Standard treatment of optic pathways gliomas consists of radiotherapy and surgery when feasible. Owing to the toxicity of irradiation, chemotherapy has emerged as an interesting therapeutic option, especially in young children. This study describes the neuropsychological profile of 27 children (aged between 1.5 and 15.7 years) with optic pathways gliomas treated with chemotherapy as first-line treatment. Eight of them also received radiotherapy as salvage treatment. Eight had neurofibromatosis type 1 (NF1). Intellectual outcome was preserved in children treated with chemotherapy only (mean ¼ 107717) compared to children also receiving radiotherapy (mean IQ ¼ 88724) or children having NF1 and treated with chemotherapy (mean IQ ¼ 80713). Scores for abstract reasoning, mental arithmetic, chessboard/coding, perception, judgement of line orientation were lower in children irradiated than in those treated only by chemotherapy. Children with Nf1 showed subnormal IQ scores with marked impairment of shortand long-term memory. With respect to long-term neuropsychological outcome, our study shows that a chemotherapy-first strategy can preserve the intellectual outcome of these patients either by avoiding the need of radiotherapy or by delaying its use as much as possible.
We shall present the development of a cohort of 40 children aged from 6 to 11 who were initially diagnosed with ADHD (T0) and then reassessed after two years of treatment with multimodal treatment in addition to stimulant medication. At the outset of the study (T0) the children underwent a complete assessment which included a child psychiatric examination, a neuropsychological evaluation of attention skills and a psychodynamic psychological assessment using the T.A.T. and Rorschach projective tests interpreted from a psychoanalytic viewpoint. An identical protocol was used for the reassessment of the children two years later (T2).Clinically, and from a strictly behavioral point of view, it is clear that there was a calming down of the symptoms associated with the ADHD. Can the same be said for the results of the neuro-psychological and projective tests as well as for the overall psychic functioning of the children?At this point in our research, and taking into account that T 2 just ended, we can affirm that the children who were assessed with neurotic disorders (according to the classification of psychopathological disorders in childhood) were those who showed the clearest signs of improvement. We shall then study in depth the majority of the population who were assessed with borderline personality disorders (BPD). As these children received a multimodal treatment over the two years time of the study which involved either individual, group or family psychotherapy, we shall use brief clinical case studies for a comparative approach to our research results.
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