Social Connectedness in Pediatric Brain Cancer Survivors

儿童脑癌幸存者的社会联系

• 批准号: 10543801
• 负责人: Matthew C. Hocking
• 金额: $ 62.5万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10543801
• 关键词: Acceleration; Address; Adult; Affect; Age; Behavior; Body Composition; Body mass index; Brain; Brain Injuries; Brain Neoplasms; Cancer Survivor; Cancer Survivorship; Cerebellar Pilocytic Astrocytoma; Childhood Brain Neoplasm; Childhood Malignant Brain Tumor; Clinical; Cognitive; Craniopharyngioma; Data; Development; Diagnosis; Endocrine; Exhibits; Face Processing; Family; Fatigue; Friends; Friendships; Goals; Health; Hearing; Hormones; Impairment; Intervention; Knowledge; Late Effects; Magnetic Resonance Imaging; Malignant - descriptor; Malignant Childhood Neoplasm; Malignant Neoplasms; Malignant neoplasm of brain; Marriage; Measurement; Measures; Medical; Mental Health; Metabolic; Methods; Modeling; Morbidity - disease rate; Neurologic; Neurosecretory Systems; Non-Malignant; Operative Surgical Procedures; Outcome; Oxytocin; Participant; Pediatric Hospitals; Personal Satisfaction; Philadelphia; Physical therapy; Pilocytic Astrocytoma; Populations at Risk; Process; Radiation; Research; Rest; Risk; Risk Factors; Schools; Secondary to; Social Behavior; Social Functioning; Social isolation; Somatotropin; Survivors; Testing; Thyroid Gland; Time; Visit; Well in self; Youth; biopsychosocial; cancer therapy; cohort; effective intervention; experience; health related quality of life; improved; information processing; innovation; interest; irradiation; longitudinal design; medulloblastoma; neurobiological mechanism; neuroimaging marker; novel; peer; prospective; recruit; sex; side effect; social; social attention; social factors; social influence; tumor

PROJECT SUMMARY/ABSTRACT Survivors of pediatric brain tumors often experience significant problems with social connectedness during youth that have lasting effects as adults (e.g., reduced rates of marriage). However, the factors contributing to these difficulties are unclear and little is known about how domains of social connectedness influence health- related quality of life (HRQL) and psychological well-being over time in survivors of pediatric brain cancer. Further, intervention efforts to address these issues have been limited by a lack of research on the underlying risk and mechanistic factors of social connectedness. Candidate risk and mechanistic factors include age at diagnosis, treatment, and treatment-related morbidities across many domains (e.g., cognitive, neurologic, endocrine, metabolic). Additionally, brain cancer treatments disrupt neurodevelopmental processes that are essential to social behavior, such as brain connectivity, face processing, and social attention. Establishing the importance of social connectedness to overall health and the mechanistic processes contributing to social connectedness impairments in pediatric brain cancer survivors is important in order to develop appropriate interventions. The broad objectives of this proposal are to compare domains of social connectedness among survivors of malignant brain tumors to survivors of non-malignant brain tumors, evaluate the influence of social connectedness on HQRL and psychological well-being among survivors, and to evaluate risk and mechanistic factors for the trajectory of social connectedness. We propose an innovative study of youth treated for medulloblastoma (MB), cerebellar pilocytic astrocytoma (PA) or craniopharyngioma (CP) (N = 180; ages 8-16) using a 2-year accelerated longitudinal design with annual visits with cohorts stratified by time since diagnosis. Clinical differences between groups (e.g., malignant/non-malignant, use of craniospinal irradiation) allow for tests of their unique impacts on social connectedness and for identification of potential intervention targets. Participants will be recruited from the Children's Hospital of Philadelphia. At each study visit, participants will complete measures of social connectedness, HRQL, and psychological well-being, as well as assessments of body composition, neuroendocrine function, hearing, brain connectivity (e.g., MRI), social information processing (SIP) and social behavior. Neuroimaging markers of interest include structural connectivity, resting state functional connectivity, and functional connectivity in the social brain during social processing tasks. We hypothesize that social connectedness, and thus HRQL and psychological well-being, are uniquely impacted in MB survivors, and that risk (e.g., CSI) and mechanistic factors (e.g., hearing, social behavior) affect social connectedness over time. We expect to establish deficits in social connectedness as a notable late effect in survivors of medulloblastoma with significant impact on HRQL and well-being and to identify mechanisms of social connectedness. By identifying the mechanisms underlying social connectedness, we can then develop interventions that target key mechanistic factors and improve social connectedness, health, and well-being.

项目概要/摘要 儿童脑肿瘤的幸存者在治疗过程中经常会遇到严重的社会联系问题。 青少年对成年后产生持久影响（例如结婚率下降）。然而，促成因素 这些困难尚不清楚，而且人们对社会联系领域如何影响健康知之甚少。 儿科脑癌幸存者随时间的相关生活质量（HRQL）和心理健康状况。 此外，由于缺乏对潜在问题的研究，解决这些问题的干预努力受到限制。 社会联系的风险和机制因素。候选者的风险和机制因素包括年龄 许多领域（例如认知、神经、 内分泌、代谢）。此外，脑癌治疗会破坏神经发育过程 对于社会行为至关重要，例如大脑连接、面部处理和社会注意力。建立 社会联系对整体健康的重要性以及促进社会发展的机制过程 儿科脑癌幸存者的连通性障碍对于开发适当的治疗方法非常重要 干预措施。该提案的主要目标是比较不同群体之间的社会联系领域 恶性脑肿瘤的幸存者与非恶性脑肿瘤的幸存者，评估社会的影响 HQRL 和幸存者心理健康的关联性，并评估风险和机制 影响社会联系轨迹的因素。我们提出一项针对接受治疗的青少年的创新研究 髓母细胞瘤 (MB)、小脑毛细胞星形细胞瘤 (PA) 或颅咽管瘤 (CP)（N = 180；年龄 8-16） 采用 2 年加速纵向设计，每年对队列进行随访，自诊断以来按时间分层。 各组之间的临床差异（例如恶性/非恶性、颅脊髓照射的使用）允许 测试它们对社会联系的独特影响并确定潜在的干预目标。 参与者将从费城儿童医院招募。在每次研究访问时，参与者将 社会联系、HRQL 和心理健康的完整测量，以及评估 身体成分、神经内分泌功能、听力、大脑连接（例如 MRI）、社会信息 处理（SIP）和社交行为。感兴趣的神经影像标记包括结构连接、休息 状态功能连接，以及社交处理任务期间社交大脑中的功能连接。我们 假设社会联系以及 HRQL 和心理健康在以下情况中受到独特影响： MB 幸存者，以及风险（例如 CSI）和机械因素（例如听力、社交行为）影响社交 随着时间的推移的连通性。我们期望将社会联系的赤字作为一个显着的后期影响 髓母细胞瘤幸存者对 HRQL 和健康有重大影响，并确定其机制 社会联系。通过识别社会联系背后的机制，我们可以开发 针对关键机制因素并改善社会联系、健康和福祉的干预措施。