Effects of Sleep Disturbance on Neuropsychological Functioning in Patients with Pediatric Brain Tumor

Abstract Purpose While the effects of sleep on cognition in typically developing children are well established, there is a paucity of research in patients with pediatric brain tumor (PBT), despite their increased risk for sleep-related disturbances. The aim of this study was to examine the impact of sleep factors on patient-reported outcome (PRO) measures, including adaptive and executive functioning within this population.Methods 133 patients with PBT (52% male) ages 5-23 (x̄ = 12.8yrs; SD = 4.5yrs) underwent neuropsychological evaluation, including assessment of adaptive and executive functioning. Subjective sleep concerns, nocturnal sleep duration, and daytime sleep behavior were also collected and compared to age-based guidelines.Results Nearly 30% of patients reported subjective sleep concerns, while the sample as a whole presented with reduced nocturnal sleep duration (approximately one hour below age-based recommendations). Despite the expectation for monophasic sleep by age five, nearly half of the sample reported consistent daytime napping. With regard to functional outcomes, inadequate sleep predicted decreased adaptive functioning, F(1, 56) = 4.23, p < .05 (R2 = .07), as well as increased symptoms of executive dysfunction, F(1, 108) = 3.51, p < .05 (R2 = .03).Conclusion Patients with PBT demonstrate several aspects of abnormal sleep, which are associated with poorer long-term PROs. Further exploration of diagnostic, treatment-related, and demographic variables will be needed to better understand these relationships among patients with PBT in order to inform appropriate interventions.

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Impact of executive functioning on health‐related quality of life of pediatric brain tumor survivors

Pediatric Blood & Cancer ◽

10.1002/pbc.29130 ◽

2021 ◽

Author(s):

Camara Murphy ◽

Naadira C. Upshaw ◽

Amanda S. Thomas ◽

Grace Fong ◽

Anna Janss ◽

...

Keyword(s):

Quality Of Life ◽

Brain Tumor ◽

Executive Functioning ◽

Pediatric Brain Tumor ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Pediatric Brain

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Exploiting Laboratory Insights to Improve Outcomes of Pediatric Central Nervous System Tumors

American Society of Clinical Oncology Educational Book ◽

10.1200/edbk_159149 ◽

2016 ◽

pp. e540-e546 ◽

Cited By ~ 2

Author(s):

Giles W. Robinson ◽

Hendrik Witt ◽

Adam Resnick

Keyword(s):

Brain Tumor ◽

Molecular Mechanisms ◽

Therapeutic Potential ◽

Pediatric Brain Tumor ◽

Pediatric Brain Tumors ◽

Low Grade ◽

Short Period ◽

Tumor Management ◽

The Impact ◽

Pediatric Brain

Over a relatively short period of time, owing to improvements in biotechnology, our ability to identify the molecular mechanisms within pediatric brain tumors has dramatically increased. These findings have reshaped the way that we describe these diseases and have provided insights into how to better treat these often devastating diseases. Although still far from reaching the full therapeutic potential these advancements hold, the impact of these findings is steadily taking hold of pediatric brain tumor management. In this article, we summarize the major discoveries within three common pediatric brain tumor categories; medulloblastoma, ependymoma, and low-grade glioma. We discuss the current impact of these findings on treatment and the direction these findings may take the field of pediatric neuro-oncology.

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CN-05 * DO PEDIATRIC BRAIN TUMOR SURVIVORS SUFFER AN INCREASED RISK OF OVARIAN/ENDOCRINE DYSFUNCTION AS COMPARED TO NON-BRAIN TUMOR SURVIVORS?

Neuro-Oncology ◽

10.1093/neuonc/nou243.5 ◽

2014 ◽

Vol 16 (suppl 5) ◽

pp. v47-v47

Author(s):

S. Z. Elsarrag ◽

J. C. Eickhoff ◽

D. M. Puccetti ◽

S. M. Salih

Keyword(s):

Brain Tumor ◽

Pediatric Brain Tumor ◽

Endocrine Dysfunction ◽

Increased Risk ◽

Pediatric Brain

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Feasibility and efficacy of an extended trial of home-based working memory training for pediatric brain tumor survivors: a pilot study

Neuro-Oncology Practice ◽

10.1093/nop/npw015 ◽

2016 ◽

Vol 4 (2) ◽

pp. 111-120 ◽

Cited By ~ 3

Author(s):

