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Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
Unraveling the relations between post-traumatic stress symptoms, neurocognitive functioning, and limbic white matter
Anne E M Leenders1, Eva Kremer-Hooft van Huijsduijnen1, Bruno Robalo1
1Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Insights
Pediatric brain tumor survivors often experience impaired attention and processing speed. Post-traumatic stress symptoms (PTSS) are linked to worse processing speed, emphasizing the need for psychological support and monitoring.
Area of Science:
- Neuroscience
- Pediatric Oncology
- Psychology
Background:
- Pediatric brain tumor patients face risks of neurocognitive deficits and white matter changes.
- Post-traumatic stress symptoms (PTSS) are known to affect cognition and white matter in other populations.
- This study investigates the impact of PTSS on neurocognitive function and limbic white matter in pediatric brain tumor patients.
Purpose of the Study:
- To determine the effect of post-traumatic stress symptoms (PTSS) on neurocognitive functioning in pediatric brain tumor patients.
- To examine the association between PTSS and limbic white matter integrity in this population.
- To identify potential risk factors influencing neurocognitive outcomes and white matter alterations.
Main Methods:
- Neuropsychological assessments and multi-shell diffusion MRI were conducted on 66 pediatric patients (6-16 years) one year post-diagnosis.
- Parents completed PTSS proxy questionnaires at two time points post-diagnosis.
- Statistical analyses included t-tests, chi-square tests, linear regression models, and correlations, controlling for age, treatment intensity, and tumor location.
Main Results:
- Patients showed significantly impaired attention and processing speed compared to normscores.
- Higher PTSS scores were significantly associated with poorer processing speed.
- Treatment intensity, age at diagnosis, and tumor location, but not PTSS, correlated with limbic white matter metrics; no direct association was found between neurocognition and white matter metrics.
Conclusions:
- Increased PTSS in pediatric brain tumor patients is linked to diminished processing speed.
- Monitoring and timely psychological interventions are crucial for optimizing neurocognitive outcomes.
- Future research should explore longitudinal effects and the efficacy of PTSS interventions on neurocognitive performance.
Background:
Pediatric brain tumor patients are at risk of developing neurocognitive impairments and associated white matter alterations. In other populations, post-traumatic stress symptoms (PTSS) impact cognition and white matter. This study aims to investigate the effect of PTSS on neurocognitive functioning and limbic white matter in pediatric brain tumor patients.
Methods:
Sixty-six patients (6-16 years) completed neuropsychological assessment and brain MRI (1-year post-diagnosis) and parents completed PTSS proxy questionnaires (CRIES-13; 1-3 months and 1-year post-diagnosis). Mean Z-scores and percentage impaired (>1SD) for attention, processing speed, executive functioning, and memory were compared to normscores (t-tests, chi-square tests). Multi-shell diffusion MRI data were analyzed for white matter tractography (fractional anisotropy/axial diffusivity). Effects of PTSS on neurocognition and white matter were explored with linear regression models (FDR correction for multiple testing), including age at diagnosis, treatment intensity, and tumor location as covariates. Neurocognition and limbic white matter associations were explored with correlations.
Results:
Attention (M = -0.49, 33% impaired; P < .05) and processing speed (M = -0.57, 34% impaired; P < .05) were significantly lower than healthy peers. PTSS was associated with poorer processing speed (β = -0.64, P < .01). Treatment intensity, age at diagnosis, and tumor location, but not PTSS, were associated with limbic white matter metrics. Neurocognition and white matter metrics were not associated.
Conclusions:
Higher PTSS was associated with poorer processing speed, highlighting the need for monitoring, and timely referrals to optimize psychological well-being and neurocognitive functioning. Future research should focus on longitudinal follow-up and explore the impact of PTSS interventions on neurocognitive performance.
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