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G Dellatolas

Publications and source records attributed to G Dellatolas.

At least 19 recordsLinked to original sources
PubMed2003

Neuropsychological outcome in long-term survivors of a childhood extracranial solid tumor who have undergone autologous bone marrow transplantation.

The purpose of this study was to evaluate neuropsychological and adaptive functioning of children who have undergone bone marrow transplantation (BMT) without previous cranial irradiation. In total, 76 children treated for an extracranial tumor with BMT without total body irradiation (TBI) were evaluated at least 5 years after the end of the treatment.Overall, their performance and skills were in the normal range and their professional and academic outcomes were satisfactory. Nevertheless, we observed a deleterious effect of deafness on verbal IQ associated with the previous administration of cisplatin during conventional chemotherapy. In addition, reading difficulties had arisen. This could be related to absence from kindergarten or primary school during hospitalization. Finally, in the younger subgroup, visual-perceptual skills were found to be more fragile.

Adolescent↗
PubMed2003

Ictal SPECT in children with epilepsy: comparison with intracranial EEG and relation to postsurgical outcome.

In order to validate the ability of ictal single photon emission computed tomography (SPECT) to localize the epileptogenic zone (EZ) in children, we compared in 20 patients aged from 10 months to 17 years (mean 6.5 years) the topography of the area of increased ictal perfusion (IPA), determined on the basis of ictal minus interictal scan values, with that of the EZ determined by intracranial EEG recordings and assessed its relationship with the postsurgical outcome. Eighteen patients had symptomatic epilepsy and 10 had extratemporal epilepsy. All patients except one had an ictal injection (mean time lag from clinical seizure onset was 18 s). Ictal and interictal SPECT images were successively co-registered, normalized, subtracted, smoothed and superimposed on MRI. All patients with ictal injection exhibited one or several IPAs. The topography of the 'highest' IPA, i.e. the maximal cerebral blood flow (CBF) change between ictal and interictal SPECT, significantly colocalized with the site of onset of the discharge, and that of the lower IPAs with that of the area of propagation (P < 0.0001). At a threshold of 30% of the maximal CBF change, the IPAs detected the onset of the discharge with a sensitivity of 0.80 and a specificity of 0.70. The highest IPA localized the EZ in 12 out of 15 patients. In the three others it missed the EZ and showed the area of propagation because of rapid seizure propagation or of infraclinical seizure onset. Among the patients with favourable surgery outcome, the highest IPA colocalized with the resected area in 70% of cases. Ictal SPECT could therefore plays an important role as a non-invasive presurgical method of investigation by optimizing the placement of intracranial electrodes, thus improving the postsurgery outcome of paediatric partial epilepsy.

Adolescent↗
PubMed2002

[Long-term efficacy and tolerance of stiripentaol in severe myoclonic epilepsy of infancy (Dravet's syndrome)].

OBJECTIVE: To describe the long term efficacy and tolerance of stiripentol associated with valproate and clobazam in an exhaustive cohort of patients with severe myoclonic epilepsy of infancy (Dravet's syndrome), in which short term efficacy of such a treatment has recently been demonstrated in a placebo-controlled trial. RESULTS: In 46 patients the frequency and the duration of seizures was significantly reduced (p < 0.001) as well as the number of convulsive status at a median of three-year follow-up. Ten patients were dramatically improved (seizures significantly decreased in number [p = 0.002] and duration [p = 0.002] and status epilepticus disappeared), 20 were moderately improved (seizures significantly decreased in duration [p = 0.001] and status were less numerous), four had no response and efficacy was non evaluable in 12 mainly because of adverse events. Efficacy was better in the youngest patients. The most frequent adverse events were loss of appetite and loss of weight. They could be so severe in patients over 12 years of age that the stiripentol dosage could not be increased to 50 mg kg-1 j-1. CONCLUSION: This follow-up study shows that stiripentol added to valproate and clobazam maintains its efficacy at long term in children with severe myoclonic epilepsy of infancy and suggests that the tritherapy should be introduced as early as possible in these patients in order to suppress the convulsive status epilepticus.

