Cognitive dysfunction in children with brain tumors at diagnosis

Background

Survivors of brain tumors have a high risk for a wide range of cognitive problems. These dysfunctions are caused by the lesion itself and its surgical removal, as well as subsequent treatments (chemo‐ and/or radiation therapy). Multiple recent studies have indicated that children with brain tumors (BT) might already exhibit cognitive problems at diagnosis, i.e., before the start of any medical treatment. The aim of the present study was to investigate the baseline neuropsychological profile in children with BT compared to children with an oncological diagnosis not involving the central nervous system (CNS).

Methods

Twenty children with BT and 27 children with an oncological disease without involvement of the CNS (age range: 6.1–16.9 years) were evaluated with an extensive battery of neuropsychological tests tailored to the patient's age. Furthermore, the child and his/her parent(s) completed self‐report questionnaires about emotional functioning and quality of life. In both groups, tests were administered before any therapeutic intervention such as surgery, chemotherapy, or irradiation. Groups were comparable with regard to age, gender, and socioeconomic status.

Results

Compared to the control group, patients with BTs performed significantly worse in tests of working memory, verbal memory, and attention (effect sizes between 0.28 and 0.47). In contrast, the areas of perceptual reasoning, processing speed, and verbal comprehension were preserved at the time of measurement.

Conclusion

Our results highlight the need for cognitive interventions early in the treatment process in order to minimize or prevent academic difficulties as patients return to school. Pediatr Blood Cancer 2015;62:1805–1812. © 2015 The Authors. Pediatric Blood & Cancer, published by Wiley Periodicals, Inc.     

Fine-tuning of auditory cortex during speech production

The cortex suppresses sensory information when it is the result of a self-produced motor act, including the motor act of speaking. The specificity of the auditory cortical suppression to self-produced speech, a prediction derived from the posited operation of a precise forward model system, has not been established. We examined the auditory N100 component of the event-related brain potential elicited during speech production. While subjects uttered a vowel, they heard real-time feedback of their unaltered voice, their pitch-shifted voice, or an alien voice substituted for their own. The subjects' own unaltered voice feedback elicited a dampened auditory N100 response relative to the N100 elicited by altered or alien auditory feedback. This is consistent with the operation of a precise forward model modulating the auditory cortical response to self-generated speech and allowing immediate distinction of self and externally generated auditory stimuli.     

Detection of coronary artery calcifications predicting coronary heart disease: comparison of fluoroscopy and spiral CT

The aim of this study was to evaluate the clinical relevance of coronary artery calcifications detected by spiral CT, congruence with fluoroscopy (FS) and coronary angiography, and comparison with studies reporting on application of double-helical CT and ultrafast CT. Forty patients underwent spiral CT (2-mm slice thickness, table feed 3 mm/s), coronary angiography, and FS (performed in the usual manner). Stenosis and calcifications were evaluated semiquantitatively. Nineteen patients suffering from a stenosis ≥ 75 % were verified at coronary angiography. All had coronary artery calcification on spiral CT. Fluoroscopy did not detect 8 of 19 patients with a stenosis ≥ 75 % (1 vessel: n = 1; 2 vessels: n = 3; 3 vessels: n = 4). In spiral CT sensitivity was 100 % and specificity was 33 % (FS: 58 and 48 %). Positive predictive value was 83 % for spiral CT (FS: 50 %), and negative predictive value was 100 % (FS: 56 %). A significant linear increase in the calcification score was found for increasing maximal stenosis (p < 0.005). Spiral CT is more sensitive than FS in the recognition of hemodynamic relevant stenoses using the detection of coronary artery calcifications. Statistical parameters are comparable to ultrafast-CT. Spiral CT is a suitable non-invasive diagnostic technique in coronary heart disease. Coronary calcifications found incidentally in symptomatic patients at chest CT should be reported to the referring physician for further cardiological workup. Received 14 July 1997; Revision received 29 December 1997; Accepted 5 January 1998     

Longitudinal changes of serum lipid and apoB levels in a newborn-infant cohort

Longitudinal changes in serum apoB levels in relation to serum lipid levels were determined in a subset (n = 30) of a newborn-infant cohort selected from infants (n = 440) of Bogalusa, Louisiana who were born between January 1, 1974 and June 30, 1975. Serum total cholesterol, triglycerides, β + pre-β-lipoprotein cholesterol and apoB levels were measured at birth, 6 mo, 1 yr, 2 yr, and 3 yr of age. The mean ± SD, mg/dl, levels of these variables increased dramatically (p < 0.0005) from birth to 6 mo (Total cholesterol: 65.0 ± 15.7 versus 136.3 ± 27.4; triglycerides: 32.9 ± 18.9 versus 82.3 ± 28.9; β + pre-β-lipoprotein cholesterol: 31.8 ± 9.1 versus 87.3 ± 25.7; apoB: 20.8 ± 5.3 versus 49.0 ± 13.5). On the other hand, the ratio of apoB to β + pre-β-lipoprotein cholesterol at birth was significantly higher than at 6 months of age (0.69 ± 0.24 versus 0.58 ± 0.12, p < 0.0005). None of the variables changed significantly between 6 mo and 3 yr of age except the increase in serum total cholesterol level from yr 2 to yr 3 (142.6 ± 26.6 versus 156.4 ± 23.0, p < 0.01). A tigh intra-child year to year correlation for serum apoB was noted beginning at 6 mo of age (r = 0.67, p < 0.0001); while the apoB levels were proportional to β + pre-β-lipoprotein cholesterol levels in some children, others had varied levels of apoB in relation to cholesterol carried by this apoprotein. The fact that apoB levels persist beginning at 6 mo of age and that we are beginning to observe interindividual differences in levels of cholesterol carried by this apoprotein may have clinical implications for coronary artery disease.     

Seltene Erkrankungen und Digitalisierung im Kontext des Nationalen Aktionsbündnisses für Menschen mit Seltenen Erkrankungen (NAMSE)

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Menschen mit Seltenen Erkrankungen stehen im Gesundheitssystem vor besonderen Herausforderungen. Die Seltenheit der einzelnen...     

Long-term sequelae after acquired pediatric hemorrhagic cerebellar lesions

Purpose  

The aim of the present study was to assess cognitive, affective, and motor long-term sequelae after acquired focal pediatric cerebellar lesions.     

MRI after implantation of a novel femoral closure device following intra-arterial catheterisation: implications for subsequent contrast-enhanced MR angiography

Objective  

To assess MRI safety aspects and artefacts of a novel femoral artery closure device during contrast-enhanced MR angiography in patients following intra-arterial catheterisation.