A comparison of neuropsychological and psychosocial functioning after prophylactic treatment for childhood leukemia in monozygotic twins.
Outcome findings based on a comprehensive battery of neuropsychological and psychosocial measurements were compared for a set of monozygotic twins. One twin had been diagnosed with acute lymphoblastic leukemia and given prophylactic treatment involving intrathecal methotrexate. Her twin sibling, who developed no signs of the disease, served as a unique control. Remarkably similar profiles were noted for the twins on tests of nonverbal intelligence, visual memory, visual attention, psychomotor speed, and mental flexibility. All performances were in the average to high average range. Significant differences were found on tasks measuring verbal abstract reasoning skills. These differences were postulated to result from prophylactic treatment, leukemia itself, or disruption in normal psychosocial development. As in previous studies, problems with auditory attention were found. However, both children displayed attentional difficulties regardless of treatment status. Emotional assessment indicated that both twins were experiencing a clinically significant level of anxiety that was postulated to play a role in reduced attention skills. Findings argue for the continued need for monitoring the neuropsychological functioning of children given prophylactic treatment and demonstrate the importance of measuring emotional factors in assessment with these children.
Williams
J
J
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock 72202.
Berry
D H
DH
Caldwell
D
D
Zolten
A J
AJ
Spence
G T
GT
D000342:Affective Symptoms / Q000503:physiopathology; D001288:Attention / Q000502:physiology; D002648:Child; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D007807:Language Tests; D017254:Leukemic Infiltration; D008568:Memory / Q000502:physiology; D008727:Methotrexate / Q000008:administration & dosage; D009483:Neuropsychological Tests; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology*; D011597:Psychomotor Performance / Q000502:physiology; D014430:Twins, Monozygotic / Q000523:psychology*; D014706:Verbal Learning / Q000502:physiology; D014888:Wechsler Scales
D008727:Methotrexate