ABSTRACT
OBJECTIVE: The purpose of this study was to measure the impact of the motor-cognitive remediation program (MCRP) that uses sensorimotor and visual-motor imagery techniques on attentional functions in preschoolers with ADHD symptoms. METHOD: A total of 15 high-risk preschoolers were selected based on high ADHD symptoms. An experimental group participated in the MCRP and was compared with a control group. The MCRP consisted of 30 activities, 3 times a week, during 12 weeks. RESULTS: Children in the experimental group improved significantly for orienting (selective attention) and executive control (inhibition, stopping, and engaging mental operations) compared with the control group. CONCLUSION: These results are a first step to support the postulate that training specific attentional functions by sensorimotor activities and visual-motor imagery has an impact on the cognitive network of attention. This study suggests the potential value of MCRP addressed to preschoolers with ADHD symptoms.
Subject(s)
Attention Deficit Disorder with Hyperactivity/diagnosis , Attention Deficit Disorder with Hyperactivity/therapy , Attention/physiology , Cognitive Remediation , Executive Function , Attention Deficit Disorder with Hyperactivity/psychology , Child, Preschool , Executive Function/physiology , Female , Humans , Inhibition, Psychological , Male , Orientation , Treatment OutcomeABSTRACT
INTRODUCTION: One of the causes of long-term morbidity associated with the treatment of acute lymphoblastic leukemia (ALL) is late neurotoxicity manifesting as impairment of higher cognitive functions. Cranial radiation therapy (CRT) and chemotherapeutic agents, particularly methotrexate (MTX), are often suggested to be major contributing factors for its development. Homocysteinemia that arises as a result of MTX-induced folate depletion was proposed to play a role in MTX-related neurotoxicity. Several enzymes are essential to maintain the homocysteine levels. Their different functional forms, associated with common genetic polymorphisms, may modulate homocysteine levels and thereby influence MTX-associated neurotoxicity. OBJECTIVES: To test this hypothesis we assessed whether the variants of the methylene tetrahydrofolate reductase (MTHFR), methionine synthase (MTR), methionine synthase reductase (MTRR), cystathionine beta-synthase (CBS) and endothelial nitric acid synthase (eNOS, NOS3) genes, acting either independently or in conjunction with other risk factors, influenced the cognitive functioning in ALL patients. The influence of the genes was measured by estimating the change in IQ scores over a period of 4 years post ALL diagnosis. RESULTS: Two variants, the CBS 844ins68 polymorphism and NOS3 894T homozygosity, were associated with a change in IQ scores (p = 0.01 and 0.007, respectively). A multivariate model obtained through step-wise selection pointed to the importance of the NOS3 894TT genotype only. This effect appears to be dependent on CRT; IQ decline was apparent among individuals with the 894TT genotype who received radiation therapy (p = 0.03). Furthermore, additional factors affecting IQ were identified, including the treatment administered (i.e., CRT; p = 0.02) and a younger age at diagnosis (p = 0.003), and the modifying effect of the treatment protocols was also noted (p = 0.04). CONCLUSION: The results suggest that NOS3 genotyping might identify individuals that are susceptible to intellectual impairment following ALL treatment.