Bonnie Carlson-Green ◽

Jennifer Puig ◽

Anne Bendel

Keyword(s):

Working Memory ◽

Brain Tumor ◽

Executive Functioning ◽

Late Effects ◽

Pediatric Brain Tumor ◽

Working Memory Training ◽

Memory Training ◽

Neurocognitive Late Effects ◽

Pediatric Brain

Abstract Background. Impaired working memory appears to play a key role in some of the neurocognitive late effects of pediatric brain tumor treatments, including declines in intellectual and executive functioning. Recent studies of pediatric cancer survivors suggest Cogmed® Working Memory Training is effective at improving working memory, although pediatric brain tumor survivors may demonstrate a less robust response than children with other cancers. The current study sought to determine if an extended course of Cogmed (35 sessions) was both feasible and efficacious for brain tumor survivors and if improvements were observable in near-transfer and far-transfer working memory measures as well as parent rating scores at 6 months post-treatment. Methods. Twenty pediatric brain tumor survivors ages 8 to 18 years with working memory deficits completed 35 sessions of Cogmed. Assessments of working memory and academic skills were completed at baseline, completion of training, and 6-month follow-up and parents completed questionnaires at baseline and 6-month follow-up. Results. Participants showed significant improvements in working memory at training completion and 6-month follow-up and math achievement at 6-month follow-up. Parents reported executive functioning improvements at follow-up as compared with baseline. Participants’ program-based working memory skills did not change significantly between sessions 25 and 35, suggesting that extended training did not provide additional benefit. Conclusions. This study replicates and extends previous research by: (1) demonstrating that brain tumor survivors at high risk for neurocognitive late effects can complete and benefit from working memory training, (2) identifying a point of diminished returns on training time investment, and (3) demonstrating benefits 6 months post-intervention.

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QOL-31. USE OF PATIENT-REPORTED OUTCOMES TO IDENTIFY YOUTH AT RISK FOR IMPAIRED OVERALL HEALTH

Neuro-Oncology ◽

10.1093/neuonc/noaa222.691 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii437-iii437

Author(s):

Lisa Ingerski ◽

Rebecca Williamson Lewis ◽

Ann Mertens ◽

Tobey MacDonald

Keyword(s):

At Risk ◽

Brain Tumor ◽

Global Health ◽

Patient Reported Outcomes ◽

Pediatric Brain Tumor ◽

Measurement Information ◽

T Score ◽

Modifiable Factors ◽

Patient Reported ◽

Pediatric Brain

Abstract Pediatric brain tumor survivors often experience persistent and clinically significant late-effects following treatment. Critical to understanding morbidity is utilization of patient-reported outcomes (PROs). The current study evaluated PROs of individuals previously diagnosed with a pediatric brain tumor and identified risk factors for less optimal overall health. Participants included 127 youth 10.59±4.81 (M±SD) years old at survey completion and 4.45±3.82 years from diagnosis of a brain tumor (34.6% Pilocytic Astrocytoma, 9.4% Medulloblastoma, 9.4% Ependymoma, 7.9% Craniopharyngioma, 38.6% Other). Outcomes were assessed via Patient-Reported Outcomes Measurement Information System (PROMIS) parent-proxy measures. Overall health was assessed via PROMIS Global Health (i.e., a measure of general, physical, mental, and social health). Univariate and logistic regression analyses examined potential demographic, medical, and psychosocial factors (e.g., age, race, diagnosis, treatment) related to poor global health. Initial descriptive analyses suggested that most youth experienced anxiety symptoms (T-score M±SD=50.71±11.54), depressive symptoms (47.96±10.34), cognitive functioning (46.52±9.10), and fatigue (55.14±10.62) similar to their peers. However, 31.0% of youth experienced impaired global health (T-score<40). After adjusting for other potential covariates, the final model suggested that youth with significant anxiety (OR=6.20, CI=1.56–24.65), youth with significant fatigue (OR=3.96, CI=1.26–12.41), and youth who did not undergo a gross total resection (OR=0.25, CI=0.07–0.96) were at risk for impaired global health. Identifying those at-risk for impaired health is essential to reducing survivor morbidity and optimizing overall quality of life following treatment. Current data suggest potentially modifiable factors that may improve long-term outcomes for survivors of pediatric brain tumors.

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