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Visual-spatial deficits in chemotherapy

Marilyn J Hockenberry, Kevin R Krull, Kathleen C Insel, Lynnette L Harris, Patricia M Gundy, Kristin B Adkins, Alice E Pasvogel, Olga A Taylor, Kari M Koerner, David W Montgomery, Adam K Ross, Adam Hill, Ida M Moore
PURPOSE/OBJECTIVES: To examine associations among oxidative stress, fine and visual-motor abilities, and behavioral adjustment in children receiving chemotherapy for acute lymphoblastic leukemia (ALL)
. DESIGN: A prospective, repeated-measures design
. SETTING: Two pediatric oncology settings in the southwestern United States. SAMPLE: 89 children with ALL were followed from diagnosis to the end of chemotherapy. METHODS: Serial cerebrospinal fluid samples were collected during scheduled lumbar punctures and analyzed for oxidative stress biomarkers...
September 2015: Oncology Nursing Forum
Kaliris Y Salas-Ramirez, Ciara Bagnall, Leslie Frias, Syed A Abdali, Tim A Ahles, Karen Hubbard
Chemotherapy is associated with long-term cognitive deficits in breast cancer survivors. Studies suggest that these impairments result in the loss of cognitive reserve and/or induce a premature aging of the brain. This study has been aimed to determine the potential underlying mechanisms that induce cognitive impairments by chemotherapeutic agents commonly used in breast cancer. Intact and ovariectomized (OVX) female rats were treated intravenously with either saline or a combination of cyclophosphamide (40 mg/kg) and doxorubicin (4 mg/kg)...
October 1, 2015: Behavioural Brain Research
R B Raffa, R J Tallarida
The diminution in certain aspects of cognitive function that is reported to occur in some patients during or after adjuvant cancer chemotherapy is variously known as 'chemo-fog', 'chemo-brain' or other such term. In addition to reported deficits in attention, concentration and other functions, most, if not all, of the studies report deficits involving visual-spatial function or visual memory. Since the visual system is part of the nervous system, it seems reasonable to ask if it is susceptible to some of the deleterious effects produced by adjuvant chemotherapeutic drugs...
June 2010: Journal of Clinical Pharmacy and Therapeutics
Robert B Raffa
Most, if not all, of the studies that report cognitive impairments in patients who have been treated with cancer chemotherapy also report deficits involving the visual system (e.g., visual-spatial function or visual memory). The visual system seems like a likely susceptible target of cytotoxic drugs. Therefore, some portion of the vision-related cognitive deficits ofchemo fog/chemo brain might result from a direct action of the drugs or from site/site interaction between effects on the visual system and other critical brain regions...
2010: Advances in Experimental Medicine and Biology
Femke K Aarsen, Philippe F Paquier, Willem-Frans Arts, Marie-Lise Van Veelen, Erna Michiels, Maarten Lequin, Coriene E Catsman-Berrevoets
PURPOSE To prospectively study cognitive deficits and predictors 3 years after diagnosis in a large series of pediatric patients treated for pilocytic astrocytoma (PA). PATIENTS AND METHODS Sixty-one of 67 children were grouped according to infratentorial, supratentorial midline, and supratentorial hemispheric site. Intelligence, memory, attention, language, visual-spatial, and executive functions were assessed. Included predictors were sex, age, relapse, diagnosis-assessment interval, hydrocephalus, kind of treatment, and tumor variables...
July 20, 2009: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Jaap Huisman, Eline J Aukema, Jan Berend Deijen, Silvia Ccm van Coeverden, Gertjan J L Kaspers, Heleen J H van der Pal, Henriette A Delemarre-van de Waal
BACKGROUND: To reduce the risk of brain damage children with acute lymphoblastic leukaemia (ALL) are nowadays mainly treated with intrathecal chemotherapy (ITC) instead of central nervous system (CNS) radiation therapy (CRT) to prevent CNS relapse. However, chemotherapy may also lead to cognitive deficits. As growth hormone deficiency (GHD) or impaired growth hormone secretion are frequently found in ALL patients treated with cranial radiation therapy and/or chemotherapy, we hypothesized that GH therapy may reduce cognitive deficits in these patients...
2008: BMC Pediatrics
Neelam Jain, Kevin R Krull, Pim Brouwers, Murali M Chintagumpala, Shiao Y Woo
BACKGROUND: Combined cisplatin chemotherapy and cranial irradiation for treatment of medulloblastoma in children can cause significant ototoxicity and impair cognitive function and quality of life. We have previously demonstrated the conformal technique of intensity-modulated radiation therapy (IMRT) to reduce ototoxicity, however, it has been suggested that IMRT may increase risk of cognitive deficits compared to conventional radiation therapy (CRT). This study compared the impact of the two treatments on measures of neurocognitive functioning...
August 2008: Pediatric Blood & Cancer
Jeffrey Schatz, Joel H Kramer, Arthur R Ablin, Katherine K Matthay
The effect of cranial radiation therapy (CRT) on visual attention was examined in long-term survivors of childhood acute lymphoblastic leukemia (ALL) compared to peers with no history of ALL (n = 24) using a cued orienting task and a global-local task. ALL participants treated with CRT (n = 13) demonstrated an increased cost in response time with invalid spatial orienting cues and inefficient shifts of attention across hierarchical levels. ALL participants treated only with chemotherapy (n = 8) showed performance similar to the non-ALL comparison group...
