||1R37CA256889-01A1 Interpret this number
||Children'S Hosp Of Philadelphia
||Social Connectedness in Pediatric Brain Cancer Survivors
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.