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Biomedical subjects

Mary Lou Smith

Publications and source records attributed to Mary Lou Smith.

At least 19 recordsLinked to original sources
PubMed2006

Memory outcome after pediatric epilepsy surgery: objective and subjective perspectives.

Memory was investigated in 27 children and adolescents in a longitudinal study before and at one and two years after epilepsy surgery. A comparison group with intractable epilepsy (n = 15), matched in age, sex, age of seizure onset, and IQ, was studied at comparable points in time. Methods included administration of standardized measures of story recall and face recognition, and qualitative interviews to probe the participants' perceptions of their memory function over time. There was no significant change over time in either group on the standardized measures. Site and laterality of excision, age at surgery, and seizure outcome were not predictive of change within the surgical group. The narratives revealed facets of memory that were problematic in daily life. The objective and subjective results showed low concordance regarding change, possibly due to limitations in the objective measures for capturing semantic and autobiographical memory.

Adolescent↗
PubMed2005

I just want to be normal: a qualitative study exploring how children and adolescents view the impact of intractable epilepsy on their quality of life.

This qualitative study explores how children and adolescents with medically refractory seizures experience the impact of epilepsy on their quality of life (QOL) within the domains of physical, emotional/behavioral, social, and cognitive/academic function. Semi-structured, open-ended interviews were conducted with 49 participants (7-18 years old). These narratives constituted our data source. Analyses involved inductive generation of themes/subthemes and connection of these themes to generate a theoretical representation of their relationships. These themes reflected the negative impact of epilepsy on QOL: physical-excessive fatigue as a barrier to academic and social pursuits; emotional/behavioral-intermittent emotional distress heightened by epilepsy-related factors such as unpredictability of seizures; social-profound social isolation; and cognitive/academic-discontinuous, fragmented learning. Youths perceive seizures as the major barrier to their sense of normalcy, setting them apart from others. Findings provide direction for assessment and evidence for developing or enhancing clinical interventions and community/school-based programs that might mitigate some of these negative experiences.

Adolescent↗
PubMed2005

Breast cancer.

Explore the source record for details and available documents.

Antineoplastic Agents↗
PubMed2004

Cognitive and psychological predictors of everyday memory in children with intractable epilepsy.

Children with epilepsy have known deficits on objective measures of learning and memory. Parents and children report that memory deficits have a negative impact on everyday functioning. In adults with epilepsy, self-report of memory is more strongly associated with depression than performance on memory tests. We investigated the cognitive and psychological predictors of everyday memory in 37 children with medically intractable epilepsy, using children's self-report and parent ratings of everyday memory performance and standard tests of attention, intelligence, visual and verbal memory, working memory, and mood/emotional state. Standard multiple regressions demonstrated that only a parent report measure of attention uniquely and significantly (P< or =0.05) predicted estimates of everyday memory performance, accounting for 33% of variance in children's own ratings and 27% of variance in parents' ratings. Findings suggest that everyday memory in children with intractable epilepsy differs from that of adults; attentional problems may underlie everyday memory problems in these children.

Adolescent↗
PubMed2004

Cognitive, psychosocial, and family function one year after pediatric epilepsy surgery.

PURPOSE: Assumptions regarding the benefits of seizure control after pediatric epilepsy surgery for cognitive, psychosocial, and family function were explored in a prospective study of 51 children with intractable epilepsy. METHODS: Thirty children who underwent surgery were studied before and 1 year after surgery, and a comparison group of 21 children with medically refractory seizures was examined at comparable times. RESULTS: One year after surgery, 57% of the surgical group was seizure free. Seizure status after surgery did not predict change over time in any of the areas measured. Cognitive and psychosocial status did not change over time in either group, and the strongest predictor of individual change in psychosocial status in the surgical group was baseline level of function. Within the surgical group, a trend toward an increase in independence promotion was noted in the family, but the children's satisfaction with the family declined. CONCLUSIONS: These findings challenge the assumption that elimination of seizures will result in improved cognitive, psychosocial, and family functioning, at least within the first year after surgery.

