Neuropsychological Sequelae, Quality of Life and Adaptive Behavior in Children and Adolescents with Anti-NMDAR Encephalitis: A Narrative Review

Anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a rare autoimmune illness characterized by a constellation of often severe, but treatable, psychiatric and neurological symptoms. Whereas symptoms such as psychosis and bizarre and abnormal motor behavior are common in adults, pediatric patients typically present with behavioral changes, irritability and sleep dysfunction. The recovery phase is usually slow and may be associated with longstanding adaptive, behavioral and neuropsychological problems. Very few studies explored the cognitive and adaptive sequelae in children with anti-NMDAR encephalitis. The present review article suggests that, although most children and adolescents return to their daily life and previous activities, they may have a low quality of life and show neuropsychological sequelae involving language, memory, especially verbal memory, and attentional resources, even after several months from the hospital discharge. In particular, the available results reveal difficulties in cognitive skills involving executive functions. This impairment is considered the “core” of the cognitive profile of young patients with anti-NMDAR encephalitis. On the other hand, some cognitive skills, such as general intelligence, show good overall recovery over time. Additional neuropsychological research evaluating larger samples, more homogenous methods and longitudinal studies is required.

A Review on Short Term effects of Radiotherapyon Memory in Patients with Tumor

The objective of the review is to evaluate the short-term effects of radiotherapy on memory performance in patients with tumors. This article presents a neuropsychological account of the memory ability after radiation therapy. By drawing attention to memory loss of cancer patients after radiation, we hope to illustrate and emphasize the importance of neuropsychological sequelae when evaluating the short-term outcome of radiotherapy for cancer patients

A-66 Neuropsychological Sequalae of SARS-CoV-2

Objective The purpose of this systematic review is to identify neuropsychological sequelae following infection of SARS-CoV-2. Data Selection A systematic search of the literature was conducted in 2021 using the keywords: neuropsychological symptoms, neuropsychological sequelae, neuropsychological manifestations, SARS-CoV-2, COVID-19, and coronavirus. The search conducted included a total of 6 databases: PsychNet, ProQuest, Taylor & Francis Online, EBSCOhost, Google Scholar, and PubMed Central. A total number of 25 articles were considered, and 8 of those articles were retained. Inclusion criteria consisted of peer-reviewed articles published in English between the years 2020 and 2021. Exclusion criteria consisted of articles not published in English and those that did not examine the neuropsychological symptoms following COVID-19 infection. Data Synthesis Literature examined reported that clinical observations of severe cases of COVID-19 infection were associated with the presence of neuropsychological symptoms. Post-infection of SARS-CoV-2, the following symptoms have been noted: severe executive dysfunction, fluctuations in attention and concentration, and instances of disorientation and confusion. Although etiological hypotheses have been made, there is still no consensus or treatment for the neuropsychological sequelae of COVID-19. Studies also reported that a significant risk factor for these individuals was the presence of premorbid psychological/psychiatric illnesses. Conclusions Patients who recover from severe COVID-19 can experience a multitude of neuropsychological manifestations. In some cases, these effects have been reported to be long-standing. Due to limited understanding regarding the nature and mechanism of action of SARS-CoV-2, it is difficult to pinpoint the cause, duration, treatment, and prognosis of neuropsychological symptoms of post-recovery patients.

Late Neurological and Cognitive Sequelae and Long-Term Monitoring of Classical Hodgkin Lymphoma and Diffuse Large B-Cell Lymphoma Survivors: A Systematic Review by the Fondazione Italiana Linfomi

Background: The continuously improving treatment outcome for classical Hodgkin lymphoma (cHL) and diffuse large B-cell lymphoma (DLBCL) over the last 25 years has led to a high number of long-term survivors. The impact of treatment, however, can sometimes be dramatic and long-lasting. Focusing on peripheral neuropathy (PN), cognitive impairment, fatigue, anxiety, and depression, researchers of the Fondazione Italiana Linfomi conducted a systematic review of the literature to collect the available data on sequelae incidence as well as evidence of follow-up strategies for long-term cHL and DLBCL survivors. Methods: The review was carried out under the methodological supervision of the Istituto di Ricerche Farmacologiche “Mario Negri”, Milan, Italy. The literature search was conducted on three databases (MEDLINE, Embase, and the Cochrane Library) updated to November 2019. The selection process and data extraction were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: A total of 2236 abstracts were screened, 247 full texts were analyzed, and 35 papers were included in the final analysis. Fatigue was the most extensively studied among neuropsychological sequelae, with a mean prevalence among cHL survivors of 10–43%. Although many of the papers showed an increased incidence of PN, cognitive impairment, and anxiety and depression in long-term cHL and DLBCL survivors, no definite conclusions can be drawn because of the methodological limitations of the analyzed studies. No data on monitoring and follow-up strategies of PN and other neuropsychological sequelae were highlighted. Conclusions: Based on our findings, future studies in this setting should include well-defined study populations and have a longitudinal trial design to assess the outcomes of interest over time, thus as to structure follow-up programs that can be translated into daily practice.

