Memory and attention after childhood brain tumors.
Explore the source record for details and available documents.
Adolescent↗
Biomedical subjects
C R Hetherington
Publications and source records attributed to C R Hetherington.
Neuropsychological sequelae of the treatment of children with medulloblastoma.
When a malignant tumor invades the child's cerebellum, the cost of successful treatment is often significant cognitive morbidity. A review of neuropsychological outcome revealed that survivors of childhood medulloblastoma (MB) have long-term deficits in intelligence, memory, language, attention, academic skills, psychosocial function, and a compromised quality of life. These deficits varied with chronological age at tumor diagnosis and/or adjuvant treatment, type and duration of presenting symptoms, tumor extension beyond the cerebellum, a history of adjuvant radiation treatment, and time since treatment. The effects on neuropsychological outcome of other factors, such as post-surgical hydrocephalus, were less clear. To understand the interaction between two factors predictive of outcome, age at diagnosis and time since treatment, we analyzed IQ results for a new sample of 25 surgically-treated and radiated MB survivors, and found that age at diagnosis and time since treatment made separable contributions to intellectual morbidity. PIQ appeared to measure some general effects of diffuse cerebral insult because it varied with chronological age of the child at tumor diagnosis but was relatively constant in magnitude, once established. VIQ, in contrast, was somewhat less sensitive to age at diagnosis in treated MB survivors, but declined with time since treatment. These results are important for understanding the academic attainments and continuing rehabilitation needs of childhood MB survivors, because they suggest that these children progressively fail to assimilate new verbally-based knowledge at a developmentally-appropriate rate.
Age Factors↗
Reaction time and variability 5 and 10 years after traumatic brain injury.
Improvement in performance can occur up to 10 years after traumatic brain injury (TBI). Few previous studies have examined the long-term effects of TBI on information processing. This study used reaction time (RT) tasks of increasing complexity with 10-year post-injury, 5-year post-injury, and control groups to assess any such effects. There were no significant group differences in mean RT; however, in the groups of persons with head injury only, response latency was related to age and to task demands. Older members of the groups of persons with head injury were slower than controls. The variability in performance was significantly higher in the 5-year post-injury group than in both the 10-year group and the control group. There were no significant differences among the groups in their ability to inhibit the processing of redundant information. There were no correlations between any dependent measure and severity of injury. Speed of processing is more sensitive to task complexity in individuals with head injury, but only when age at injury is considered. Most importantly, for rehabilitation purposes, recovery of consistency in performance can be expected more than 5 years after a TBI.
Adolescent↗
"No longer Gage": frontal lobe dysfunction and emotional changes.
This review presents the multiple changes in emotional response and personality that occur after damage to the frontal systems, proposes operational definitions, and analyzes the published reports according to these definitions. Neurological causes of frontal lobe damage and associations of frontal dysfunction with psychiatric disturbances are summarized. It is concluded that symptoms of frontal lobe damage that have been labeled as emotional disturbances may be classified as disorders of drive or motivation, mood (subjective emotional experience), and affect (emotional expression). It is proposed that the primary change after frontal lobe pathology is a disorder of personality, a change in the stable response patterns that define an individual as a unique self. Dysfunction of personality includes cognitive abilities, with a disorder of self-reflective awareness as a key deficit.
Adult↗