Search PubMed⌕ Search

Biomedical subjects

G Dellatolas

Publications and source records attributed to G Dellatolas.

At least 37 records · Page 2Linked to original sources

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

Eye dominance in children: a longitudinal study.

In a sample of 807 normal preschool children aged from 3 to 6, examined eye dominance was not associated with the declared eye dominance of their parents. Forty percent of the children showed left-eyedness. Eyedness was associated with handedness and not significantly related to age group or sex. A strong relationship between the answers of the two parents concerning eye preference was observed. Two hundred forty-four children were followed-up for 2 years. The examinations were carried out once every 6 months. Two thirds of the children showed perfect stability in eye dominance. There was some evidence that stability in eye use tends to increase with age and to be lower in left-handed children with left-handed parents. There is, at present, very little evidence of a positive association between eye dominance in parents and that in their children.

Analysis of Variance↗

Environmental influences in hand preference: an African point of view.

In order to examine further the role of cultural and environmental factors in human manual preference, two surveys were undertaken in students from Ivory Coast and Sudan. In the first study (Abidjan, Ivory Coast) 382 secondary students, ages 12 to 22, answered a 20-item manual preference questionnaire. The observed frequency of left-hand preference was 7.9%, with very low left-hand use among the 18-22 age group (1%) and high among the 12-15 age group (14%). In the second study (Khartoum, Sudan) 759 undergraduates, ages 18 to 33, answered a 25-item questionnaire. The observed frequency of left manual preference was 5%. Subjects were also asked to indicate any pressure to change hand for writing, eating, or other manual activities and, in the second study, any upper limb injury which temporarily rendered the subject unable to use his (her) preferred hand. Report of an upper limb injury in the past was related to mixed (or inconsistent) hand preference. In both studies, the target activity against left-hand use was eating. These results show that cultural and environmental factors could change "natural" hand preference in three ways: (i) by changing the hand used for only one activity (e.g., eating), with no change for other familiar unimanual activities; (ii) by reducing the degree of hand preference; (iii) by changing the overall preferred hand, generally reducing the prevalence of left-handedness. The design of handedness studies should allow these possibilities to be distinguished.

Adolescent↗

Handedness scale: how many and which items?

A stepwise analysis of the Cronbach Alpha Coefficient (CAC) was performed on five large samples of adults and young children, in order to choose the ''minimum'' set of items of a handedness scale which gives the maximum reliability. In adults, a handedness scale with 12 items has nearly the same or even a better CAC than other scales with more items; so, a choice of 10 to 12 items seems to be adequate. For children, a scale with eight items seems to be quite reliable but it is not impossible that a scale including more items would lead to a slight increase of CAC. The controversial usefulness of a precise assessment of the ''general handedness factor'' (the first principal component) generated by handedness questionnaires and its J-shaped distribution in the general population are discussed.

Journal Article↗

Visual and motor components in simple line bisection: an investigation in normal adults.

Visuomotor bisection and bisection judgement of centrally presented 10-cm horizontal lines were proposed to 43 normal adults, both on paper and on the vertical screen of a computer. Tasks on paper showed slight left-side of the line overestimation and weak link between actual bisection and judgement. Tasks on screen showed, on the contrary, right-side of the line overestimation and stronger link between actual bisection and judgement. Centrally pretransected lines were often judged wrongly. These results suggest an important role of motor factors on classical paper-and-pencil visuomotor line bisection, and the relevance of the distinction between peripersonal and extrapersonal space.

Adult↗

Bisection and perception of horizontal lines in normal children.

Simple line bisection is a complex task in which both perceptual/attentional factors and motor factors are involved. Using a judgment task on prebisected lines it is possible to assess independently the role of perceptual/attentional factors. The judgment-bisection relationship was investigated in 37 preschool children aged 4-5 and 70 school children aged 10-12. At bisection, a clear shift of the right hand with age from right to left bisections was observed, more pronounced in right- than in left-handers, and probably related to learned patterns. At judgment, a slight but significant left side overestimation was observed. In right-handers, judgment was related to left-hand but not to right-hand bisection. It is concluded that motor (manual) factors strongly influence visuo-motor bisection in normal children, and it is suggested that the judgment-bisection relationship has to be systematically investigated when bisection is used as a task informing on space perception or on direction of attention.

Adolescent↗

Calculation and number processing: neuropsychological assessment and daily life difficulties.

One hundred unselected brain-damaged outpatients received a standardized battery of numerical tests (EC301) and, independently, a questionnaire on numerical activities in daily life (ADL). Comparisons between the two types of measurement were drawn from the scorings for different functional components of the calculation and number processing system. Results indicated high ranking correlations between the two instruments. The EC301 battery generally proved more powerful than the questionnaire in detecting the presence of mild-to-discrete impairments, but some aspects of numerical difficulties in nonaphasic patients were scored higher on the ADL questionnaire.

Activities of Daily Living↗

Parental hand preference and manual functional asymmetry in preschool children.

Hand preference and hand skill in 1150 normal children between 3 and 6 years of age and hand preference of their parents were assessed to study the effect of parental hand preference on different dimensions of manual asymmetry in children. Children hand skill was measured with a computerized version of the Peg Moving Task which allowed us to split the overall performance into two components, a "transport time" and a "search time." Paternal and maternal left-handedness was significantly related to child left-handedness. Both components of hand skill asymmetry were reduced with mother's left-handedness. and one component (search time) with father's left-handedness. A significant impact of paternal and preference on child hand skill asymmetry, after controlling for child hand preference, was observed. When this analysis was limited to strong right-handed children, a greater paternal effect on child hand skill emerged. These results show the usefulness of performance tasks in detecting parent-child associations concerning manual functional asymmetry.

Child Development↗

Verbal and visual memory impairment in children with epilepsy.

Verbal and visual memory performances were evaluated in 60 epileptic children and 60 normal control subjects with Signoret's Memory Battery scale. Eighteen patients had idiopathic generalized epilepsy and 42 had partial epilepsy, mostly of the temporal (n = 28) and frontal (n = 10) lobes. Memory scores were statistically lower in epileptics than in controls and significant differences were found within each group: (1) children with idiopathic generalized epilepsy had a slight depression of visual memory; (2) memory disorder was more severe in partial epilepsy; and (3) children with left and right temporal lobe epilepsy had marked memory deficits related to hemispheric specialization.

Adolescent↗

Pathological left-handedness. Left-handedness correlatives in adult epileptics.

Factors associated with left-handedness were examined in a large sample of adults who suffered with epileptic seizures (n = 446) in an attempt to delineate the concept of pathological left-handedness. Three main pathological factors were found associated with left-handedness: (i) right-hemiparesis of early onset; (ii) cognitive deficit; (iii) evidence of left-hemisphere disease on clinical examination. Familial sinistrality was also associated with left-handedness, independently of the above-mentioned pathological factors. Results support a clear-cut distinction between normal and pathological left-handedness. This distinction seems presently important for the evaluation of the great number of anomalies proposed to be associated with left-handedness.

Adult↗