Anti-Anxiety Agents↗
PubMed2001

Lateral preferences among indian school children.

In the first study, 718 children from India, aged 4 to 11 years, were observed for their hand preference for ten common unimanual activities. The prevalence of left-handedness was found to be only 3.2 percent, i.e. one-third of that (9.6%) observed in a French study using a similar procedure. The degree (weak to strong) but not the direction of hand preference was found to be related to the children's age, with stronger preference among older children. The factor structure of handedness items was similar in France and India. In the second study, 400 schoolchildren from India, aged 6 to 18 years, were examined for handedness, footedness, eyedness, use of hand in space, and absolute and relative hand skill assessed by a peg-moving task and a dot-filling task. Prevalence of left-handedness was 4.2%. A sex difference was observed for handedness, footedness, use of hand in space. and relative hand skill, with higher proportions of right preferences and higher degree of lateralization (i.e., relative between hands asymmetry) in females. The degree of hand skill asymmetry increased with age. These results are discussed in relation to findings from previous studies in other countries using similar procedures.

Adolescent↗
PubMed2001

Subjective experience after traumatic brain injury.

The present investigation aims to show which specific difficulties are reported with greater frequency in traumatic brain injury (TBI) patients than in controls, and in hetero-assessment than in self-assessment. Ninety-seven patients with severe TBI were compared to 97 controls matched for age and gender. The 63-item European Brain Injury Questionnaire (EBIQ) was completed by patients, close relatives and controls. A principal component analysis showed three main factors: "depressive mood", "cognitive difficulties", and "difficulties in social interactions". Relatives scored higher than patients for items concerning the three domains. Patients scored higher than controls for "depressive mood" and "cognitive difficulties", but not for "difficulties in social interactions", which included items related to both self-assertion and lack of self-control. After TBI, emotional problems and, especially, depressive mood associated to cognitive difficulties have an important impact in everyday life and family functioning. Difficulties in social interactions are not specific of TBI patients.

Adolescent↗
PubMed2001

A psychological assessment of adolescent and young adult inpatients after traumatic brain injury.

The purpose of this study was to evaluate the cognitive, behavioural, depressive and self-awareness disorders, and their relationships, after severe traumatic brain injury (TBI) in adolescent and young adult inpatients. Two groups of patients with (n = 83) and without (n = 103) TBI, aged 14-25 years, hospitalized after severe traumatic pathology, were compared using the clinician's report and self-report. A higher frequency of depressive tendencies in TBI patients than in controls was shown in the clinician's therapeutic attitude (i.e. prescription of antidepressant drugs), the clinician's report and the self-report. The same difference between the two groups was observed for behavioural and schooling problems in the clinician's report, but not in the self-report. Discrepancies between self- and clinician's evaluation were in favour of a lack of self-awareness of behavioural and cognitive disorders among TBI patients. Correlations of depressive mood with anxiety and cognitive complaints were stronger in TBI than in non-TBI patients. Depression in TBI patients seems compatible with some degree of lack of self-awareness of cognitive and behavioural difficulties.

Adolescent↗
PubMed2001

Lateralities in normal children ages 3 to 8 and their role in cognitive performances.

The presence and type of correlations between laterality and cognitive skills in normal adults or children remains controversial. This study examines relations between different lateralities, that is, handedness, footedness, eyedness, parental left-handedness, asymmetry of hand skill on a computerized version of the Peg-Moving Task (CPMT) proposed by Annett (1985), and different verbal and non-verbal skills assessed by 13 tasks in 254 normal children, aged 3 to 8 years. Results showed increasing performances with increasing dextrality on the CPMT for 2 tasks involving phonology (Phonological Fluency and Reading Nonwords), 2 tasks involving visual memory and visuospatial skills, and for finger localization. Footedness, eyedness, and parental left-handedness had no significant effect on cognitive performance. The pattern of performance according to the sinistrality-dextrality continuum was highly variable from one cognitive task to the other. The previously mentioned results suggest that relative hand skill is a better correlative of cognitiveperformance than the usual measures of handedness. Further study is needed to specify the pattern of associations.

