain

A pediatric brain tumor diagnosis impacts an entire family unit, from diagnosis through curative treatment, and into survivorship or bereavement. Paternal caregiver experience has been significantly underexplored in pediatric neuro-oncology research as compared to maternal experience. This case series study explores the paternal roles, responsibilities, strengths, challenges, personal growth, and support needs of fathers of children with brain tumors receiving new palliative care consultations. In the study setting, a neuro-oncology diagnosis results in an automatic referral to the palliative care team, and thus, a convenience sampling model was employed based on consecutive palliative care consults for new childhood brain tumor diagnoses. In this study, four fathers of pediatric brain tumor patients receiving palliative care consultations responded to eight open-ended questions. Individual, voice-recorded interviews were transcribed for semantic content qualitative analysis. Analysis followed Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Participants completed quantitative surveys of their information preferences and support needs. Participants defined their father role as: being a team parent, an adaptable father, supporter, provider, a present father, and protector. Role conflict due to paternal responsibilities were recognized, such as the absence from the hospital to provide financial security for the family, and yet a desire to be physically present for the child. Fathers prioritized their knowledge needs about their child’s diagnosis, prognosis, and treatment above emotional needs. Fathers shared experiences of their personal growth through their child’s brain tumor diagnosis and advised on preferred support formats to include both verbal and written information. Understanding how paternal caregivers of children with cancer define their roles and goals has potential to improve the care and communication delivered to families of pediatric neuro-oncology patients.

scholarly journals IMMU-21. INVESTIGATION OF WHITE BLOOD CELL CHARACTERISTICS IN CSF SAMPLES AT PEDIATRIC BRAIN TUMOR DIAGNOSIS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii364-iii364
Author(s):  
Hunter Greer ◽  
Kristen Campbell ◽  
Sadaf Samay ◽  
Adam Green
Keyword(s):  
Brain Tumor ◽  
Tumor Cell ◽  
Pediatric Brain Tumor ◽  
High Grade Glioma ◽  
Pediatric Brain Tumors ◽  
Tumor Diagnosis ◽  
Low Grade ◽  
Brain Tumor Diagnosis ◽  
Pediatric Brain ◽  
Insight Into

Abstract BACKGROUND There has been a recent surge in investigation of immunity and immunotherapy, but their role in pediatric brain tumors is incompletely defined. We hypothesized that investigating an understudied dataset, WBC and differential results in CSF drawn at the time of pediatric brain tumor diagnosis to look for microscopic metastases, would provide insight into the role of immunology and potential for immunotherapy in these diseases and correlate with prognosis and/or metastasis. METHODS We conducted a retrospective comparison analysis of CSF values in 349 patients at our institution from samples drawn within 60 days of initial CNS tumor diagnosis from 1998–2018. We examined total nucleated cell count, absolute counts and percentages for WBC subtypes. We compared CSF values by tumor cell presence, patient vital status, and disease group: atypical teratoid rhabdoid tumor, ependymoma, germinoma, high-grade glioma (HGG), low-grade glioma (LGG), medulloblastoma, non-germinomatous germ cell tumor, and other embryonal tumors (OET). We used Wilcoxon and Kruskal-Wallis tests for comparisons. RESULTS Overall, higher lymphocyte percentage (p=0.002) and lower monocyte percentage (p=0.007) were associated with survival. WBC characteristics did not differ significantly based on tumor cell presence. Compared to medulloblastoma, ependymoma showed a more active CSF immune response, while LGG, HGG, and OET showed a less active response, based on total WBC and/or absolute neutrophil count (p=0.001–0.007). CONCLUSIONS Higher lymphocyte and lower monocyte percentages in CSF correlated with better prognosis overall; causality requires further investigation. Tumor subtypes varied in their immune stimulation, offering potential insight into which will be amenable to immunotherapy.

scholarly journals TR-04 * NANOPARTICLE siRNA DELIVERY VEHICLES INHIBIT DNA REPAIR AND SENSITIZE PEDIATRIC BRAIN TUMOR CELLS TO RADIATION THERAPY

2015 ◽  
Vol 17 (suppl 3) ◽  
pp. iii37-iii37
Author(s):  
F. Kievit ◽  
Z. Stephen ◽  
K. Wang ◽  
C. Dayringer ◽  
J. Silber ◽  
...  
Keyword(s):  
Dna Repair ◽  
Radiation Therapy ◽  
Brain Tumor ◽  
Tumor Cells ◽  
Sirna Delivery ◽  
Pediatric Brain Tumor ◽  
Brain Tumor Cells ◽  
Delivery Vehicles ◽  
Pediatric Brain

scholarly journals Large Vessel Arteriopathy After Cranial Radiation Therapy in Pediatric Brain Tumor Survivors

