Anesthesia Exposure during Therapy Predicts Neurocognitive Outcomes in Survivors of Childhood Medulloblastoma.
Adolescent
Anesthesia
/ methods
Attention
/ physiology
Cerebellar Neoplasms
/ complications
Child
Child, Preschool
Cognition Disorders
/ diagnosis
Combined Modality Therapy
/ methods
Female
Humans
Male
Medulloblastoma
/ complications
Memory, Short-Term
/ physiology
Mental Status and Dementia Tests
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ complications
Prognosis
Retrospective Studies
Risk Factors
Young Adult
Journal
The Journal of pediatrics
ISSN: 1097-6833
Titre abrégé: J Pediatr
Pays: United States
ID NLM: 0375410
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
08
11
2019
revised:
11
03
2020
accepted:
15
04
2020
pubmed:
14
6
2020
medline:
2
12
2020
entrez:
14
6
2020
Statut:
ppublish
Résumé
To examine the contribution of anesthesia exposure during treatment for childhood medulloblastoma to neurocognitive outcomes 3 years after tumor diagnosis. In this retrospective study, anesthesia data were abstracted from medical records for 111 patients treated with risk-adapted protocol therapy at St Jude Children's Research Hospital. Neurocognitive testing data were obtained for 90.9% of patients. For the 101 patients (62.4% male) who completed testing, mean age at diagnosis was 10.1 years, and 74.3% were staged to have average-risk disease. Anesthesia exposure during treatment ranged from 1 to 52 events (mean = 19.9); mean cumulative duration per patient was 21.1 hours (range 0.7-59.7). Compared with normative expectations (16%), the group had a significantly greater frequency of at-risk scores (<1 SD) on measures of intelligence (28.7%), attention (35.2%), working memory (26.6%), processing speed (46.7%), and reading (25.8%). Including anesthesia exposure duration to linear regression models accounting for age at diagnosis, treatment intensity, and baseline IQ significantly increased the predicted variance for intelligence (r In survivors of childhood medulloblastoma, a neurodevelopmentally vulnerable population, greater exposure to anesthesia significantly and independently predicts deficits in neurocognitive and academic functioning. When feasible, anesthesia exposure during treatment should be reduced.
Identifiants
pubmed: 32532646
pii: S0022-3476(20)30494-7
doi: 10.1016/j.jpeds.2020.04.039
pmc: PMC7387137
mid: NIHMS1587136
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
141-147.e4Subventions
Organisme : NCI NIH HHS
ID : P30 CA021765
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Références
Twin Res Hum Genet. 2009 Jun;12(3):246-53
pubmed: 19456216
J Clin Oncol. 2005 Aug 20;23(24):5511-9
pubmed: 16110011
Pediatrics. 2012 Sep;130(3):e476-85
pubmed: 22908104
Anesthesiology. 2011 May;114(5):1076-85
pubmed: 21368654
Dev Med Child Neurol. 2013 May;55(5):408-17
pubmed: 23157447
Eur J Anaesthesiol. 2015 May;32(5):303-10
pubmed: 25101714
Neuro Oncol. 2017 Nov 29;19(12):1673-1682
pubmed: 29016818
Mayo Clin Proc. 2012 Feb;87(2):120-9
pubmed: 22305025
J Neurosci. 2003 Feb 1;23(3):876-82
pubmed: 12574416
Brain Imaging Behav. 2016 Mar;10(1):258-71
pubmed: 25967954
Science. 1999 Jan 1;283(5398):70-4
pubmed: 9872743
JAMA Oncol. 2019 Jun 20;:
pubmed: 31219514
Indian J Pediatr. 2016 Mar;83(3):209-13
pubmed: 26477350
Neurosci Lett. 2013 Feb 8;534:41-6
pubmed: 23295901
J Int Neuropsychol Soc. 2013 Jan;19(1):44-53
pubmed: 23095276
Pediatrics. 2011 Nov;128(5):e1053-61
pubmed: 21969289
J Clin Oncol. 2013 Oct 1;31(28):3494-500
pubmed: 23980078
Radiology. 1969 Dec;93(6):1351-9
pubmed: 4983156
Anesthesiology. 2009 Apr;110(4):805-12
pubmed: 19293699
Lancet Oncol. 2006 Oct;7(10):813-20
pubmed: 17012043
J Pediatr Psychol. 2014 Jun;39(5):501-11
pubmed: 24627465
PLoS One. 2014 Apr 09;9(4):e94019
pubmed: 24718364
Anesth Analg. 2011 Nov;113(5):1143-51
pubmed: 21415431
J Child Neurol. 2002 Dec;17(12):885-90
pubmed: 12593460
Neuro Oncol. 2010 Dec;12(12):1311-7
pubmed: 20713408
J Am Acad Child Adolesc Psychiatry. 1997 Jun;36(6):853-9
pubmed: 9183142
Eur J Pediatr. 2010 Sep;169(9):1079-85
pubmed: 20225122
Anesthesiology. 2007 Sep;107(3):427-36
pubmed: 17721245
Pediatr Radiol. 2014 Jan;44(1):64-72
pubmed: 23917588
Neuro Oncol. 2014 Aug;16(8):1129-36
pubmed: 24497405
Support Care Cancer. 2018 Jun;26(6):1815-1824
pubmed: 29260390
Anesth Analg. 2013 Dec;117(6):1419-28
pubmed: 24132012
Anesthesiology. 2009 Apr;110(4):796-804
pubmed: 19293700
Behav Brain Funct. 2011 May 06;7:10
pubmed: 21548928
Arch Dis Child Fetal Neonatal Ed. 2013 May;98(3):F267-8
pubmed: 23013611
Br J Anaesth. 2010 Dec;105 Suppl 1:i61-8
pubmed: 21148656