Neurobehavioral Late-Effects in Pediatric Brain Tumors

小儿脑肿瘤的神经行为迟发效应

• 批准号: 6857970
• 负责人: M Douglas Ris
• 金额: $ 45.99万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-03-22 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6857970
• 关键词: adolescence (12-20); attention; behavioral /social science research tag; bioimaging /biomedical imaging; brain morphology; brain neoplasms; child psychology; clinical research; diffusion magnetic resonance imaging; human subject; longitudinal human study; middle childhood (6-11); neoplasm /cancer radiation therapy; neural information processing; neuroimaging; neuropathology; neuropsychological tests; neuropsychology; prognosis; radiation therapy dosage; short term memory; therapy adverse effect

DESCRIPTION (provided by applicant): Significant neurobehavioral sequelae of radiotherapy (RT) in children treated for brain tumors is well-documented and is of increasing concern as larger numbers of such children become long-term survivors. Research on long-term outcomes has promoted the development of RT techniques and protocols that attempt to reduce this morbidity. Further understanding of RT late-effects, though, requires improvements in how we characterized radiation delivered to the brain. Recent technical advances in radiation ontology that permit detailed examination of dose heterogeneity throughout the brain offer new possibilities for improving our models of outcome. One index that shows considerable promise is Integral Biologically effective Dose (IBED). IBED combines numerous RT parameters (dose, volume, fractionation, biological effect) into a Single index for the entire brain or for designated volumes/structures. In this proposal we describe a novel approach to studying outcome that improves upon existing research in three ways: (a) the use of IBED as a index of radiation insult, (b) an improved neurobehavioral measurement strategy that focuses on three crucial constructs (Attention, Processing Speed, and Working Memory), and (e) the use of sophisticated, multimodal imaging techniques (MR Volumetrics, Spectroscopy, and Diffusion Imaging) to measure late-effects on brain composition. This prospective study will be conducted at two sites (Cincinnati and Columbus) enrolling and following children for up to four yeas who have been treated for brain tumors. It will address neurobehavioral imaging changes for participants treated with RT compared to those treated without RT (Specific Aim 1), IBED as a predictor of neurobehavioral and imaging changes over time (Specific Aims 2 & 3), and the relationship between neurobehavioral and imaging changes (Specific Aim 4). The results of this study promise to improve our knowledge and prediction of radiation-related late-effects, which in turn will guide further improvements in RT techniques. It will also provide important information about the development of vulnerable neurobehavioral functions, how they might be protected/preserved, and where to focus early interventions to limit functional morbidity.

描述（由申请人提供）：在接受脑肿瘤治疗的儿童中放射疗法（RT）的明显神经行为后遗症是有据可查的，并且随着大量此类儿童成为长期幸存者而引起了人们的关注。长期结果的研究促进了试图降低这种发病率的RT技术和协议的发展。但是，对RT延迟效应的进一步了解需要改善我们表征向大脑传递的辐射的方式。允许对整个大脑中剂量异质性进行详细检查的辐射本体的最新技术进步为改善我们的结果模型提供了新的可能性。一个表现出巨大希望的指数是整体生物学上有效剂量（IBED）。 IBED将许多RT参数（剂量，体积，分级，生物学效应）结合在一起，以用于整个大脑或指定体积/结构的单个指数。 In this proposal we describe a novel approach to studying outcome that improves upon existing research in three ways: (a) the use of IBED as a index of radiation insult, (b) an improved neurobehavioral measurement strategy that focuses on three crucial constructs (Attention, Processing Speed, and Working Memory), and (e) the use of sophisticated, multimodal imaging techniques (MR Volumetrics, Spectroscopy, and Diffusion成像）测量对大脑组成的晚期作用。这项前瞻性研究将在入学的两个部位（辛辛那提和哥伦布）进行，并追随儿童，以接受多达四个接受过接受脑肿瘤治疗的Yeas。与未经RT治疗的参与者相比，它将针对接受RT治疗的参与者的神经行为成像变化（特定的AIM 1），i作为神经行为的预测因子和成像随时间变化（特定的目标2＆3）以及神经行为和成像变化（特定目标4）之间的关系。这项研究的结果有望提高我们对辐射相关晚期效应的知识和预测，这反过来将指导RT技术的进一步改进。它还将提供有关脆弱神经行为功能的发展，如何受到保护/保存以及在哪里集中早期干预以限制功能发病率的重要信息。