2018 ◽  
Vol 33 (5) ◽  
pp. 359-366 ◽  
Author(s):  
Matthew Nordstrom ◽  
Erin Felton ◽  
Katherine Sear ◽  
Benita Tamrazi ◽  
Joseph Torkildson ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Brain Tumor ◽  
Pediatric Brain Tumor ◽  
Childhood Cancer Survivors ◽  
Large Vessel ◽  
Arterial Ischemic Stroke ◽  
Cranial Radiation ◽  
Radiation Induced ◽  
Cerebral Arteriopathy ◽  
Pediatric Brain

Among childhood cancer survivors, increased stroke risk after cranial radiation therapy may be caused by radiation-induced arteriopathy, but limited data exist to support this hypothesis. Herein, we assess the timing and presence of cerebral arteriopathy identified by magnetic resonance angiography (MRA) after cranial radiation therapy in childhood brain tumor survivors. In a cohort of 115 pediatric brain tumor survivors, we performed chart abstraction and prospective annual follow-up to assess the presence of large vessel cerebral arteriopathy by MRA. We identified 10 patients with cerebral arteriopathy. The cumulative incidence of arteriopathy 5 years post–cranial radiation therapy was 5.4% (CI 0.6%-10%) and 10 years was 16% (CI 4.6%-26%). One patient had an arterial ischemic stroke 2.4 years post–cranial radiation therapy in the distribution of a radiation-induced stenotic artery. We conclude that large vessel arteriopathies can occur within a few years of cranial radiation therapy and can become apparent on MRA in under a year.

scholarly journals Self-compassion and Perceived Criticism in Adults with Attention Deficit Hyperactivity Disorder (ADHD)

Mindfulness ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 2506-2518
Author(s):  
Danielle M. Beaton ◽  
Fuschia Sirois ◽  
Elizabeth Milne
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Self Report ◽  
Cross Sectional ◽  
Natural Group ◽  
Adhd Diagnosis ◽  
Hyperactivity Disorder ◽  
Self Compassion ◽  
Perceived Criticism ◽  
Group Comparisons

Abstract Objectives Attention deficit hyperactivity disorder (ADHD) is associated with increased criticism from others. To date, there is little research considering the consequences of how others respond to people with ADHD. Self-compassion is a positive way of relating to oneself during difficulty. Here, we investigate whether levels of self-compassion differ between people with and without ADHD, and whether perceived criticism mediates any differences in self-compassion between people with and without ADHD. Methods A cross-sectional design was used to conduct natural group comparisons. A sample of 1203 adults (46% with a self-reported ADHD diagnosis) recruited via social media, online forums and posters completed online self-report measures of diagnostic status, ADHD traits, self-compassion and perceived criticism. Between-group comparisons of self-compassion and perceived criticism were conducted on participants grouped by diagnosis, then grouped by ADHD trait severity. Perceived criticism was tested as a mediator variable between ADHD diagnosis and self-compassion. Results Adults with an ADHD diagnosis showed significantly lower self-compassion and higher perceived criticism than the participants without ADHD. Participants high in ADHD traits but without a diagnosis had significantly similar levels of self-compassion to the diagnosed group. Mediation analysis found that higher perceived criticism partially explained the relationship between ADHD diagnosis and self-compassion, even after accounting for co-occurring mood disorder diagnosis. Conclusions Adults with ADHD are less self-compassionate than adults without ADHD. This is partially explained by the higher level of criticism they perceive from others.

Holly's Story: Illustration of an Attention Deficit Hyperactivity Disorder Case

2008 ◽  
Vol 21 (4) ◽  
pp. 1049-1051
Author(s):  
A. Aureli ◽  
D. Piancatelli ◽  
T. Del Beato ◽  
P. Sebastiani ◽  
V. Melillo ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Neuropsychological Tests ◽  
Hla Class I ◽  
Statistical Manual ◽  
Adhd Diagnosis ◽  
Hyperactivity Disorder ◽  
Diagnostic And Statistical Manual ◽  
Allele Drb1

During the last 10 years a significant increase of childhood neuropsychiatric disorders, such as attention deficit hyperactivity disorder (ADHD), has been reported. ADHD is believed to have a multifactorial etiology including multiple genetic and prenatal environmental factors. For this reason, there has been a recent revival regarding the role of autoimmunity in this pathology. An ADHD combined-type patient born from a drug-addicted mother was studied. Neuropsychological tests according to the criteria of the 4th edition of the Diagnostic and Statistical Manual (DSM4) permitted us to make the ADHD-diagnosis. The HLA-A, -B, and -DRB1 alleles of the child were determined by sequence-based typing (SBT) after DNA extraction. Although no autistic behavioral features were observed in the patient, a double genetic association between ADHD and autism was reported. In fact, HLA class I alleles (A*02 and B*44) associated to autism and the HLA class II allele (DRB1*04) associated both to autism and ADHD were identified.

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