Peta M. Sharples

High frequency stimulation of the mamillothalamic tract for the treatment of resistant seizures associated with hypothalamic hamartoma

We investigate the clinical outcome from stimulation of the mamillothalamic tract in two patients with intractable epilepsy secondary to hypothalamic hamartomas. One patient has a left‐sided and the other a right‐sided tumor. Both patients presented with a history of gelastic and complex partial seizures resistant to multiple antiepileptic drugs. Both patients underwent insertion of a single deep brain‐stimulating electrode ipsilateral to the site of the tumor, lying adjacent to the mamillothalamic tract. Postoperatively they both had a significant reduction in seizure frequency, with one patient being seizure free for the last 10 months. An improvement in mood was reported by the patient’s primary carers and demonstrated on quality of life questionnaires.

Family, demographic and illness-related determinants of HRQL in children with brain tumours in the first year after diagnosis

To evaluate the relationship between parent‐ and child‐report Health‐Related Quality of Life (HRQL) and demographic, tumour and family variables in children with a brain tumour in the first year after diagnosis and to identify determinants of HRQL at 12 months.

Child-related determinants of health-related quality of life in children with brain tumours 1 year after diagnosis†

Infratentorial tumour site and health‐related quality of life (HRQL) 1 month after diagnosis have been shown to predict HRQL 1 year after diagnosis in children with brain tumours. This study aimed to identify additional early child‐related determinants of parent‐ and child‐report HRQL.

Cognitive function in children with brain tumors in the first year after diagnosis compared to healthy matched controls

Improved survival of children with brain tumors (BTs) has increased focus on ameliorating morbidity. To reduce the risk of progressive cognitive decline, remedial strategies need to be instituted early, based upon accurate appraisal of need, yet few studies have investigated cognition in BT children early post‐diagnosis. The study aims were to investigate cognition in children with primary BTs 1, 6, and 12 months post‐diagnosis compared with healthy children, exploring the impact of disease and treatment variables.

Health-related quality of life in children with traumatic brain injury; relationship between parent–proxy report and child self-report

Introduction The ultimate aim of neurorehabilitation for traumatic brain injury (TBI) survivors is good health-related quality of life (HRQL). Despite recommendation by the WHO that self-reporting measures of HRQL in children should be used whenever possible, paediatric TBI studies have almost all have used parent–proxy report to assess HRQL. Aims (1) To examine the relationship between parent and child-report estimations of HRQL at 1 (T1), 6 (T6) and 12 (T12) months post-TBI; (2) to investigate factors influencing parent–child agreement. Methods Prospective cohort study. HRQL was measured by Paediatric Quality of Life Inventory (PedsQL). Severity of TBI was classified by admission Glasgow Coma Score (GCS), post-traumatic amnesia (PTA) and length of hospital stay (LOS). Verbal and performance IQ in the child were assessed by the Wechsler Intelligence Scale for Children-III; emotional state by the Child Behaviour Checklist (CBCL). Burden to the main carer and family were assessed by Beck Depression Inventory (BDI) and family burden of injury inventory (FBII). Results 47 TBI subjects were studied. Mean age was 11.2 yrs. 66% were boys. 51% had severe/moderate TBI, 49% mild. Significant correlations were found between parent and child report PedsQL total, physical and psychosocial summary scores at T1 (TSS, r=0.36, p=0.020; physical, r<0.001; PSS, r=0.32, p=0.036), T6 (TSS, r=0.63, p<0.001; physical, r=0.69, p<0.001; PSS, r=0.58, p<0.001) and T12 (r=0.57, p=0.001; physical, r=0.74, p<0.001; PSS, r=0.45, p=0.008) post-TBI. In contrast to other chronic disorders, parents tended to score HRQL higher than children. However, mean differences between parent and child scores were not significant for any domain at any time point, with the exception of school domain at T6 (mean bias, −7.91, SD=21.88, p=0.022) and T12 (mean bias, −7.83, SD=19.55, p=0.036). Differences between parent and child-report scores did not correlate with VIQ or PIQ, but did significantly correlate with parent and child emotional state at T1 and T6 (T6, BDI, r=−0.40, p=0.010; FBII, r=−0.56, p=0.001; CBCL total problem score, r=−0.511, p=0.001). By T12, differences only correlated with injury severity (admission GCS, r=0.44, p=0.011; PTA, r=−0.51, p=0.009; LOS, r=−0.49, p=0.008). Conclusion Parent and child-report HRQL generally agree, despite emotional state influencing assessment. Parents tend to underestimate HRQL after TBI.