Adaptation, Psychological↗
PubMed2003

Memory in children with temporal or extra-temporal excisions.

Memory was assessed before and after surgery in 44 children and adolescents with focal epilepsy who underwent either right temporal, left temporal or extra-temporal excisions. Measures included tests of verbal (story recall, and verbal list learning) and visually mediated (recall of a complex design, face recognition) memory. Changes in children's memory from pre- to post-operative assessment were examined and individual differences in outcome were evaluated. Although substantial variability existed in performance, no group differences or post-operative changes were found for measures of verbal memory or design recall. For face recognition, all groups improved after surgery, although children with right temporal resections performed more poorly than the other groups. Finally, with the exception of face recognition, no material-specific effects were observed before or after surgery.

Adolescent↗
PubMed2003

Factors associated with atypical speech representation in children with intractable epilepsy.

The purpose of this study was to investigate the relationship between hemispheric speech dominance and several demographic and seizure variables in a large sample of children (N=75) who underwent the intracarotid amobarbital procedure (IAP) prior to surgery. The findings were similar to results previously reported in adults and children, suggesting that variables, such as age at seizure onset, laterality of seizure focus, location of seizure focus and handedness are related to the presentation of atypical speech representation in children with epilepsy. The impact of multiple variables in determining the risk for atypical speech dominance was also assessed. The results demonstrated an increased probability of atypical speech representation in children with a greater number of risk variables, suggesting the need for further investigations in this area.

Adolescent↗
PubMed2002

Developmental patterns in priming and familiarity in explicit recollection.

Developmental trajectories of two classes of human memory, implicit and explicit memory, appear to diverge. We examined how developmental differences in perceptual and conceptual priming, two types of implicit memory, coincide with differences between familiarity and recollective responses on explicit memory tests that employ the Remember/Know paradigm ( Tulving, 1985 ). Both types of priming were characterized by developmental invariance in 52 children and adolescents ages 8-19 years. Contrary to Komatsu, Naito, and Fuke (1996) results, few age-group differences in perceptual priming were observed following a levels-of-processing encoding manipulation. In contrast, age group differences were found for "Remember" but not "Know" responses. Neither levels of awareness nor strategies influenced priming. Adult levels of performance appear earlier in development on perceptual and conceptual priming tests compared to explicit memory tests. Similar developmental dissociations exist between explicit and implicit memory performance as between "Remember" and "Know" recollective responses.

Adolescent↗
PubMed2002

Intact perceptual and conceptual priming in temporal lobe epilepsy: neuroanatomical and methodological implications.

Explicit memory appears to be supported by medical temporal lobe structures, whereas separate neocortical regions may mediate perceptual and conceptual implicit memory. Children and adults with temporal lobe epilepsy (TLE) and matched controls were administered experimental verbal memory tests. Performance on implicit tests--word identification and word generation--was contrasted with explicit recognition and recall. Encoding conditions emphasized either conceptual or perceptual aspects of study words and were crossed with presentation modality. The priming performance of participants with TLE did not differ from controls, but participants with TLE did show deficits on recognition and recall measures. Thus, intact left temporal cortex does not appear to be necessary for normal implicit memory performance, even when conceptual processing is emphasized at study or test.

Adolescent↗
PubMed2002

Working memory performance predicts subjective cognitive complaints in HIV infection.

The authors examined the contribution of working memory performance to subjective cognitive complaints in HIV infection beyond the influence of depressive symptoms. Thirty-six adults with HIV infection were administered neuropsychological (NP) tests of working memory, complex psychomotor efficiency, verbal learning, delayed recall, and questionnaires measuring depressive symptoms and cognitive complaints. Working memory performance, depression scores, and complex psychomotor efficiency were most strongly associated with self-reported cognitive complaints, whereas verbal learning scores and simple psychomotor efficiency showed more modest associations. Regression analyses revealed working memory performance to be the strongest NP predictor of self-reported cognitive complaints, comparable with depression scores in the amount of variance explained. These results suggest that working memory performance may be well suited to reflect how patients function in their everyday environment.

