Survived but Changed: Investigating the Effects of Pediatric Cancer and Cancer-Related Posttraumatic Stress Symptoms on Hippocampal Volumes
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Survival rates among children diagnosed with pediatric cancer have tremendously increased over the past few decades due, in part, to advances in cancer treatments. As a result, survivors, their families, and clinicians are increasingly confronted with the injurious effects of cancer and its treatments on physical and mental health. Childhood cancer and related treatments may lead to stressful and potentially traumatic experiences for children and their families. In fact, up to 50% of pediatric cancer survivors (PCS) experience posttraumatic stress symptoms (PTSS) and other mental health problems. Previous studies of pediatric cancer survivors have shown changes in underlying neurobiology in response to stress - particularly changes in the hippocampus, a region critical for emotion and memory. Additional reports on PTSD/PTSS in non-cancer populations show changes in hippocampal volume. Further research links treatment-related variables (e.g., chemotherapy) to hippocampal volume. The goal of the experiment was to test the effects of pediatric cancer and cancer-related PTSS on hippocampal volume. Bilateral hippocampal volumes and cancer-related PTSS were measured in 24 PCS (11 females, ages 5-17) and 24 age-matched healthy controls. No differences were observed between groups for overall hippocampal volume. However, among PCS, higher cancer-related PTSS was associated with lower left and right hippocampal volumes compared to PCS with low levels of PTSS. Given prior reports showing females to be more susceptible than males to increased PTSS, interactive effects of sex and PTSS on hippocampal volume were tested. Data suggest a significant sex x PTSS interaction such that males with higher cancer-related PTSS had larger hippocampal volume than females with higher cancer-related PTSS.
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