ABSTRACT
A sixteen-year-old girl with neuropsychological dysfunction after cerebral encephalopathy came to our hospital for evaluation of her cognitive impairment and ability to acquire compensatory skills for communicative dysfunction. Neuropsychological examinations revealed low scores on FSIQ, VCI, WMI and PSI by WISC-Ⅳ. We intervened using a process-orientated speech-language-hearing therapy to improve her cognitive, language and communicative skills for a year. After that, we evaluated her cognitive ability by WISC-Ⅳ and LCSA. As a result of our intervention, her word knowledge, idiom and mental expression, sentence expression and reading social condition and expression scores in LCSA performance were improved but each IQ by WISC-Ⅳ was preserved. In ST intervention for pediatric neuropsychological dysfunction, the patient evaluation should be made not only using IQ by WISC-IV but also by measuring other communicative skills such as by LCSA.
ABSTRACT
We assessed the neuropsychological test performances of 26 patients (mean age = 41.5 ± 6.1 years; mean years of education = 9.8 ± 1.8; 20 males) diagnosed with chronic occupational mercurialism who were former workers at a fluorescent lamp factory. They had been exposed to elemental mercury for an average of 10.2 ± 3.8 years and had been away from this work for 6 ± 4.7 years. Mean urinary mercury concentrations 1 year after cessation of work were 1.8 ± 0.9 æg/g creatinine. Twenty control subjects matched for age, gender, and education (18 males) were used for comparison. Neuropsychological assessment included attention, inhibitory control, verbal and visual memory, verbal fluency, manual dexterity, visual-spatial function, executive function, and semantic knowledge tests. The Beck Depression Inventory and the State and Trait Inventory were used to assess depression and anxiety symptoms, respectively. The raw score for the group exposed to mercury indicated slower information processing speed, inferior performance in psychomotor speed, verbal spontaneous recall memory, and manual dexterity of the dominant hand and non-dominant hand (P < 0.05). In addition, the patients showed increased depression and anxiety symptoms (P < 0.001). A statistically significant correlation (Pearson) was demonstrable between mean urinary mercury and anxiety trait (r = 0.75, P = 0.03). The neuropsychological performances of the former workers suggest that occupational exposure to elemental mercury has long-term effects on information processing and psychomotor function, with increased depression and anxiety also possibly reflecting the psychosocial context.