Browsing by Subject "Neuropsychiatry"
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Item Neurocognitive and Psychosocial Profiles of Pediatric Multiple Sclerosis and Transverse Myelitis(2018-07-30) Tan, Alexander; Harder, Lana; Hughes, Jennifer L.; Hynan, Linda S.; Lacritz, Laura H.; Greenberg, Benjamin M.Research shows that youth with multiple sclerosis (MS) are at risk for neuropsychological deficits due to cerebral involvement, but establishing a clear profile remains difficult due to disease complexity. Emerging evidence also shows neuropsychological deficits and the possibility of brain-based involvement in youth with transverse myelitis (TM) despite absence of obvious cerebral pathology. The present objective is to further investigate neuropsychological sequelae associated with pediatric MS and TM by characterizing and comparing neurocognitive and psychosocial profiles using profile analysis, a method which has not been utilized to investigate neuropsychological functioning in pediatric demyelinating diseases. Sixty-two pediatric MS and 46 pediatric idiopathic TM participants were administered brief neuropsychological screening evaluations during routine clinical care. Separate profile analyses were conducted on performance-based neurocognitive and parent-rated psychosocial variables of interest. Results of the neurocognitive profile analysis revealed significantly (p < .05) poorer overall performance in MS, with measures of cognitive flexibility, visual-motor integration, and fine-motor speed and dexterity found to be significant (p < .05) contributors to combined profiles. However, no significant difference was found in profile patterns between MS and TM groups. Results of the psychosocial profile analysis revealed no significant difference in overall levels of psychosocial problems between groups, with no individual measures found to be significant contributors to combined profiles. However, a significant (p < .05) difference in profile patterns was found between MS and TM groups, characterized by increased elevations in working memory and attention difficulties in MS and physical and social quality of life difficulties in TM. These findings elucidate the neurocognitive and psychosocial sequelae of pediatric MS and TM. While it is established that pediatric patients with MS often present with wide-ranging neuropsychological deficits consistent with brain-based pathology, the present study shows that pediatric patients with TM are also considered to be at risk for neuropsychological difficulties, suggesting that disease mechanisms may impact brain function despite the lack of obvious cerebral involvement. Findings of the current study indicate neuropsychologists play an important role in assessment and treatment planning for these populations, and youth with TM may also benefit from interventions to address cognitive and psychosocial problems.Item Neuropsychological Profiles in Temporal Lobe Epilepsy With and Without a History of Traumatic Brain Injury(2018-07-25) Wadsworth, Hannah Elizabeth; Cullum, C. Munro; Lacritz, Laura H.; Hynan, Linda S.; Busch, Robyn; Ding, KanNeuropsychological deficits have long been observed in those with temporal lobe epilepsy (TLE). Language and verbal memory are often impaired in individuals with left TLE and visuospatial and visual memory can be impaired in patients with right TLE. Traumatic brain injury (TBI) is the most common known cause of epilepsy. Given the heterogeneous nature of TBI, neurocognitive deficits can vary after injury; however, difficulty in memory, attention, processing speed, and executive functioning are consistently observed. Even though these two neurological conditions are intertwined, very little is known about the combined effects on neurocognitive functioning. This study aimed to examine neuropsychological functioning in TLE patients with and without a history of TBI. It was predicted that those with a history of TBI would have greater deficits in attention, processing speed, and executive functioning than those without TBI. Binary logistic regression models were used to determine the value of an array of neuropsychological measures in differentiating those with and without TBI. Results suggested greater cognitive difficulties, particularly in executive functioning, in those with a history of TBI. Understanding that TLE patients with a TBI history could have greater cognitive impairments may assist with clinician interpretation of neuropsychological findings. Future research should expand on the current results to further describe differences in epilepsy populations with and without a history of TBI in a larger, more diverse sample, and with a greater number of individuals who completed semantic fluency and AVLT.