Neuropsychological Sequelae in Attention and Memory in Women Victims of Gender-Based Violence and Their Implication in Depression. A Multivariate Analysis

Women victims of abuse can suffer neuropsychological sequelae that affect memory and attention, as well psychopathological disorders such as depression. These consequences affect their daily life and physical and psychological health. Objective: To analyze sequelae that affect attention and memory, as well a possible association of these sequelae to depression. Method: A total of 68 women victims of gender-based violence participated in the study. The participants were between 15 and 62 years of age and resided in Spain at the time of data collection. The Luria DNA Battery (Neuropsychological Diagnosis of Adults) by Manga and Ramos (2000); and the Beck Depression Inventory were applied. Results: Women victims of gender-based violence suffer neuropsychological sequelae, presenting low short-term memory and attentional control; and score low on the Luria-DNA battery. Of these women, 60% suffer from some relevant type of depression, and there are significant differences according to their degree of memory. Through the HJ-Biplot, a direct relationship was found between memory and attentional control with the total score of the Luria battery. On the other hand, an inverse relationship was found between short-term memory and depression. Lastly, three well-differentiated gender clusters of women victims of gender-based violence were identified. Conclusions: A lower rate of depression is observed in women victims of abuse when they have a more intact short-term memory.

Neuropsychological Phenotypes of Pediatric Anti-Myelin Oligodendrocyte Glycoprotein Associated Disorders: A Case Series

Emerging research has demonstrated that anti-myelin oligodendrocyte associated disorders (MOG-AD) are associated with a less severe clinical course than demyelinating conditions associated with the presence of aquaporin-4 antibodies. While a heterogeneity of neuropsychological outcomes in pediatric demyelinating conditions have been described in the literature, no studies to date have investigated the neuropsychological sequelae of pediatric MOG-AD specifically. The objective of the present case series was to describe the clinical and neuropsychological phenotypes of seven pediatric patients (ages 3–15 years) with MOG-AD of different diagnoses (e.g., acute disseminated encephalomyelitis, optic neuritis, multiple sclerosis, and neuromyelitis spectrum disorders). Neuropsychological outcomes were evaluated by retrospective chart review. Results indicated largely intact neuropsychological profiles in five of the seven patients, with mild weaknesses in attention, executive functioning, processing speed, visual-motor/fine-motor skills, and mood concerns being observed. Two patients with a Kurtzke Extended Disability Status Scale of 0 still demonstrated findings on neuropsychological testing. Of the other two patients, one demonstrated higher levels of impairment in the context of a complex medical history and premorbid learning difficulties, while the other demonstrated declines in functioning likely associated with an earlier age of onset. Findings suggest that neuropsychological outcomes may be correspondingly less severe in this population compared with what has previously been described in the pediatric demyelinating disease literature. This differential impact may contribute to the heterogeneity of neuropsychological outcomes found in previous studies, and future research should separate participants with myelin oligodendrocyte antibodies given the difference in clinical course, treatment outcomes, and neuropsychological sequelae.

Benefits of glioma resection in the corpus callosum

Due to anticipated postoperative neuropsychological sequelae, patients with gliomas infiltrating the corpus callosum rarely undergo tumor resection and mostly present in a poor neurological state. We aimed at investigating the benefit of glioma resection in the corpus callosum, hypothesizing neuropsychological deficits were mainly caused by tumor presence. Between 01/2017 and 1/2020, 21 patients who underwent glioma resection in the corpus callosum were prospectively enrolled into this study. Neuropsychological function was assessed preoperatively, before discharge and after 6 months. Gross total tumor resection was possible in 15 patients, and in 6 patients subtotal tumor resection with a tumor reduction of 97.7% could be achieved. During a median observation time of 12.6 months 9 patients died from glioblastoma after a median of 17 months. Preoperatively, all cognitive domains were affected in up to two thirds of patients, who presented a median KPS of 100% (range 60–100%). After surgery, the proportion of impaired patients increased in all neurocognitive domains. Most interestingly, after 6 months, significantly fewer patients showed impairments in attention, executive functioning, memory and depression, which are domains considered crucial for everyday functionality. Thus, the results of our study strongly support our hypothesis that in patients with gliomas infiltrating the corpus callosum the benefit of tumor resection might outweigh morbidity.

The intergenerational effects of mass trauma in sculpting new perpetrators

The issue of intergenerational transmission of traumatic memory and its link to violent backlash in communities that have suffered collective trauma is a topic well studied in psychology and the peace building field. However, the question of how the legacies of mass human rights abuses at the level of the state play out in individual perpetrators is an area that demands investigation. In the post-apartheid era, South Africa has witnessed the emergence of different forms of violence, including crowd violence, xenophobic violence, unspeakable forms of rape, and gang violence. This chapter explores the mechanisms whereby youth who have grown up with the legacies of collective violence are primed to become perpetrators of crime themselves. Specifically, we take a closer look at perpetrators of gang and domestic violence in the context of a South African low-income community. Drawing on neuroscientific findings regarding the effects of traumatic stress and emotional deprivation on the developing brain, the chapter reviews the neuropsychological sequelae of growing up in an environment where violence has persisted over time and across generations. In this process the notion of a “victim-perpetrator cycle” is clarified, amidst the complex matrix of interacting factors of historical oppression, a culture of violence, and its intergenerational consequences.