Brain stem tumors in children can exacerbate cognitive, emotional, and behavioral impairment

Professor Zhang Liwei et al.
of the Department of Neurosurgery of Beijing Tiantan Hospital used CBCL to detect the behavioral and emotional responses of children with brainstem tumors.
Results were compared with healthy children, and differences were analysed
in conjunction with the pathological and radiological features of brainstem tumors.

Article was published online in the November 2022 issue of the Journal of Neuro-Oncology
.

- Excerpted from the article chapter

【Ref: Jia H, et al.
J Neurooncol.
2022 Nov; 160(2):423-432.
doi: 10.
1007/s11060-022-04161-x.
Epub 2022 Nov 4.
】

Research background

Brainstem tumors in children are a rare fatal disease
.

Among them, diffuse primary pontine glioma (DIPG) is the most common malignant glioma, with a very poor prognosis and a median survival of less than one year
.

Studies have shown that patients with brainstem tumors have "psychiatric/psychological symptoms"
.

The Child Behavior Checklist (CBCL)
is used to assess children's behavioural and emotional problems.

Professor Zhang Liwei et al.
of the Department of Neurosurgery of Beijing Tiantan Hospital used CBCL to detect the behavioral and emotional responses of children with brainstem tumors.
Results were compared with healthy children, and differences were analysed
in conjunction with the pathological and radiological features of brainstem tumors.

Article was published online in the November 2022 issue of the Journal of Neuro-Oncology
.

Research methods

The investigators included 172 children with brainstem tumors aged 4-18 years as the study group and 46 age-matched healthy children as the control group
.

After excluding 20 children who did not undergo further MRI examination and 6 children who did not have brainstem tumors, 146 cases of brainstem tumors and 46 healthy children in the control group were diagnosed in the study group, and behavior and emotions
were assessed using the child behavior checklist.

Various clinical factors
influencing behavior and emotion are analyzed simultaneously.

Study results

It was found that the study group had significant differences
in most behavioral and emotional symptoms between healthy children in the control group.

In addition, the scores of children with pontine brain tumor were significantly higher than those with bulbar tumor (p=0.
012), including withdrawal (p=0.
043), anxiety/depression symptoms (p=0.
046), thinking (p=0.
004), attention deficit (p=0.
008), dealing with external problems (p=0.
013) and aggressive behavior (p=0.
004).


Pontine tumors (OR=4.
5; 95% CI, 1.
4-14.
059; p=0.
01) or midbrain tumors (OR=3.
818; 95% CI, 1.
629-8.
948; p=0.
002) are risk factors
more associated with neuropsychiatric symptoms.

Conclusion of the study

The results of the study noted that children with brainstem tumors showed serious behavioral and emotional problems
.

Tumor invasion of the pontine and midbrain is a serious risk factor
.

Structural and functional abnormalities of the brainstem lead to long-term behavioral problems and emotional cognitive dysfunction
in young children.

CBCL is easily grasped by parents and pediatricians to assess abnormal behavior problems in children, which can help in the early detection of adolescents
with brainstem tumors.