Neuropsychology
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Fifty children diagnosed with medulloblastoma completed 188 psychological evaluations using the Wechsler Intelligence Scales for Children (D. Wechsler, 1974, 1991) over a 7-year study period following 35-40 Gy postoperative craniospinal irradiation. ⋯ A steeper decline was found for those with higher baseline performance. Clinicians may use the proposed predictive model to identify those patients who are at risk of significant intellectual decline.
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Longitudinal neuropsychological outcomes of traumatic brain injury (TBI) were investigated in 53 children with severe TBI, 56 children with moderate TBI, and 80 children with orthopedic injuries only. Neuropsychological functioning was assessed at baseline, at 6- and 12-month follow-ups, and at an extended follow-up (a mean of 4 years postinjury). ⋯ Further recovery was uncommon after the first year postinjury. Family factors did not moderate neuropsychological outcomes, despite their demonstrated influence on behavior and academic achievement after childhood TBI.
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Cognitive decline after cardiopulmonary bypass (CPB) surgery has been a concern since the advent of CPB procedures. A primary focus of many studies on this topic has been to quantify the incidence of post-CPB cognitive impairment. ⋯ For the present study, the authors used a split-plot analysis of variance model that revealed preoperative memory impairments in the CPB patients and new postoperative impairments of attention. The authors discuss the assumptions of, and problems associated with, analysis methods that are often used to quantify the incidence of cognitive impairment following CPB surgery.
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Comparative Study Clinical Trial
Dichotic listening and corpus callosum magnetic resonance imaging in relapsing-remitting multiple sclerosis with emphasis on sex differences.
Twenty-five early-onset relapsing-remitting multiple sclerosis patients (12 women and 13 men) with mild disability were compared with 25 matched controls in a dichotic listening (DL) test under nonforced and forced attentional-shift conditions. Patients showed left ear impairment and no left ear advantage in the forced-left condition. ⋯ Moreover, in men, the correlations with DL scores were linked mainly to the splenium and posterior isthmus, and in women, they were stronger for anterior isthmus and posterior body. An inverse correlation between months of disease evolution and CC area was found only in women.
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Longitudinal behavior and achievement outcomes of traumatic brain injury (TBI) were investigated in 53 children with severe TBI, 56 children with moderate TBI, and 80 children with orthopedic injuries not involving brain insult. Measures of preinjury child and family status and of postinjury achievement skills were administered shortly after injury. Assessments were repeated 3 times across a mean follow-up interval of 4 years. ⋯ Recovery of math skills was observed in the severe TBI group but only for children from less stressed families. Social disadvantage in children with TBI predicted more adverse behavioral sequelae and less favorable changes in some outcome measures. The findings suggest that pediatric TBI has long-term effects on behavior and achievement but that postinjury progress is influenced by the family environment.