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Harris W, Brunette-Clement T, Wang A, Phillips HW, Brelie CVD, Weil AG, Fallah A. Long-term Outcomes of Pediatric Epilepsy Surgery: Individual Participant Data and Study Level Meta-Analyses. Seizure 2022; 101:227-236. [DOI: 10.1016/j.seizure.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/13/2022] [Accepted: 08/26/2022] [Indexed: 12/01/2022] Open
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Keng A, Stewart DE, Sheehan KA. Neuropsychiatric Symptoms After Brain Tumor Resection in Children and Adolescents: A Scoping Review. J Acad Consult Liaison Psychiatry 2021; 63:110-118. [PMID: 34229094 DOI: 10.1016/j.jaclp.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/23/2021] [Accepted: 06/26/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Brain tumors are one of the most common solid tumors in pediatric populations, with their treatments having significant neuropsychiatric impact. OBJECTIVE The objective of this study was to review the literature on neuropsychiatric sequelae after surgical resection of brain tumors in children and adolescents. METHODS Using a scoping method, we reviewed empirical articles describing pediatric patients with brain tumors who underwent partial or total resection and examined major neuropsychiatric domains postoperatively over time. RESULTS The initial search yielded 15,543 articles. After duplicate removal, abstract screening, and review, 44 articles were included. Cognitive deficits were the most widely studied outcomes and found to be associated with tumor location, operative variables, perioperative complications, treatment types, and psychosocial factors. Cerebellar mutism, or posterior fossa syndrome, commonly co-occurred with emotional and behavioral dysregulation after posterior fossa resections. Depression, anxiety, and somatization were frequently grouped together as "distress," with higher rates among pediatric patients with brain tumor than among healthy peers. Problematic school behaviors, antisocial, and attention-deficit traits were increased; however, several other behaviors (e.g., risky sexual behaviors, substance use) were equal or lower when compared to peers. Posttraumatic stress disorder was highly prevalent and often interfered with social functioning. Delirium, eating disorders, and longer-term outcomes received inadequate attention. CONCLUSION Identifying risk factors of neuropsychiatric sequelae and their impact after pediatric brain tumor resection is important for prognostication and the development of tailored management strategies for these children and adolescents.
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Affiliation(s)
- Alvin Keng
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Donna E Stewart
- Centre for Mental Health, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Kathleen Ann Sheehan
- Centre for Mental Health, University Health Network, University of Toronto, Toronto, ON, Canada
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Ehrstedt C, Ahlsten G, Strömberg B, Lindskog C, Casar-Borota O. Somatostatin receptor expression and mTOR pathway activation in glioneuronal tumours of childhood. Seizure 2020; 76:123-130. [PMID: 32062323 DOI: 10.1016/j.seizure.2020.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 12/15/2019] [Accepted: 01/16/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To investigate the expression of somatostatin receptors (SSTRs) and markers of mTOR pathway in paediatric glioneuronal tumours and correlate these findings with tumour type, BRAFV600E mutational status and clinical characteristics such as tumour location, seizure frequency and duration, and age. METHOD 37 children and adolescents with a neuropathological diagnosis of glioneuronal tumour were identified over a 22-year period. Immunohistochemical analyses for SSTRs type 1, 2A, 3, 5 and ezrin-radixin-moesin (ERM) and phosphorylated S6 (pS6), which are indicators of mTOR pathway activation, were performed in tumour specimens from 33 patients and evaluated using the immunoreactive score (IRS). The IRS were compared to tumour type, BRAFV600E status and clinical characteristics. RESULTS Ganglioglioma (GG) was the most frequently encountered subgroup (n = 27), followed by dysembryoplastic neuroepithelial tumour (DNET; n = 4). GGs expressed SSTR2A and SSTR3 to a high extent, 56 % and 44 % respectively. Expression of SSTR2A was also found in DNETs. Signs of mTOR pathway activation were abundant in GGs, but only present in one DNET. No correlations with BRAFV600E presence or clinical characteristics were found. CONCLUSIONS Expression of SSTRs and activation of mTOR pathway in paediatric glioneuronal tumour suggest that somatostatin analogues and mTOR inhibitors may have potential therapeutic implications in a subset of inoperable childhood glioneuronal tumours causing medically refractory epilepsy and/or tumour growth. Further clinical studies are warranted to validate these findings.
