Waber Deborah P, Pomeroy Scott L, Chiverton Abigail M, Kieran Mark W, Scott R Michael, Goumnerova Liliana C, Rivkin Michael J
Division of Psychology, Department of Psychiatry, Children's Hospital Boston, MA 02115, USA.
Pediatr Neurol. 2006 Jan;34(1):13-9. doi: 10.1016/j.pediatrneurol.2005.06.002.
Despite clinical impressions that cognitive complaints are prominent in patients with a history of craniopharyngioma, formal neuropsychologic documentation is inconsistent. This study assessed everyday cognitive complaints and neuropsychologic test performance to evaluate the prevalence of problems and the relationship of these domains to one another in patients treated for craniopharyngioma in childhood or adolescence. Ten patients treated for craniopharyngioma completed measures of everyday cognitive function (Cognitive Failures Questionnaire, Rivermead Behavioural Memory Test) and a battery of standard neuropsychologic tests. The prevalence of problems was ascertained for each measure. Most patients demonstrated significant deficits in everyday memory (Cognitive Failures Questionnaire, 9/10 patients; Rivermead Behavioural Memory Test, 7/10 patients). Scores were within normal limits, however, for intelligence quotient, achievement, attention, verbal memory, and spatial working memory. Processing speed was slow (5/10 patients). Spatial working memory predicted Cognitive Failures Questionnaire (P < 0.07), as did somatic symptoms from the Beck Depression Inventory (P < 0.01), but these associations appeared independent. Adolescents and young adults with treated craniopharyngioma experience deficits in everyday cognitive functions, many involving memory, that are not easily detected by standard neuropsychologic testing. The extent of self-rated cognitive problems is related to spatial working memory and somatic concerns.
尽管临床印象显示，颅咽管瘤病史患者中认知主诉较为突出，但正式的神经心理学记录并不一致。本研究评估了日常认知主诉和神经心理学测试表现，以评估儿童或青少年期接受颅咽管瘤治疗的患者中问题的患病率以及这些领域之间的相互关系。10名接受颅咽管瘤治疗的患者完成了日常认知功能测量（认知失误问卷、里弗米德行为记忆测试）以及一系列标准神经心理学测试。确定了每项测量中问题的患病率。大多数患者在日常记忆方面表现出显著缺陷（认知失误问卷，9/10患者；里弗米德行为记忆测试，7/10患者）。然而，智商、学业成绩、注意力、言语记忆和空间工作记忆的得分均在正常范围内。处理速度较慢（5/10患者）。空间工作记忆可预测认知失误问卷（P < 0.07），贝克抑郁量表中的躯体症状也可预测（P < 0.01），但这些关联似乎是独立的。接受治疗的颅咽管瘤青少年和年轻成人在日常认知功能方面存在缺陷，许多涉及记忆，而这些缺陷不易通过标准神经心理学测试检测到。自我评定的认知问题程度与空间工作记忆和躯体担忧有关。
