TY - JOUR

T1 - Brain tumours in children and adolescents may affect the circadian rhythm and quality of life

AU - Pickering, Line

AU - Main, Katharina M.

AU - Feldt-Rasmussen, Ulla

AU - Klose, Marianne

AU - Sehested, Astrid

AU - Mathiasen, René

AU - Jennum, Poul

PY - 2021

Y1 - 2021

N2 - AimChildren with brain and cervical medulla tumours may experience circadian abnormalities and poor health. We aimed to examine their circadian rhythm, fatigue and quality of life (QoL).MethodsChildren with a brain or cervical medulla tumour were recruited from the Paediatric Department, Rigshospitalet, Copenhagen, Denmark, between 2016 and 2020. They were grouped by tumour location involving the circadian regulatory system, defined as diencephalon, pineal gland, brain stem and cervical medulla, or other areas. Saliva melatonin and cortisol concentrations were measured. Sleep diaries and actigraphy assessed sleep-wake patterns. The Pediatric Quality of Life Inventory, Multidimensional Fatigue Scale and Generic Core Scale measured fatigue and QoL.ResultsWe included 68 children (62% males) with a median age (25th-75th percentiles) of 12.2 (7.7–16.3) years. Children with tumours involving the circadian regulatory system typically had a lower melatonin peak (p=0.06) and experienced significantly more fatigue and poorer QoL. Low melatonin profiles were observed in 31% and 4% had a phase-shifted daytime peak, compared with 14% and 0%, respectively, in children with tumours located elsewhere. Children with low melatonin profiles had significantly lower inter-daily stability than those with normal profiles.ConclusionTumours involving the circadian regulatory system adversely affected circadian function, fatigue and QoL.

AB - AimChildren with brain and cervical medulla tumours may experience circadian abnormalities and poor health. We aimed to examine their circadian rhythm, fatigue and quality of life (QoL).MethodsChildren with a brain or cervical medulla tumour were recruited from the Paediatric Department, Rigshospitalet, Copenhagen, Denmark, between 2016 and 2020. They were grouped by tumour location involving the circadian regulatory system, defined as diencephalon, pineal gland, brain stem and cervical medulla, or other areas. Saliva melatonin and cortisol concentrations were measured. Sleep diaries and actigraphy assessed sleep-wake patterns. The Pediatric Quality of Life Inventory, Multidimensional Fatigue Scale and Generic Core Scale measured fatigue and QoL.ResultsWe included 68 children (62% males) with a median age (25th-75th percentiles) of 12.2 (7.7–16.3) years. Children with tumours involving the circadian regulatory system typically had a lower melatonin peak (p=0.06) and experienced significantly more fatigue and poorer QoL. Low melatonin profiles were observed in 31% and 4% had a phase-shifted daytime peak, compared with 14% and 0%, respectively, in children with tumours located elsewhere. Children with low melatonin profiles had significantly lower inter-daily stability than those with normal profiles.ConclusionTumours involving the circadian regulatory system adversely affected circadian function, fatigue and QoL.

KW - Central nervous system tumour

KW - circadian rhythm

KW - cortisol

KW - melatonin

KW - quality of life

KW - Central nervous system tumour

KW - circadian rhythm

KW - cortisol

KW - melatonin

KW - quality of life

U2 - 10.1111/apa.16080

DO - 10.1111/apa.16080

M3 - Journal article

C2 - 34432900

VL - 110

SP - 3376

EP - 3386

JO - Acta Paediatrica

JF - Acta Paediatrica

SN - 0803-5253

IS - 12

ER -