Age Factors↗
PubMed2001

Assessment of calculation and number processing using the EC301 battery: cross-cultural normative data and application to left- and right-brain damaged patients.

To provide referential normative data on simple tasks dealing with number processing and calculation which could be used in clinical investigations, 551 normal volunteers aged between 18 and 69 years from France and Belgium (n = 180). Italy (n = 212) and Germany (n = 159). performed the 31 tasks which constitute the EC301 calculation and number processing battery. Differences between countries were significant for 16 tasks and a Gender x Education interaction was observed for some tasks, with men performing better than women among subjects with low education only. To present an overview of preserved and impaired calculation and number processing abilities in left-brain damaged (LBD) aphasic patients and right-brain damaged (RBD) nonaphasic patients, the 31 subtests of the EC301 battery were proposed to 80 patients with cerebrovascular accident, 56 left and 24 right, for most cases in the territory of the middle cerebral artery. LBD aphasic patients showed low performance on oral and alphabetical spoken verbal and written verbal counting, transcoding when a written code was involved, and mental or written calculation; but relatively good performance at finding the number of elements in small sets, comparing numbers written in the Arabic digital code and placing correctly numbers on an analogue number line. The lowest performances of RBD patients were observed for estimation tasks and for placing a number on a scale. Results and their implications for further research are discussed according to the present information processing and anatomofunctional models of calculation and number processing.

Adolescent↗
PubMed2000

Number processing and mental calculation in school children aged 7 to 10 years: a transcultural comparison.

Neuropsychological studies of dyscalculic patients show that arithmetical development is not a unidimensional process. In transcultural investigations, cultural, educational and linguistic factors might affect differently the various components of mathematical development. Four hundred and sixty schoolchildren aged 7 to 10 years from Brasilia, Brazil (n = 141), Paris, France (n = 160) and Zurich, Switzerland (n = 159) were asked to perform eleven number processing and calculation tasks. Chronological age, which was almost confounded in this study to educational level, had a strong effect on some tasks (knowledge of the written code of numbers, number comparison, mental calculation, problem solving), but only a slight effect on other tasks (counting dots, counting backwards, estimation). Also, linguistic factors and factors related to the socio-economic level of the family had different effects on the various components of calculation and number processing. Evidence from developmental studies has to be integrated into theoretical models of calculation and number processsing, which are presently based mainly on results from neuropsychological studies of dyscalculic patients.

Brazil↗
PubMed2000

Epileptic syndromes, cognitive assessment and school placement: a study of 251 children.

Two-hundred and fifty-one children (98 girls and 153 boys, aged from 3 to 17 years) with documented diagnosis of epileptic syndrome, IQ measurement, and information on school placement were included in this retrospective study. The relations between these three parameters as well as effects of age at onset and duration of epilepsy, seizure frequency, and number of antiepileptic drugs (AEDs) were analysed. Both IQ and schooling were univariately related to epileptic syndrome, age at onset and duration of epilepsy, and number of AEDs; seizure frequency was related to IQ but not to school placement. Multiple regression showed that IQ was independently related to epileptic syndrome and AED; multiple logistic regression showed that type of school (mainstream versus adapted or special) was independently related to IQ and AED. Children with idiopathic generalised or with localisation-related epilepsy had higher IQ scores and higher probability of mainstream schooling than those with symptomatic or cryptogenic generalised epilepsies or epileptic syndromes which were undetermined. Subtests profile of intelligence scale in localisation-related epilepsies showed different specific cognitive deficits, according to the location of the epileptic focus.

Adolescent↗
PubMed2000

Factors affecting compliance with treatment in an outpatient child psychiatric practice: A retrospective study in a community mental health centre in Athens.

