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Grant Details

Grant Number: 5R21CA175840-02 Interpret this number
Primary Investigator: Compas, Bruce
Organization: Vanderbilt University
Project Title: Neuroplasticity-Based Cognitive Remediation for Pediatric Brain Tumor Survivors
Fiscal Year: 2015


Abstract

DESCRIPTION (provided by applicant): Over 4,000 children are diagnosed with brain tumors in the U.S. each year and advances in treatment have led to significant increases in survival rates for these patients. However, as a result of the disease and treatment with surgery, radiation and chemotherapy, pediatric brain tumor patients show deficits in frontal lobe functions including several aspects of executive function, showing significant declines over time. Remediation of these deficits is a critical target for research. Major changes in brain maturation and connectivity occur during childhood and adolescence, making this a potentially critical window of opportunity for neuroplasticity-based cognitive interventions to support the neural changes that integrate multiple key regions. Computerized cognitive training programs have been used successfully with the patients with schizophrenia, individuals with ADHD, and prodromal adolescents at risk for psychosis. However, these programs have been limited in their application to pediatric brain tumor survivors and untested in brain tumor patients who are undergoing treatment. In the context of an innovative longitudinal design, we aim to test the feasibility, acceptability, and initial efficacy of a neuroplasticiy-based cognitive training progrm, Cogmed, to enhance working memory and attention in children and adolescents who have been diagnosed with brain tumors. We will recruit 72 children with brain tumors at the time of their diagnosis and conduct cognitive testing at baseline (pre-surgery), and at 4-, 5-, and 6-month follow-ups. At 4 months, half will undergo Cogmed adaptive computerized cognitive training (treatment condition) for 5 weeks and half will be assigned to a control condition (the non-adaptive version of Cogmed). Cognitive assessments will be conducted at completion of the cognitive intervention and at 5-weeks post-intervention. We will use near infrared spectroscopy, a noninvasive functional imaging method that uses infrared light to detect changes in cortical hemoglobin levels at pre- and post-cognitive intervention and at 5-weeks post-intervention. We expect that Cogmed adaptive, which will be administered at home, will be feasible and acceptable for the majority (85% or more) of patients. Further, we hypothesize that Cogmed adaptive will help improve working memory and attention skills and increase frontal cortical activity in the brain tumor patients who receive the remediation program compared to those who do not. Using growth curve analyses, we expect that patients who receive the intervention will show a deflection in the negative trajectory of cognitive functions over time. Findings from this pilot study will be used to develop an application for a multi- site randomized clinical trial to test this intervention in a large sample of pediatric brain tumor patients.



Publications

Predictors of cognitive function in pediatric brain tumor patients: pre-surgery through 24-month follow-up.
Authors: Fraley C.E. , Thigpen J.C. , Pearson M.M. , Kuttesch J.F. , Desjardins L. , Hoskinson K.R. , Alvarado-Gonzalez A. , Esbenshade A.J. , Pastakia D. , Friedman D.L. , et al. .
Source: Applied neuropsychology. Child, 2019-12-30; , p. 1-8.
EPub date: 2019-12-30.
PMID: 31887256
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Parent reports of children's working memory, coping, and emotional/behavioral adjustment in pediatric brain tumor patients: A pilot study.
Authors: Desjardins L. , Thigpen J.C. , Kobritz M. , Bettis A.H. , Gruhn M.A. , Ichinose M. , Hoskinson K. , Fraley C. , Vreeland A. , McNally C. , et al. .
Source: Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence, 2018 10; 24(7), p. 959-974.
EPub date: 2017-10-02.
PMID: 28969482
Related Citations

Neurocognitive deficits in children with chronic health conditions.
Authors: Compas B.E. , Jaser S.S. , Reeslund K. , Patel N. , Yarboi J. .
Source: The American psychologist, 2017 May-Jun; 72(4), p. 326-338.
PMID: 28481580
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Presurgical assessment of cognitive function in pediatric brain tumor patients: feasibility and initial findings.
Authors: Thigpen J.C. , Pearson M. , Robinson K.E. , Andreotti C. , Dunbar J.P. , Watson K.H. , Dejardins L. , Holmes L. , Byram R. , Fraley C. , et al. .
Source: Neuro-oncology practice, 2016 Dec; 3(4), p. 261-267.
EPub date: 2016-01-24.
PMID: 27833756
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