Adult↗
PubMed2002

Cognitive skills in children with intractable epilepsy: comparison of surgical and nonsurgical candidates.

PURPOSE: To compare neuropsychological performance of two groups of children with intractable epilepsy: those who are surgical candidates, and those who are not. METHODS: Intelligence, verbal memory, visual memory, academic skills, and sustained attention were measured in children aged 6-18 years. The effects of number of antiepileptic drugs (AEDs), seizure frequency, age at seizure onset, and duration of seizure disorder were examined. RESULTS: Both groups had high rates of impairment. Group differences were found only on the verbal memory task. Children who experienced seizures in clusters had higher IQ, reading comprehension, and arithmetic scores. Age at seizure onset and proportion of life with seizures were related to IQ. Performance did not vary with AED monotherapy versus polytherapy. CONCLUSIONS: Few differences exist in cognitive performance between children with intractable seizures who are and those who are not surgical candidates. These findings suggest that children who are not surgical candidates can serve as good controls in studies on cognitive outcome of surgery.

Adolescent↗
PubMed2002

Cognitive development in school-age children with vertically transmitted HIV infection.

We examined a broad range of neuropsychological functioning in school-age children with vertically transmitted HIV infection and a control group made up of siblings of children with HIV infection. Fourteen children with HIV (2 asymptomatic, 8 mildly symptomatic, and 4 with AIDS) and 11 control children were administered a battery of neuropsychological tests assessing intelligence, receptive language, expressive language, visual and verbal memory, visual-motor speed and coordination, visual-motor and visual-spatial processing, fine motor skill, and academic achievement. Results revealed that school-age children with vertically transmitted HIV infection show many areas of cognitive function within the normal range. Despite normal cognitive development, subtle motor impairments were documented in children with vertically transmitted HIV infection. Our results are the first report of fine motor and motor strength deficits in school-age children with vertically transmitted HIV. Lastly, computed tomography (CT) results suggest that children with HIV who have documented structural anomalies in the brain may be at risk for deficits in visual-motor and visual-spatial processing. This finding should be explored with larger samples and other measures to determine its generalizability.

Adolescent↗
PubMed2001

Predictors of Intelligence after Temporal Lobectomy in Children with Epilepsy.

Performance on standardized measures of intelligence was examined before and after temporal lobectomy in 50 children and adolescents. Group results showed small positive changes in Performance IQ (PIQ), but not Verbal IQ (VIQ). Analyses of individual patients showed that 28% had a significant change in VIQ after surgery, half of whom showed improvements. Increases in VIQ were associated with older age at time of surgery, lower VIQ before surgery, and positive seizure outcome after surgery, whereas longer follow-up time was predictive of smaller change. Increases in PIQ were seen in 25% of patients, and decreases occurred in 8%. Predictors of postoperative change in PIQ were dual pathology and longer follow-up interval, both of which showed negative correlations. Enhanced intellectual function is not one of the benefits to be expected in the majority of children undergoing temporal lobectomy. Further studies are required to determine whether these conclusions may or may not be applied to other aspects of cognitive function.

Journal Article↗
PubMed2001

Single and Dual Pathologies of the Temporal Lobe: Effects on Cognitive Function in Children with Epilepsy.

The neuropathologies associated with temporal lobe epilepsy (TLE) are heterogeneous. The performance of 61 children with single pathology of hippocampal sclerosis (HS), temporal lobe tumor, or cortical dysplasia (CD) or dual pathology of HS + tumor or HS + CD was examined on measures of intelligence, language, memory, and executive function. Children with single pathologies performed significantly better than did children with HS + CD on all standardized measures of IQ. Children with tumors performed significantly better than children with dual pathology on receptive vocabulary. These results support prior research of an association between neuropathology and cognitive function in children with epilepsy and extend the findings to include additional neuropathologies and measures of cognitive functioning.

Journal Article↗