SES AND NEUROANATOMY IN READING DISABILITY 2 Although reading disability (RD) and socioeconomic status (SES) are independently associated with variation in reading ability and brain structure/function, the joint influence of SES and RD on neuroanatomy and/or response to intervention is unknown. Sixty-five children with RD (ages 6 to 9) with diverse SES were assigned to an intensive, 6-week summer reading intervention (n = 40) or to a waiting-list control group (n = 25). Before and after, all children completed standardized reading assessments and magnetic resonance imaging (MRI) to measure cortical thickness. At baseline, higher SES correlated with greater vocabulary and greater cortical thickness in bilateral perisylvian and supramarginal regions-especially in left pars opercularis. Within the intervention group, lower SES was associated with both greater reading improvement and greater cortical thickening across broad, bilateral occipitotemporal and temporoparietal regions following the intervention. Additionally, treatment responders (n = 20), compared to treatment non-responders (n = 19), exhibited significantly greater cortical thickening within similar regions. The waiting control and non-responder groups exhibited developmentally-typical, non-significant cortical thinning during this time period. These findings indicate that effective summer reading intervention is coupled with cortical growth, and is especially beneficial for children with RD who come from lower-SES home environments. (Word count: 197)
BACKGROUND:Cognitive dysfunction experienced by individuals with cancer represents an important survivorship issue because of its potential to affect occupational, scholastic, and social activities. Whereas early efforts to characterize cognitive dysfunction primarily focused on the effects of chemotherapy, more recent evidence indicates that impairment may exist before systemic treatment. This study characterized cognitive dysfunction before adjuvant chemotherapy in a sample of men diagnosed with nonseminomatous germ cell tumors (NSGCT) of the testis. METH-ODS: Men with newly diagnosed NSGCT were recruited after orchiectomy but before adjuvant chemotherapy. Patients completed neuropsychological tests to assess attention, learning, language, executive function, and motor function. Self-report measures of depression and anxiety were also administered. An overall cognitive function index was computed for participants. Cognitive impairment was defined as a z-score of less than or equal to À1.5 on 2 or more tests, or a z-score of less than or equal to À2.0 on a single test. RESULTS: Approximately 46% of patients exhibited cognitive impairment at the time of assessment, which is significantly greater than would be expected considering healthy population norms (binomial test: P < .0001). Patients exhibited impairments in motor function, verbal learning, and executive function much more frequently relative to normative expectations (binomial test: P < .0001). CONCLUSIONS: The prevalence of cognitive impairment in men with newly diagnosed NSGCT is unexpectedly high before the receipt of adjuvant chemotherapy. Efforts to track cognitive function over time and to develop effective interventions are warranted. Cancer 2011;117:190-6.
Objective Longitudinal neuropsychological assessments were performed to determine if adjuvant chemotherapy was associated with cognitive dysfunction in men with non-seminomatous germ cell tumors (NSGCT). Methods Patients with NSGCT status post orchiectomy that either received adjuvant chemotherapy (n=55) or did not (n=14) were recruited. Patients were tested before chemotherapy, one week post chemotherapy (or three months later in the surveillance group) and 12 months after the baseline evaluation. Results Compared to the surveillance group, patients treated with chemotherapy had higher rates of cognitive decline at 12 months (overall cognitive decline: 0%, 52% and 67% in the surveillance, LE and HE group, respectively), greater number of tests that declined (mean of 0.1, 1.4 and 2.0 in the surveillance, LE and HE group, respectively), and more frequent worsening in motor dexterity (0%, 48% and 46% in the surveillance, LE and HE group, respectively). Compared to the surveillance group, patients receiving more cycles of chemotherapy demonstrated worse psychomotor speed and learning and memory. Younger age was associated with greater incidence of overall cognitive decline at 12 month follow-up. Conclusions Men with NSGCT that received chemotherapy demonstrated greater rates of cognitive decline in a dose-response manner. Reductions in motor dexterity were most common. Decline in learning and memory also was evident particularly at later follow up time points and in men receiving more chemotherapy. Men that receive chemotherapy for NSGCT are at risk for cognitive decline and may benefit from monitoring and referral for psychosocial care.
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