BackgroundThis study was realized thanks to the collaboration of children and adolescents who had been resected from cerebellar tumors. The medulloblastoma group (CE+, n = 7) in addition to surgery received radiation and chemotherapy. The astrocytoma group (CE, n = 13) did not receive additional treatments. Each clinical group was compared in their executive functioning with a paired control group (n = 12). The performances of the clinical groups with respect to controls were compared considering the tumor's localization (vermis or hemisphere) and the affectation (or not) of the dentate nucleus. Executive variables were correlated with the age at surgery, the time between surgery-evaluation and the resected volume.MethodsThe executive functioning was assessed by means of WCST, Complex Rey Figure, Controlled Oral Word Association Test (letter and animal categories), Digits span (WISC-R verbal scale) and Stroop test. These tests are very sensitive to dorsolateral PFC and/or to medial frontal cortex functions. The scores for the non-verbal Raven IQ were also obtained. Direct scores were corrected by age and transformed in standard scores using normative data. The neuropsychological evaluation was made at 3.25 (SD = 2.74) years from surgery in CE group and at 6.47 (SD = 2.77) in CE+ group.ResultsThe Medulloblastoma group showed severe executive deficit (≤ 1.5 SD below normal mean) in all assessed tests, the most severe occurring in vermal patients. The Astrocytoma group also showed executive deficits in digits span, semantic fluency (animal category) and moderate to slight deficit in Stroop (word and colour) tests. In the astrocytoma group, the tumor's localization and dentate affectation showed different profile and level of impairment: moderate to slight for vermal and hemispheric patients respectively. The resected volume, age at surgery and the time between surgery-evaluation correlated with some neuropsychological executive variables.ConclusionResults suggest a differential prefrontal-like deficit due to cerebellar lesions and/or cerebellar-frontal diaschisis, as indicate the results in astrocytoma group (without treatments), that also can be generated and/or increased by treatments in the medulloblastoma group. The need for differential rehabilitation strategies for specific clinical groups is remarked. The results are also discussed in the context of the Cerebellar Cognitive Affective Syndrome.

El objetivo de este estudio de caso fue mejorar la capacidad de focalización y sostenimiento de la atención en un paciente de 28 años con antecedentes de Trauma Cráneo Encefálico (TCE) severo, utilizando un programa basado en estrategias metacognitivas y análisis de tareas. Se realizaron mediciones pre-test y post-test para evaluar la efectividad del programa. Aunque, al finalizar el programa, el paciente continuaba presentando dificultades de atención, se encontraron mejores puntajes en la medición pos-test y una mejor capacidad a nivel de planeación y evaluación metacognitiva. Se discute la efectividad del programa, las posibles modificaciones y la realización de posteriores investigaciones que permitan llegar a resultados concluyentes.

El presente estudio tuvo como propósito diseñar y pilotar un programa de ejercicios físico-lúdicos para explorar el efecto producido sobre los niveles atencionales en niños. Para ello se realizó una aplicación piloto a una muestra de 20 niños de 8 a 10 años utilizando un diseño cuasi experimental pretest-postest con grupo placebo. La aplicación tuvo una duración de dos meses y medio, 16 sesiones, dos por cada semana. Los resultados obtenidos muestran que tanto el grupo experimental como el placebo mejoraron en la medición postest respecto al pretest, siendo los hallazgos más significativos en el grupo experimental; no obstante, dichos resultados no son concluyentes debido a algunas limitaciones propias de éste tipo de estudios.