Palmer Shawna L, Gajjar Amar, Reddick Wilburn E, Glass John O, Kun Larry E, Wu Shengjie, Xiong Xiaoping, Mulhern Raymond K
Division of Behavioral Medicine, St. Jude Children's Research Hospital, Memphis, TN 38105-2794, USA.
Neuropsychology. 2003 Oct;17(4):548-55. doi: 10.1037/0894-4105.17.4.548.
Fifty children diagnosed with medulloblastoma completed 188 psychological evaluations using the Wechsler Intelligence Scales for Children (D. Wechsler, 1974, 1991) over a 7-year study period following 35-40 Gy postoperative craniospinal irradiation. Random coefficient models were used to predict the trend in the children's intellectual performance as a function of time since diagnosis, with both patient and treatment variables as parameters of this function. A quadratic model demonstrated a delay prior to decline in performance for older patients, whereas the younger patients showed an immediate loss of performance with a plateau at approximately 6 years postdiagnosis. A steeper decline was found for those with higher baseline performance. Clinicians may use the proposed predictive model to identify those patients who are at risk of significant intellectual decline.
50名被诊断为髓母细胞瘤的儿童在术后接受35 - 40 Gy颅脊髓照射后的7年研究期内，使用韦氏儿童智力量表（D. 韦克斯勒，1974年，1991年）完成了188次心理评估。随机系数模型用于预测自诊断以来儿童智力表现随时间的变化趋势，将患者和治疗变量作为该函数的参数。二次模型表明，年龄较大的患者在表现下降之前有一个延迟期，而年龄较小的患者在诊断后约6年出现表现立即下降并趋于平稳。基线表现较高的患者下降更为明显。临床医生可使用所提出的预测模型来识别那些有显著智力下降风险的患者。
