Perfil neuropsicológico y efectos de la rehabilitación cognitiva en la leucemia linfoblástica aguda: a propósito de un caso / Neuropsychological profile and cognitive rehabilitation training effects on acute lymphoblastic leukaemia: a case study

La Leucemia Linfoblástica Aguda (LLA) infantil es el cáncer pediátrico más frecuente. Actualmente cuenta con un alto porcentaje de supervivencia, pero dichos pacientes presentan secuelas cognitivas secundarias a la enfermedad debidas, principalmente, al tratamiento médico recibido para evitar la recidiva del cáncer. Por lo tanto, resulta necesaria la implementación de programas de rehabilitación cognitiva específicos para este tipo de población. Es por ello que el objetivo del presente estudio fue describir los déficits cognitivos en un varón de 17 años que fue diagnosticado con LLA a los 9 años. Tras la valoración neuropsicológica inicial se desarrolló un programa de rehabilitación cognitiva intensivo durante dos años consecutivos. Realizamos un estudio pre-post en el que administramos el Conners Continuous Performance Test (CPT-II) y la Escala de Inteligencia de Wechsler para niños (WISC-IV). Los resultados, antes de la intervención, mostraron que el paciente manifestaba una menor velocidad de procesamiento y dificultades de atención sostenida y alternante, comprensión verbal y razonamiento perceptivo. Además, también presentó un número considerable de errores perseverativos, signo de dificultades de flexibilidad cognitiva y control inhibitorio. Dichos déficits mejoraron notablemente tras el programa de rehabilitación cognitiva. En conclusión, nuestro estudio pone de manifiesto la necesidad de aplicar programas de rehabilitación cognitiva tempranos para paliar las secuelas cognitivas derivadas de la LLA y de su tratamiento médico, así como mejorar la calidad de vida del paciente, ya que las mejoras cognitivas redundarán en su rendimiento académico y en su funcionamiento cotidiano.

Childhood Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer. It currently has a high survival rate, but these patients have cognitive sequelae secondary to the disease, mainly due to the medical treatment received to prevent cancer recurrence. Therefore, it is necessary to implement specific cognitive rehabilitation programs for this type of population. Hence, the main objective of this study was to describe cognitive deficits in a 17-year-old male who was diagnosed with ALL when he was 9 years old. After the initial neuropsychological evaluation, an intensive cognitive rehabilitation program was developed during two consecutive years. We conducted a pre-post study in which we administered the Conners Continuous Performance Test (CPT-II) and the Wechsler Intelligence Scale for Children (WISC-IV). Results, before the intervention, showed that the patient presented a lower processing speed and difficulties of sustained and alternating attention, verbal comprehension and perceptive reasoning; in addition to a large number of perseverative errors, sign of self-monitoring difficulties and inhibitory control. These deficits improved markedly after a program of cognitive rehabilitation. In conclusion, our study highlights the need to apply early cognitive rehabilitation programs to alleviate the cognitive sequelae derived from ALL and its medical treatment. In addition, any improvement in their cognitive capabilities will have a positive impact in their academic performance and quality of life.

Does being a Stranger make it Difficult to Cooperate?

Competition and cooperation are two somewhat opposed strategies for interpersonal social interaction that help us to achieve both individual and shared goals. The main aim of this study was to explore which type of social interaction (cooperative or competitive) is more stressful in a face-to-face same-sex dyad in healthy young participants (n = 178), considering outcome obtained in these tasks (positive or negative) and sex as moderating variables, and performance of the task alone as a control condition. Salivary cortisol (Csal) was measured in one sample obtained before task and four obtained after the task (+0, +15, +30 and +45 minutes after). Anxiety-state was assessed before and immediately after the task. Participants who cooperated and obtained negative outcomes had higher Csal levels than those who worked alone with negative outcomes in all periods after the task (p = .008, η p 2 = .058 and p = .033, η p 2 = .031, respectively). Moreover, those who cooperated showed higher mean self-reported state anxiety levels than the rest of the participants (p = .013, η p 2 = .051 and p < .001, η p 2 = .530, respectively). Our study indicates that cooperation between strangers in face-to-face dyads is highly stressful, more so than competing or working alone. These results should be taken into account for understanding situations of social stress and can be generalized to situations in which subjects cooperate or must decide between cooperating and competing to attain a goal.

Does being a stranger make it difficult to cooperate?

Competition and cooperation are two somewhat opposed strategies for interpersonal social interaction that help us to achieve both individual and shared goals. The main aim of this study was to explore which type of social interaction (cooperative or competitive) is more stressful in a face-to-face same-sex dyad in healthy young participants (n = 178), considering outcome obtained in these tasks (positive or negative) and sex as moderating variables, and per-formance of the task alone as a control condition. Salivary cortisol (Csal) was measured in one sample obtained before task and four obtained after the task (+0, +15, +30 and +45 minutes after). Anxiety-state was assessed before and imme-diately after the task. Participants who cooperated and obtained negative outcomes had higher Csal levels than those who worked alone with negative outcomes in all periods after the task (p = .008, ηp2 = .058 and p = .033, ηp2 = .031, respectively). Moreover, those who cooperated showed higher mean self-reported state anxiety levels than the rest of the participants (p = .013, ηp2 = .051 and p < .001, ηp2 = .530, respectively). Our study indicates that cooperation between strangers in face-to-face dyads is highly stressful, more so than competing or working alone. These results should be taken into account for understanding situations of social stress and can be generalized to situations in which subjects cooperate or must decide between cooperating and competing to attain a goal (AU)

No disponible