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Wilson K, Lesica S, Donders J. Clinical Utility of the Child and Adolescent Memory Profile (ChAMP) After Pediatric Traumatic Brain Injury. Assessment 2020; 29:309-316. [DOI: 10.1177/1073191120976855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sixty-one children and adolescents with traumatic brain injury completed the Child and Adolescent Memory Profile (ChAMP; Sherman & Brooks, 2015) within 1 to 12 months post injury. Most of the ChAMP index scores demonstrated statistically significant negative correlations with time to follow commands following traumatic brain injury. Compared with demographically matched neurologically healthy controls, selected from the ChAMP standardization sample, participants with traumatic brain injury had statistically significantly lower scores on all ChAMP index scores but sensitivity and specificity were suboptimal. We conclude that the ChAMP has modest clinical utility as part of a more comprehensive evaluation of sequelae of traumatic brain injury in children and adolescents.
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Affiliation(s)
- Kate Wilson
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Sofia Lesica
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Jacobus Donders
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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Ringdahl EN, Becker ML, Hussey JE, Thaler NS, Vogel SJ, Cross C, Mayfield J, Allen DN. Executive Function Profiles in Pediatric Traumatic Brain Injury. Dev Neuropsychol 2018; 44:172-188. [PMID: 30590952 DOI: 10.1080/87565641.2018.1557190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Traumatic brain injury (TBI) results in heterogeneous patterns of neuropsychological impairment. This study investigated heterogeneity in executive function (EF) using the Comprehensive Trail Making Test (CTMT) to evaluate 121 children and adolescents with TBI and 121 matched normal controls. The TBI group performed approximately two standard deviations below controls. Cluster analyses indicated that a three-cluster solution best classified the TBI group and a four-cluster solution best classified controls. Greater impairment in EF was associated with lower intellectual, achievement, and neuropsychological test performance in the TBI group. Results suggest that EF deficits reflected in CTMT performance may be useful for classifying severity of TBI.
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Affiliation(s)
- Erik N Ringdahl
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Megan L Becker
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Julia E Hussey
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | | | - Sally J Vogel
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | - Chad Cross
- b School of Medicine and School of Community Health Sciences , University of Nevada, Las Vegas , Las Vegas , Nevada , USA
| | | | - Daniel N Allen
- a University of Nevada, Las Vegas , Las Vegas , Nevada , USA
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DeMaster D, Johnson C, Juranek J, Ewing‐Cobbs L. Memory and the hippocampal formation following pediatric traumatic brain injury. Brain Behav 2017; 7:e00832. [PMID: 29299377 PMCID: PMC5745237 DOI: 10.1002/brb3.832] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/15/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Previous research indicates disruption of learning and memory in children who have experienced traumatic brain injury (TBI). Objective This research evaluates the impact of pediatric TBI on volumetric differences along the long axis of the hippocampus, a region of the brain that is critical for explicit memory. Methods Structural brain data and behavioral measures were collected 6 weeks following TBI or extracranial injury (EI), in children aged 8-15 years and from a group of age matched typically developing controls (TDC). Total hippocampal volume and hippocampal subregion volumes corresponding to hippocampal head, body, and tail were compared across groups and were examined in relation to verbal and visual memory. Results Group differences were evident such that hippocampal body volume was found to be smaller for TBI and EI groups compared to the TDC group. Analysis restricted to the TBI group indicated that hippocampal head volume was associated with severity of injury. The relation between severity of injury and hippocampal head volume is particularly important considering results from our investigation of hippocampal volume-to-memory performance relations indicating positive correlations between hippocampal head volume and performance on memory measures for both the TBI group and the TDC group. Significant negative correlations between hippocampal body volume and memory were evident for the TBI group but not EI or TDC groups. Correlations between memory performance and hippocampal tail volume were not significant for the TBI or TDC groups, although for the EI group, a positive correlation was found between hippocampal tail volume and memory. Conclusion Together these results underscore an important relation between hippocampal structure and memory function during the subacute stage of recovery from pediatric TBI.
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Affiliation(s)
- Dana DeMaster
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
| | - Chad Johnson
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
| | - Jenifer Juranek
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
| | - Linda Ewing‐Cobbs
- Department of PediatricsChildren's Leaning InstituteUniversity of Texas McGovern Medical SchoolHoustonTXUSA
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Meekes J, Braams OB, Braun KPJ, Jennekens-Schinkel A, van Rijen PC, Alpherts WCJ, Hendriks MPH, van Nieuwenhuizen O. Visual memory after epilepsy surgery in children: a standardized regression-based analysis of group and individual outcomes. Epilepsy Behav 2014; 36:57-67. [PMID: 24857810 DOI: 10.1016/j.yebeh.2014.04.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 04/15/2014] [Accepted: 04/18/2014] [Indexed: 10/25/2022]
Abstract
Visual memory is vulnerable to epilepsy surgery in adults, but studies in children suggest no change or small improvements. We investigated visual memory after epilepsy surgery, both group-wise and in individual children, using two techniques to assess change: 1) repeated measures analysis of variance (ANOVA) and 2) an empirically based technique for detecting cognitive change [standardized regression-based (SRB) analysis]. A prospective cohort consisting of 21 children completed comprehensive assessments of memory both before surgery (T0) and 6 (T1), 12 (T2), and 24 months (T3) after surgery. For each patient, two age- and gender-matched controls were assessed with the same tests at the same intervals. Repeated measures ANOVA replicated the results of previous studies reporting no change or minor improvements after surgery. However, group analysis of SRB results eliminated virtually all improvements, indicating that the ANOVA results were confounded by practice effects. Standardized regression-based group results showed that in fact patients scored lower after surgery than would be predicted based on their presurgical performance. Analysis of individual SRB results showed that per visual memory measure, an average of 18% of patients obtained a significantly negative SRB score, whereas, on average, only 2% obtained a significantly positive SRB score. At T3, the number of significantly negative SRB scores outweighed the number of significantly positive SRB scores in 62% of patients. There were no clear associations of clinical variables (including side and site of surgery and postsurgical seizure freedom) with memory outcome. The present analysis revealed that given their individual presurgical functioning, many children obtained disappointing results on some visual memory tests after epilepsy surgery. Comparison of the SRB analysis with ANOVA results emphasizes the importance of empirically based techniques for detecting cognitive effects of epilepsy surgery in childhood.