BACKGROUND: The literature review shows that treatment compliance in child psychiatric practice is a multifactorial issue that includes parameters such as the type of problem presented by the child, the family's functioning and the therapeutic team's organization and functioning. METHODS: In order to examine these parameters and their inter-relationship, epidemiological data from the files of 455 cases, representing the total number of cases admitted to our Centre between 1990-1994, were collected. We noted that the majority of patients (58.6%) failed to comply with treatment. RESULTS: The statistical analysis shows that the sex and age of the child, the socio-economic status of the family, the family's size, the parents' educational background as well as the referral source are unrelated to compliance. On the contrary, the type of problem presented by the child, the type of recommended treatment, the number of sessions attended and the season of admission are correlated with treatment compliance. CONCLUSIONS: Certain aspects of our team's techniques concerning the admission procedure, therapeutic contract and parental counselling have been re-examined and improved.

Adolescent↗
PubMed1999

Long-term intellectual outcome in children with posterior fossa tumors according to radiation doses and volumes.

PURPOSE: To analyze the relationship between craniospinal irradiation (CSI) and intellectual outcome in children with posterior fossa (PF) tumors. METHODS AND MATERIALS: A neuropsychological evaluation was performed retrospectively in 31 children, aged 5-15 years, who had received radiotherapy for PF tumors, and who had been off therapy for at least 1 year. Factors evaluated for impact on intellectual outcome were: socioeconomic status, disease presentation, histology, complications, chemotherapy, age at radiotherapy, interval between radiotherapy and testing, and radiation doses and volumes. Patients were divided into 3 subgroups according to the CSI doses (0 Gy [i.e., PF irradiation only], 25 Gy, and 35 Gy), with 11, 11, and 9 patients, respectively. RESULTS: Long-term cognitive impairment occurred in most of the patients, even after PF irradiation only. Moreover, there was a significant correlation between the full-scale IQ score (FSIQ) and the CSI dose, with mean FSIQ scores at 84.5 (SD = 14.0), 76.9 (SD = 16.6), and 63.7 (SD = 15.4) for 0 Gy, 25 Gy, and 35 Gy of CS1, respectively. A marked drop in verbal comprehension scores was noted in children who had received the higher dose. CONCLUSION: This preliminary study further supports the rationale for de-escalation of CSI doses and volumes in standard-risk PF tumors.

Adolescent↗
PubMed1999

A calculation and number processing battery for clinical application in illiterates and semi-literates.

Ten simple tasks assessing counting, number processing, elementary calculation and quantity estimation were proposed to 122 normal Brazilian adults aged between 18 and 58 years with 0, 1, 2, 3 or 4 years of education. Tasks such as counting the number of elements in small sets were almost perfectly mastered by these illiterate or semi-literate normal subjects; however in other tasks (e.g. those assessing knowledge of the correspondence between numbers and banknotes) a sizeable proportion of the sample showed errors. The pattern of errors was analysed to identify difficulty factors. A strong gender effect with better performance in men than women was observed, which was even greater than the expected effect of educational level. Results in normals allowed to propose cut-off scores for neuropsychological assessment in brain-damaged patients with very low levels of education, which were tested in a small sample of illiterate or semi-literate patients with cerebrovascular accident. It is argued that the relatively neglected area of neuropsychological assessment in illiterates is of great practical and theoretical interest.

Adolescent↗
PubMed1999

Delineation of cryptogenic Lennox-Gastaut syndrome and myoclonic astatic epilepsy using multiple correspondence analysis.

