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Prevalence, associations, and predictors of apathy in adult survivors of infantile (<5 years of age) posterior fossa brain tumors
Carroll, C., WATSON, P., Spoudeas, H.A., Hawkins, M.M., Walker, D.A., Clare, I.C.H., Holland, A.J. and Ring, H.A.
Neuro-Oncology, 15(4), 497-505
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Background: Apathy is associated with pervasive and disadvantageous effects on daily functioning. It has been observed transiently in some children following surgery for posterior fossa tumors. In this study our objective was to examine prevalence, associations and predictors of apathy in adult survivors of an infantile posterior fossa brain tumor (PFT). Methods: 117 adult survivors of a childhood PFT before aged 5 years and 60 of their siblings were assessed in a cross-sectional study an average of 32 years (range 18 – 53) after survivors’ initial tumor diagnosis, using the Marin Apathy Evaluation Scale (AES), the Weschler Abbreviated Scale of Intelligence and the Composite International Diagnostic Interview for psychiatric disorders. Results: AES reached or exceeded a criterion score for clinically significant apathy in 35% of survivors compared with 18% of a sibling comparison group. In both sibs and survivors , apathy was associated with lower verbal and full scale IQ and, amongst survivors, with having undergone partial rather than total tumor resection (independent of irradiation status?). Apathy was not related to presence of concurrent ICD -10 depression diagnoses but correlated negatively with employment? Female gender was associated with late apathy following a PFT, with increased likelihood of women reaching the apathy criterion relative to men if they were survivors. Conclusions: Clinically significant and potentially treatable apathy occurs relatively commonly in adult survivors of an early/infantile childhood PFT, particularly women. Clinicians, including those managing posterior fossa pathology in very young children, should be aware of this association and future research should clarify whether specific treatment-related variables are implicated in increasing this risk of apathy.