[Formula: see text] The multifaceted role of neuropsychology in pediatric solid organ transplant: preliminary guidelines and strategies for clinical practice.

IF 1.6 3区 心理学 Q3 CLINICAL NEUROLOGY
Child Neuropsychology Pub Date : 2024-04-01 Epub Date: 2023-06-08 DOI:10.1080/09297049.2023.2221759
Elise M Turner, Adam R Cassidy, Kelly E Rea, Julia M Smith-Paine, Kelly R Wolfe
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引用次数: 0

Abstract

The incidence of pediatric solid organ transplantation (SOT) has increased in recent decades due to medical and surgical advances as well as improvements in organ procurement. Survival rates for pediatric kidney, liver, and heart transplantation are above 85% but patients continue to experience complex healthcare needs over their lifetime. Long-term developmental and neuropsychological sequelae are becoming increasingly recognized in this population, although preliminary work is limited and deserves further attention. Neuropsychological weaknesses are often present prior to transplantation and may be related to underlying congenital conditions as well as downstream impact of the indicating organ dysfunction on the central nervous system. Neuropsychological difficulties pose risk for functional complications, including disruption to adaptive skill development, social-emotional functioning, quality of life, and transition to adulthood. The impact of cognitive dysfunction on health management activities (e.g., medication adherence, medical decision-making) is also an important consideration given these patients' lifelong medical needs. The primary aim of this paper is to provide preliminary guidelines and clinical strategies for assessment of neuropsychological outcomes across SOT populations for pediatric neuropsychologists and the multidisciplinary medical team, including detailing unique and shared etiologies and risk factors for impairment across organ types, and functional implications. Recommendations for clinical neuropsychological monitoring as well as multidisciplinary collaboration within pediatric SOT teams are also provided.

[公式:见正文] 神经心理学在小儿实体器官移植中的多方面作用:临床实践的初步指南和策略。
近几十年来,由于医疗和外科手术的进步以及器官采购的改善,小儿实体器官移植(SOT)的发病率不断上升。小儿肾脏、肝脏和心脏移植的存活率超过了 85%,但患者在其一生中仍会经历复杂的医疗需求。在这一人群中,长期发育和神经心理后遗症正日益得到认可,尽管初步工作还很有限,但值得进一步关注。神经心理方面的缺陷通常在移植前就已存在,可能与潜在的先天条件以及指示器官功能障碍对中枢神经系统的下游影响有关。神经心理障碍会带来功能性并发症的风险,包括影响适应技能的发展、社会情感功能、生活质量以及向成年期的过渡。考虑到这些患者的终生医疗需求,认知功能障碍对健康管理活动(如服药依从性、医疗决策)的影响也是一个重要的考虑因素。本文的主要目的是为儿科神经心理学家和多学科医疗团队提供初步指南和临床策略,以评估不同 SOT 人群的神经心理结果,包括详细说明各器官类型损伤的独特和共同病因及风险因素,以及对功能的影响。此外,还对临床神经心理学监测以及儿科 SOT 团队内部的多学科协作提出了建议。
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来源期刊
Child Neuropsychology
Child Neuropsychology 医学-临床神经学
CiteScore
4.10
自引率
9.10%
发文量
71
审稿时长
>12 weeks
期刊介绍: The purposes of Child Neuropsychology are to: publish research on the neuropsychological effects of disorders which affect brain functioning in children and adolescents, publish research on the neuropsychological dimensions of development in childhood and adolescence and promote the integration of theory, method and research findings in child/developmental neuropsychology. The primary emphasis of Child Neuropsychology is to publish original empirical research. Theoretical and methodological papers and theoretically relevant case studies are welcome. Critical reviews of topics pertinent to child/developmental neuropsychology are encouraged. Emphases of interest include the following: information processing mechanisms; the impact of injury or disease on neuropsychological functioning; behavioral cognitive and pharmacological approaches to treatment/intervention; psychosocial correlates of neuropsychological dysfunction; definitive normative, reliability, and validity studies of psychometric and other procedures used in the neuropsychological assessment of children and adolescents. Articles on both normal and dysfunctional development that are relevant to the aforementioned dimensions are welcome. Multiple approaches (e.g., basic, applied, clinical) and multiple methodologies (e.g., cross-sectional, longitudinal, experimental, multivariate, correlational) are appropriate. Books, media, and software reviews will be published.
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