Neuropsychological evaluation of children with intracranial tumors: Impact of treatment modalities

Abstract

Antineoplastic treatment has a deleterious effect on intellectual functions, which is mainly attributable to radiotherapy. With the object of determining the neuropsychological disturbances associated with brain irradiation in the child, and to try to differentiate them from the effects caused by the other types of treatment (surgical and chemotherapy) as well as from the effects of the tumor itself, a cross-sectional study was carried out in 25 survivors of medial edge intracranial tumors. In order to monitor the effect of systemic chemotherapy on the cognitive functions, and the effect of prolonged absence from school, two control groups were formed, one made up of subjects treated with chemotherapy for extracranial tumors, and the other of patients with nonmalignant chronic disease. Neuropsychological functions were measured using the Spanish version of the Wechsler scale, as well as the following tests: SpreenBenton, ITPA and TALE scales, Yuste Memory Test, Thurstone Attention Test, and the Rey Complex Figure. In addition to a progressive decline found in the full scale intelligence quotient in children irradiated for intracranial tumors, variance analysis showed that these patients deteriorate mainly in visual attention and memory, but also significantly in verbal fluency and in the Performance Intelligence Quotient and all its subtests, when compared to the control groups. Visual attention and the Wechsler Picture Arrangement and Block Designs, were the tests whose decline correlated with the total radiation administered. The article relates this specific neuropsychological injury with the total brain irradiation dose but also with the structures located in the cone-down fields of irradiation to boost regions in the middle edge intracranial content. KEY WORDS Intracranial tumors Cognitive sequelae Radiotherapy ChemotherapyAddress reprint requests to A. García-Pérez MD

Hippocampal brain amines in methotrexate-induced learning and memory deficit

“…2). The present study supports a few of the earlier investigations that claim cognitive dysfunction in the form of learning difficulties and impairment of memory (Spencer 1998;Garcia et al 1994;Kingma et al 1993) after methotrexate treatment. Williams et al (1992), in their experiment on monozygotic twins, observed neuropsychological dysfunction in both methotrexate-treated (for leukemia) and untreated (normal children) subjects.…”

Quality of Life and Cognitive Function in Patients with Pituitary Insufficiency

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Neuropsychological outcome in children with optic pathway tumours when first-line treatment is chemotherapy

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