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Affiliation(s)
- Joost Meekes
- Sector of Neuropsychology for Children and Adolescents, Hp KG 01.327.1, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands.
| | - Olga B Braams
- Sector of Neuropsychology for Children and Adolescents, Hp KG 01.327.1, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands.
| | - Kees P J Braun
- Department of Child Neurology, Hp KC 03.063.0, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
| | - Aag Jennekens-Schinkel
- Sector of Neuropsychology for Children and Adolescents, Hp KG 01.327.1, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands; Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands.
| | - Peter C van Rijen
- Department of Neurosurgery, Hp G 03.124, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Willem C J Alpherts
- SEIN, Epilepsy Institute of the Netherlands Foundation, Location Meer en Bosch, P.O. Box 540, 2103 SW Heemstede, The Netherlands.
| | - Marc P H Hendriks
- Department of Behavioural Sciences, Kempenhaeghe Expertise Centre for Epileptology, Sleep Medicine and Neurocognition, P.O. Box 61, 5590 AB Heeze, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands.
| | - Onno van Nieuwenhuizen
- Bio Research Center for Children, Wekeromseweg 8, 6816 VS Arnhem, The Netherlands; Department of Child Neurology, Hp KC 03.063.0, Brain Center Rudolf Magnus, University Medical Center Utrecht, P.O. Box 85090, 3508 AB Utrecht, The Netherlands.
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Abstract
BACKGROUND Rodents with gestational thyroid-hormone (TH) deficiencies and children with congenital hypothyroidism show abnormal hippocampal development. Given that the human hippocampus starts to develop early in gestation, we asked if children born to women with hypothyroidism during pregnancy also show hippocampal abnormalities and if this is related to the severity of maternal TH insufficiency and current memory functioning. We additionally sought to determine whether effects were more prominent in anterior or posterior hippocampal subsections given these support different memory functions and have different developmental trajectories. We hypothesized that these children would have smaller than normal hippocampal volumes than controls and show memory deficits on both standardized tests and indices of "everyday" memory functioning. METHODS We studied 54 children aged 9 to 12 years: 30 controls and 24 HYPO cases-offspring from women diagnosed with hypothyroidism prior to or during pregnancy and treated with l-thyroxine. All children received a thorough assessment of memory functions and an MRI scan. For each child, right and left hippocampi were manually traced, and volumes of right and left hippocampi and anterior and posterior segments were determined. RESULTS HYPO cases showed significantly smaller right and left hippocampal volumes than controls, particularly in right posterior and left anterior segments. In HYPO children, hippocampal volumes were negatively correlated with maternal third-trimester TSH levels and positively correlated with third-trimester fT4. HYPO cases scored significantly below controls on one objective and several subjective memory indices, and these were correlated with hippocampal volumes. CONCLUSION Early TH insufficiency from maternal hypothyroidism affects offspring hippocampal development and memory.
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Affiliation(s)
- Karen A Willoughby
- 1 Neuroscience and Mental Health Research Program , The Hospital for Sick Children, Toronto, Canada
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Verbal memory after epilepsy surgery in childhood. Epilepsy Res 2013; 107:146-55. [PMID: 24042124 DOI: 10.1016/j.eplepsyres.2013.08.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 07/21/2013] [Accepted: 08/14/2013] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate verbal memory after epilepsy surgery both group-wise and at the level of individual children, and to assess associations with side of surgery and removal of the temporal lobe. METHODS A prospective controlled study in a consecutive sample of 21 children undergoing epilepsy surgery, with comprehensive assessments of verbal memory before surgery and six, 12 and 24 months after surgery. For each patient, two age- and gender-matched controls were tested at similar intervals. Standardized regression-based (SRB) analysis was applied to compare post-surgical change in individual patients with change in controls. RESULTS Group-wise, average normed scores on verbal memory tests were higher after epilepsy surgery than before, corroborating earlier reports. By dint of empirically based SRB analysis, however, considerable individual differences in post-surgical change were revealed. Children with resections that included the left temporal lobe functioned significantly poorer than predicted on the basis of their pre-surgical performance. In contrast, verbal memory performance after surgery was consistent with pre-surgical baseline in the majority of children with resections that spared the left temporal lobe. CONCLUSIONS Despite cessation of epileptic seizures, verbal memory remains vulnerable in children who required surgery including the left temporal lobe. In most - but not all - children with other types of surgery, post-surgical verbal memory is consistent with their individual pre-surgical base level.
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