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Affiliation(s)
- Christoffer Ehrstedt
- Department of Women´s and Children´s Health, Section for Paediatrics, Uppsala University, Sweden; Uppsala University Children´s Hospital, Uppsala, Sweden.
| | - Gunnar Ahlsten
- Department of Women´s and Children´s Health, Section for Paediatrics, Uppsala University, Sweden; Uppsala University Children´s Hospital, Uppsala, Sweden
| | - Bo Strömberg
- Department of Women´s and Children´s Health, Section for Paediatrics, Uppsala University, Sweden; Uppsala University Children´s Hospital, Uppsala, Sweden
| | - Cecilia Lindskog
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Olivera Casar-Borota
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Department of Clinical Pathology, Uppsala University Hospital, Uppsala, Sweden
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Zhang L, Hou XH, Zou XP, Li RZ, Wang CD, Sun J, Wang CH, Xu CF, Chen CX, Deng MM, Zuo XL, Zou DW. Survey of nocturnal reflux in patients with gastroesophageal reflux disease in China. J Dig Dis 2019; 20:589-595. [PMID: 31574578 DOI: 10.1111/1751-2980.12820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/11/2019] [Accepted: 09/16/2019] [Indexed: 12/11/2022]
Abstract
UNLABELLED To evaluate current diagnosis and treatment of patients with nocturnal gastroesophageal reflux (nGER). METHODS This multicenter observational study was conducted in 44 hospitals in China from May 2017 to February 2018. Outpatients with nGER were recruited and their relevant data were collected using a questionnaire, including age, gender, body mass index, history of smoking and alcohol consumption, comorbid diseases, lifestyle, self-reported health status, medical history, nGER symptoms and severity, Hospital Anxiety Depression Scale, Pittsburgh Sleep Quality Index, diagnosis and treatment choices. The study was registered on the Chinese Clinical Trial Registry (no. ChiCTR1800017525). RESULTS The study included 4978 individuals, with valid questionnaires collected from 4448 patients (89.4%). The symptoms of heartburn and regurgitation were more severe at night than during the day (P < 0.05). Age and body mass index were positively correlated with reflux severity at night and during the day (P < 0.05). The severity of nGER was positively associated with lifestyle factors such as smoking, a high-fat diet, carbonated beverage consumption, late supper (later than 9 pm), and snoring (all P < 0.05). Night-time heartburn and regurgitation were related with sleep disorder. CONCLUSIONS Lifestyle factors are associated with nGER severity, and nGER affects sleep quality. It will be beneficial to popularize and strengthen the diagnosis and treatment of nGER.
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Affiliation(s)
- Ling Zhang
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.,Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Hua Hou
- Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiao Ping Zou
- Department of Gastroenterology, Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, China
| | - Rong Zhou Li
- Department of Gastroenterology, Rui'an People's Hospital, Wenzhou, Zhejiang Province, China
| | - Cheng Dang Wang
- Department of Gastroenterology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China
| | - Jing Sun
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Cai Hua Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Chun Fang Xu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Chun Xiao Chen
- Department of Gastroenterology, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Ming Ming Deng
- Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
| | - Xiu Li Zuo
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Duo Wu Zou
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Skirrow C, Cross JH, Owens R, Weiss‐Croft L, Martin‐Sanfilippo P, Banks T, Shah E, Harkness W, Vargha‐Khadem F, Baldeweg T. Determinants of IQ outcome after focal epilepsy surgery in childhood: A longitudinal case‐control neuroimaging study. Epilepsia 2019; 60:872-884. [DOI: 10.1111/epi.14707] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Caroline Skirrow
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeuropsychologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
- Cambridge Cognition Cambridge UK
| | - J. Helen Cross
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeurologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Rosie Owens
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeuropsychologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Louise Weiss‐Croft
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeuropsychologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
- Science Gallery LondonKing's College London London UK
| | - Patricia Martin‐Sanfilippo
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeuropsychologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Tina Banks
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of RadiologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Emily Shah
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
| | - William Harkness
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeurosurgeryGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Faraneh Vargha‐Khadem
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeuropsychologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
| | - Torsten Baldeweg
- Developmental Neurosciences ProgrammeGreat Ormond Street Institute of Child Health, University College London London UK
- Department of NeuropsychologyGreat Ormond Street Hospital for Children NHS Foundation Trust London UK
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