Sleep-wake disturbance in patients with brain tumors

Armstrong, Terri S.; Shade, Marcia; Breton, Ghislaı̀n; Gilbert, Mark R.; Mahajan, Anita; Scheurer, Michael E.; Vera, Elizabeth; Berger, Ann M.

doi:10.1093/neuonc/now119

Cited by 62 publications

(67 citation statements)

References 114 publications

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“…Stupp et al (2005) found that the median survival of patients receiving TMZ in addition to RT was 14.6 months as compared with 12.1 months among those who were assigned to RT alone [39]. However, despite the benefits, the treatment with TMZ can entail in some immediate side effects such as nausea, vomiting, lymphopenia, neutropenia, thrombocytopenia, fatigue, disturbed sleep and depression [40,41,42].…”

Section: Nose-to-brain Drug Deliverymentioning

confidence: 99%

Nasal Drug Delivery of Anticancer Drugs for the Treatment of Glioblastoma: Preclinical and Clinical Trials

Bruinsmann¹,

Vaz²,

Alves³

et al. 2019

Preprint

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Glioblastoma (GBM) is the most lethal form of brain tumor, characterized by rapid growth and surrounding tissue invasion. The current standard treatment is surgery followed by radiotherapy, and concurrent chemotherapy, typically with temozolomide. Although extensive research has been performed over the past years to develop an effective therapeutic strategy for the treatment of GBM, efforts have not provided major improvements in the overall survival of patients with GBM. Thus, new therapeutic approaches are urgently needed. A major challenge in the development of therapies for central nervous system (CNS) disorders is overcoming the blood–brain barrier (BBB). In this context, the intranasal (IN) route of drug administration has been proposed as a non-invasive alternative route to directly targeting the CNS. In fact, this route of drug administration may bypass the blood-brain barrier and reduce systemic side effects. Recently, formulations have been developed to further enhance nose-to-brain transport, mainly with the use of nano-sized and nanostructured drug delivery systems. The focus of this review will be on the strategies developed to deliver a number of anticancer compounds for the treatment of GBM using the nasal administration. In particular, the specific properties of nanomedicines proposed for the nose-to-brain delivery will be critically evaluated. The number of preclinical and clinical data reviewed support the idea that nasal delivery of anticancer drugs might represent a breakthrough advancement in the fight against GBM.

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Section: Nose-to-brain Drug Deliverymentioning

confidence: 99%

Nasal Drug Delivery of Anticancer Drugs for the Treatment of Glioblastoma: Preclinical and Clinical Trials

Bruinsmann¹,

Vaz²,

Alves³

et al. 2019

Preprint

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“…Damage to structures in the brainstem and posterior fossa involved in control of breathing may lead to central sleep apnea and hypoventilation [8,30,31]. Sleep problems are a significant factor negatively impacting quality of life in cancer survivors but often go under recognized and under reported [21,32]. In the following sections, we will review the prevalence and etiologies of various sleep problems reported by children with CNS tumors and discuss our approach to screening, diagnosis, and management.…”

Section: Pediatric Brain Tumors and Sleepmentioning

confidence: 99%

“…However, data remains mixed, as recent prospective surveys of pediatric brain tumor survivors found no association between tumor location and EDS [33,35]. Other reported risk factors for development of EDS include obesity [26,36], exposure to cranial radiation therapy [32,34], and use of antiepileptic medications [34].…”

Section: Excessive Daytime Sleepiness and Narcolepsymentioning

confidence: 99%

“…Insomnia often co-occurs with excessive daytime sleepiness and fatigue and like EDS, may have a multitude of secondary causes. Insomnia is purported to be the most common sleep problem in adults with cancer, including those with primary brain tumors [32,54]. Insomnia and interrupted sleep are common complaints in children still receiving cancer therapy but are less often reported than other sleep complaints in cancer survivors [24,55].…”

Section: Insomnia and Interrupted Sleepmentioning

confidence: 99%

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Sleep Disorders in Children with Central Nervous System Tumors

Maloney¹,

Lewinter²,

Ward³

et al. 2018

obm neurobiol

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Sleep complaints are common in pediatric patients with central nervous system (CNS) tumors. These problems may result from disruption of normal homeostatic, circadian, neuroendocrine, and cardiorespiratory pathways and vary by tumor location and treatment received. Children with tumors within the hypothalamus and surrounding regions are prone to excessive daytime sleepiness. Sleep-related breathing disorders, especially those involving abnormal control of breathing, may occur in patients with tumors of the brainstem and posterior fossa. Maintaining a high index of suspicion for sleep disorders in children with CNS tumors is essential for early recognition and treatment. In this article, we will review the various sleep problems reported in pediatric brain tumor survivors, explore underlying neurobiological mechanisms, and discuss approaches to screening and diagnosis.Sleep is an essential physiologic function for growth, cognition, and physical and emotional well-being. It is particularly important in childhood, when the brain and body are undergoing rapid development. Normal sleep occurs through a complex interplay between homeostatic, circadian, neuroendocrine, and cardiorespiratory pathways. Cancer and cancer treatment may cause disruptions and imbalances in these pathways, resulting in abnormal sleep. Compared to the general population, pediatric cancer survivors are more likely to experience sleep problems. Patients with a history of brain tumors are particularly prone to sleep issues. In this article, we will review the physiology of normal sleep, describe the sleep problems and pathophysiologic mechanisms behind disrupted sleep in children with central nervous system (CNS) tumors, and discuss strategies for screening, diagnosis, and management. Sleep Mechanisms and PhysiologySleep and wakefulness. Sleep is fundamentally important in promoting growth, repair, and neurocognitive functioning. The timing, duration, and quality of sleep depend on complex, balanced interactions between sleep-promoting and wake-promoting pathways. The majority of these pathways are housed in the basal forebrain, diencephalon, and brainstem. The balance between sleep and wakefulness is governed by two distinct biologic processes: sleep-wake homeostasis (Process S) and circadian rhythm (Process C) [1]. Homeostatic drive to sleep intensifies with continued wakefulness over time and subsides as an individual sleeps. During the day, the sleep-dependent homeostatic drive is counteracted by sleep-independent circadian arousal mechanisms. Circadian rhythms are coordinated by an internal pacemaker housed in the bilateral suprachiasmatic nuclei (SCN) of the anterior hypothalamus [1]. The near-24 hour circadian rhythm is externally entrained by the light-dark cycle on Earth through direct input received by the SCN from retinal ganglion cells via the retinohypothalamic tract, which runs through the optic chiasm [2,3]. Additional input from the intergeniculate leaflet and median raphe nucleus modulate circadian phase shifts [3]. The SCN sends...

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“…Нередко у таких пациентов имеются трудности с засыпанием и поддержанием сна. Его низкая эффективность, ран-нее пробуждение и другие нарушения сна [6] становятся хроническими и сохраняются продолжительное время после завершения противоопухолевой терапии. Поэтому изучение механизмов нарушения сна и изменений в биоэлектрической активности мозга во время сна имеют важное значение для разработки программ нейрореабилитации у пациентов с опухолями головного мозга.…”

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