PURPOSE: To distinguish various types of childhood severe cryptogenic/idiopathic generalised epilepsy on the basis of reproducible diagnostic criteria, using multiple correspondence analysis (MCA). METHODS: We applied MCA to a series of 72 children with no evidence of brain damage, starting epilepsy between 1 and 10 years, with two or more types of generalised seizures. We excluded patients with infantile spasms or typical absences. MCA was performed on all clinical and EEG parameters, first throughout follow-up, then restricted to the first year of the disease. RESULTS: When including all follow-up variables, there were three groups: (1) Thirty-seven children with male predominance, familial history of epilepsy, simple febrile convulsions, massive myoclonus, tonic-clonic fits. Outcome was favourable, with no seizures and mildly affected cognitive functions. Interictal EEG showed short sequences of irregular 3-Hz spike-waves. (2) In 18 children, clinical characteristics were similar to those of the first group at the early stage, but 95% exhibited myoclonic status and vibratory tonic seizures, with persisting seizures on follow-up. EEG showed long sequences of generalised irregular spike and slow waves. Those two groups meet the characteristics of childhood onset myoclonic-astatic epilepsy (MAE) with respectively, favourable and unfavourable outcome. (3) Eleven children had later onset, atypical absences, tonic and partial seizures, and no myoclonus, or vibratory tonic seizures. All had mental retardation and persisting seizures. EEG showed long sequences of slow spike-wave activity and half the patients had spike and slow wave foci. These patients met the major characteristics of Lennox-Gastaut syndrome. Initial parameters failed to distinguish the first two groups, but Lennox-Gastaut syndrome (the third group) was distinct from both groups of myoclonic astatic epilepsy from the onset. Within MAE groups combined, clinical and EEG risk factors for mental retardation could be identified. CONCLUSION: It is possible to validate statistically the distinction between discrete epileptic syndromes. Myoclonic astatic epilepsy is therefore distinct from Lennox-Gastaut syndrome, and the distinction appears from the first year of the disorder.

Adolescent↗
PubMed1999

Assessment of calculation and number processing by adults: cognitive and neuropsychological issues.

Calculation and number processing abilities were assessed in normal (n = 138) and traumatic brain-injured (n = 15) Brazilian literature subjects. The study aimed (i) to analyse the effects of demographic factors and to provide tentative norms adjusted for the relevant variables, (ii) to examine the factorial structure of the battery and to evaluate its clinical validity for diagnosis purposes, and (iii) to question the power of current models to account for effects and dissociations found for these groups. Analysis indicated a main effect of education on most subtests and of sex on three, but none for age. Cut-off scores for normality were defined at Percentile 10 with reference to education. The sensitivity of the battery to the presence of arithmetical impairments was considered satisfactory since 11 out of the 15 patients showed pathological scores. A principal component analysis indicated that the different sub-tests were grouped into three factors, which were tentatively interpreted with reference to current information-processing models. The multiple single-case analysis of dissociations in patients' performance suggested some limits with respect to anatomo-functional models of calculation and number processing.

Adult↗
PubMed1998

Clinical assessment of olfactory dysfunction in Parkinson's disease.

We used two simple tasks to test the capacities of patients with Parkinson's disease to discriminate and identify olfactory stimuli. The patients presented defective odor identification abilities whereas their capacity to discriminate between odors was apparently unaffected. This raises a question about the nature of olfactory dysfunction in Parkinson's disease. Further clinical data is required for analysis of this dysfunction. We therefore propose simple and rapid tests appropriate for clinical use with Parkinson's disease patients.

Adult↗
PubMed1998

Right-left orientation and significance of systematic reversal in children.

Shortly before the acquisition of right and left, which generally occurs around age 6-7 years, a very simple right/left discrimination task makes it possible to distinguish groups of children with strikingly different cognitive abilities. Preschool children aged from 5 to 6.4 years were asked to show their left hand, right eye, left ear and right hand. On a variety of simple cognitive tasks exploring verbal fluency, syntactic comprehension, working memory, visuo-spatial ability and number processing, children who made from 1 to 3 errors (14% of the sample) performed significantly worse than those who showed systematic reversal (30%) and those who made no error. Differential use of logical thinking can partially explain these differences. Neuropsychological implications of these developmental findings are discussed.

Age Factors↗