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Background Limited information is available regarding neurocognitive outcomes of children who experience seizures during treatment for acute lymphoblastic leukemia (ALL). Accordingly, the main objectives of this study were to determine the incidence and risk factors for treatment-related seizures among children with ALL, and the neurocognitive outcomes associated with treatment-related seizures. Procedure Prospective neuropsychological assessment and magnetic resonance imaging (MRI) were planned for all 498 patients with newly diagnosed ALL enrolled on the St. Jude Total Therapy XV (TOTXV) protocol at three time-points. The study database was reviewed retrospectively to identify those with treatment-related seizure. To assess neurocognitive changes associated with seizure, each patient with treatment-related seizure was matched with two cohort patients without seizure for age at treatment, gender, race, and treatment intensity. Results Nineteen patients developed seizure, with a 2-year cumulative risk of 3.82% ± 0.86% (SE). No risk factors were identified to be associated with the development of seizure, with a possible exception of intensive chemotherapy used on the standard/high-risk arm as compared to the low-risk arm. Neuropsychological performance of the seizure group, as compared to normative scores and non-seizure control cohort, indicated problems in attention, working memory, and processing speed. Cognitive deficits persisted two years post-therapy, with additional declines in intellectual function observed. MRI indicated early neurotoxicity among the seizure group, as evidenced by greater leukoencephalopathy on initial exams. Conclusion Treatment-related seizures were associated with leukoencephalopathy and decreased neuropsychological performance. Prospective studies are needed to detect changes in neurocognitive status associated with long-term functional impairment.

This article is Part 2 of a two-part series on the conceptual and methodological applications of single-case design research in psychophysiological research (Gustafson, Nassar, & Waddell, 2011). Part 1 in this series presented the context, structure, and fundamentals of single-case design in relation to psychophysiology. Part 2 introduces four statistical analyses that are utilized in single-case research design and are broadly applicable to a wide range of research questions or clinical outcome studies. These techniques are reviewed in sufficient detail so that clinicians and researchers may apply them in real-world contexts. The following analyses-(a) Percentage of Non-overlapping Data Points and Percentage of All Nonoverlapping Data, (b) Split-Middle and Percentage of Data Points Exceeding the Median, (c) Improvement Rate Difference, and (d) Hierarchical Linear Modeling-were chosen for their suitability with psychophysiological data. Although these analyses may be unfamiliar, their calculations are quite straightforward. Special emphasis is given to statistics that provide effect size data, as this statistic allows studies to be incorporated in to metaanalytic studies, promoting cumulative knowledge across time.

Given the relationship between depressive symptoms and life satisfaction for women, follow-up depression screenings among veterans with SCI should include quality of life assessments. Additionally, assessment of somatic symptoms, such as pain, in relation to depressive symptomatology is recommended, particularly among men. (PsycINFO Database Record

There is a growing consensus in the clinical literature about the importance of establishing and utilizing empirically supported treatments (ESTs). A number of established criteria for determining the efficacy and effectiveness levels of treatments are reviewed, and an argument is put forth that the research paradigm of large-scale group comparison designs may not be the best conceptual fit for studying psychophysiological phenomena. Clinical psychophysiology employs reinforcing successive approximations of functional abilities: a model closer in nature to operant conditioning, physical rehabilitation, and education than the standard pharmacological model. Single-case designs have a long, well-accepted history in scientific disciplines and require resources that allow practice-level clinicians to make meaningful contributions to the scientific literature. They also have a clear role in the establishment of a treatment as an EST. A discussion of the logic, structure, and techniques of single-case design is presented in sufficient detail to actively construct publishable studies. The adaptive nature of this technique makes it possible to address a wide range of potential psychophysiological research questions, along with barriers to utilization, including ethical considerations. Techniques are presented to allow researchers to examine treatment efficacy and effectiveness as well as isolate components of treatment to determine the most powerful elements of a clinical intervention.