March 2004: Journal of the International Neuropsychological Society: JINS
L Levisohn, A Cronin-Golomb, J D Schmahmann
Acquired cerebellar lesions in adults have been shown to produce impairments in higher function as exemplified by the cerebellar cognitive affective syndrome. It is not yet known whether similar findings occur in children with acquired cerebellar lesions, and whether developmental factors influence their presentation. In studies to date, survivors of childhood cerebellar tumours who demonstrate long-term deficits in cognitive functions have undergone surgery as well as cranial irradiation or methotrexate treatment...
May 2000: Brain: a Journal of Neurology
P G Lesnik, K T Ciesielski, B L Hart, E C Benzel, J A Sanders
BACKGROUND: Following brain insult in early childhood, the later maturing neocerebellum and frontal lobes frequently show abnormalities. OBJECTIVE: To investigate the morphologic characteristics and function of a proposed cerebellar-frontal subsystem in children treated for acute lymphoblastic leukemia (ALL) with intrathecal methotrexate using quantitative magnetic resonance imaging, neuropsychological measures, nonlinear multiple regression analysis, and a statistical effect size model that augments interpretive validity of nonsignificant statistical findings, particularly from small sample size studies...
December 1998: Archives of Neurology
D E Hill, K T Ciesielski, L Sethre-Hofstad, M H Duncan, M Lorenzi
Assessed survivors of childhood lymphoblastic leukemia (ALL) treated with intrathecal chemotherapy, using the Wide Range Assessment of Memory and Learning (WRAML), compared to controls without cancer, matched as closely as possible in age, SES, and gender. Mild, but consistent, deficits were found in both visual-spatial and verbal single-trial memory tasks. In multitrial learning, only visual-spatial tasks resulted in deficient scores, while verbal learning was within the normal range. IQ results indicated scores 10-20 points lower in the ALL group...
December 1997: Journal of Pediatric Psychology
K T Ciesielski, R J Harris, B L Hart, H F Pabst
A developmental chronometry hypothesis of early brain damage is suggested in which regions of the brain with a protracted course of postnatal development will be more vulnerable than earlier maturing areas to deleterious effects of early insult and, therefore, may become common sites of abnormality across many disorders originating in early childhood. Initial investigations of the cerebellum and frontal lobes are presented using MRI and neuropsychological measures. Planimetric measures of the cerebellar vermis (lobuli I-V and VI-VII) and pons, and neuropsychological frontal lobe measures were obtained from high functioning individuals with autism (A), survivors of acute lymphoblastic leukemia (ALL) with brain sequelae following radiation and chemotherapy, and from rigorously selected healthy controls (C)...
May 1997: Neuropsychologia
K T Ciesielski, R Yanofsky, R N Ludwig, D E Hill, B L Hart, R S Astur, T Snyder
BACKGROUND: Neurodevelopmental evidence of the cerebellum's protracted course of postnatal development suggests that it is particularly sensitive to early toxic insult from cancer therapy. If this is the case, one would expect that there is a relationship between the pattern of neuropsychological and magnetic resonance imaging deficits and that both may indicate cerebellar abnormalities. OBJECTIVE: To investigate the profiles of neuropsychological functions and the morphologic features of the cerebellum, using in vivo magnetic resonance imaging planimetry in survivors of acute lymphoblastic leukemia (ALL) treated with radiation and chemotherapy...
October 1994: Archives of Neurology
R K Mulhern, A L Wasserman, D Fairclough, J Ochs
Previous studies have found that CNS prophylaxis of children with leukemia, especially young children receiving cranial irradiation, causes neuropsychologic deficits. In the present study, 40 children in continuous complete remission from acute lymphocytic leukemia (ALL) were given a battery of tests to assess memory functioning 5 years after CNS prophylaxis. All children were free of CNS disease at diagnosis and had been randomly assigned to receive CNS prophylaxis with either 1,800 cGy cranial irradiation (CRT) plus intrathecal (IT) methotrexate (MTX) or IT MTX plus intravenous (IV) high-dose MTX (HDMTX)...
February 1988: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
R J Packer, L N Sutton, T E Atkins, J Radcliffe, G R Bunin, G D'Angio, K R Siegel, L Schut
As survival rates have risen for children with malignant primary brain tumors, so has the concern that many survivors have significant permanent cognitive deficits. Cranial irradiation (CRT) has been implicated as the major cause for cognitive dysfunction. To clarify the etiology, incidence, and severity of intellectual compromise in children with brain tumors after CRT, a prospective study was undertaken comparing the neuropsychological outcome in 18 consecutive children with malignant brain tumors treated with CRT to outcome in 14 children harboring brain tumors in similar sites in the nervous system who had not received CRT...
May 1989: Journal of Neurosurgery
A S Gamis, M E Nesbit
Intelligence and academic achievement testing of long-term survivors of childhood cancer reveal a high incidence of memory deficits, visual-spatial skill impairment, and attention deficit disorders. While the results of various studies must be interpreted carefully, the data available identify CNS irradiation and the toxic synergism of CNS irradiation and intrathecal chemotherapy as primary etiologic factors in the neuropsychologic sequelae of curative therapy. Early education intervention is mandatory to identify survivors of childhood cancer who require assistance in overcoming intellectual disabilities...
1991: Pediatrician
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