The Brainfit study: efficacy of cognitive training and exergaming in pediatric cancer survivors – a randomized controlled trial

Abstract

BackgroundCancer survival comes at a price: pediatric cancer survivors bear a high risk for a wide range of cognitive difficulties. Therefore, interventions targeting these difficulties are required. The aim of the present clinical trial is to extend empirical evidence about efficacy of cognitive and physical training in pediatric cancer survivors. It is hypothesized that early cognitive and physical interventions affect the remediation of pediatric cancer survivors in terms of improved executive functions (primary outcome). Additional positive effects of cognitive and physical intervention to other areas such as memory and attention are expected (secondary outcome). Changes in cognitive performance are expected to be associated with structural and functional changes in the brain.MethodsOverall, 150 pediatric cancer survivors and 50 matched controls will be included in this trial. The cancer survivors will be randomly assigned to either a computerized cognitive training, a physical training (exergaming) or a waiting control group. They will be assessed with neuropsychological tests, tests of sport motor performance and physical fitness before and after 8 weeks of training and again at a 3-months follow-up. Moreover, neuroimaging will be performed at each of the three time points to investigate the training impact on brain structure and function.DiscussionWith increasing cancer survival rates, evidence-based interventions are of particular importance. New insights into training-related plasticity in the developing brain will further help to develop tailored rehabilitation programs for pediatric cancer survivors.Trial registrationKEK BE 196/15; KEK ZH 2015–0397; ICTRP NCT02749877; date of registration: 30.11.2016; date of first participant enrolment: .18.01.2017.

Post-operative cerebellar mutism syndrome: rehabilitation issues

“…Interventions, particularly those focused on the cognitive consequences of pCMS, should consider the use of telemedicine or alternative intervention delivery (e.g., home-based computer intervention programs) to maximize access and feasibility to these interventions. In addition, the emerging literature on the positive impact of physical exercise programs in pediatric brain tumor survivors also supports this as a target for future research and clinical implementation [5,50,60].…”

“…Two studies have been published to date and others are in progress evaluating the effect of exercise programs in pediatric brain tumor survivors [5,50,60]. In a controlled crossover exercise program study in long-term survivors of pediatric brain tumors treated with radiation, there is some evidence of structural brain changes including increased white matter and hippocampal volume and increased cortical thickness in multiple brain regions [50,60].…”

“…Aside from emerging evidence for its benefit on cognitive outcomes [5,60], there is a particular lack of literature on physical rehabilitation for children with pCMS to improve motor outcomes. However, there is evidence of functional improvement in children with brain tumors in general following acute inpatient multidisciplinary rehabilitation [44].…”

Glucosylceramide synthase maintains influenza virus entry and infection

“…We thus hypothesized that glucosylceramide synthase (UGCG), which converts ceramide to glucosylceramide, may also play a role in the influenza virus life cycle (green box). When we treated target cells with PPMP, a broadly utilized inhibitor of UGCG [31][32][33], we observed a decrease in infection by PR8 influenza virus encoding NS1-GFP, as monitored by flow cytometry for GFP expression (Fig 2A). However, in order to ensure our results were not due to any off target effects of PPMP we sought to employ a genetic knockout of UGCG.…”

Cognitive Functions State In Pediatric Cancer Survivors And Healthy Controls

“…Given the essential role of them in individual's life, they are also quite fragile. Hence, different diseases, such as cancer, can cause the impairment of cognitive functioning (Benzing, 2018;.…”