nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.17650/2311-1267-2017-4-3-35-42nodgo-313Research ArticleОригинальные исследованияКоррекция исполнительных функций и работы саккадической системы у детей с опухолями задней черепной ямкиCorrection of executive functions and the operation of the saccadic system in children with tumors of the posterior cranial fossaКасаткинВ. Н.KasatkinV. N.

Россия, 117997, Москва, ул. Саморы Машела, 1

1 Samory Mashela St., Moscow, 117997, Russia

БородинаИ. Д.BorodinaI. D.

Россия, 117997, Москва, ул. Саморы Машела, 1

1 Samory Mashela St., Moscow, 117997, Russia

ШуруповаМ. А.ShurupovaM. A.

Россия, 117997, Москва, ул. Саморы Машела, 1; Россия, 119234, Москва, ул. Ленинские Горы, 1, стр. 12

1 Samory Mashela St., Moscow, 117997, Russia; 1, Bldg. 12 Leninskie Gory St., Moscow, 119234, Russia

ДренёваА. А.DrenevaA. A.

Россия, 117997, Москва, ул. Саморы Машела, 1; Россия, 125009, Москва, ул. Моховая, 11, стр. 9

1 Samory Mashela St., Moscow, 117997, Russia; 11, Bldg. 9 Mokhovaya St., Moscow, 125009, Russia

РябоваА. А.RyabovaA. A.

Россия, 117997, Москва, ул. Саморы Машела, 1

1 Samory Mashela St., Moscow, 117997, Russia;

МироноваЕ. В.MironovaE. V.

Россия, 117997, Москва, ул. Саморы Машела, 1

1 Samory Mashela St., Moscow, 117997, Russia;

elvmironova@mail.ruКарелинА. Ф.KarelinA. F.

Россия, 117997, Москва, ул. Саморы Машела, 1

1 Samory Mashela St., Moscow, 117997, Russia

РумянцевА. Г.RumyantsevA. G.

Россия, 117997, Москва, ул. Саморы Машела, 1

1 Samory Mashela St., Moscow, 117997, Russia

 

 

ФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава РоссииРоссияDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of RussiaRussian FederationФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России; Биологический факультет, кафедра высшей нервной деятельности ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»РоссияDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia; Biological Faculty, Department of Higher Nervous Activity, Lomonosov Moscow State UniversityRussian FederationФГБУ «НМИЦ ДГОИ им. Дмитрия Рогачева» Минздрава России; Факультет психологии, кафедра методологии психологии ФГБОУ ВО «Московский государственный университет им. М.В. Ломоносова»РоссияDmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Ministry of Health of Russia; Faculty of Psychology, Department of Psychology Methodology, Lomonosov Moscow State UniversityRussian Federation201720092017433542Copyright © Касаткин В.Н., Бородина И.Д., Шурупова М.А., Дренёва А.А., Рябова А.А., Миронова Е.В., Карелин А.Ф., Румянцев А.Г., 20172017Касаткин В.Н., Бородина И.Д., Шурупова М.А., Дренёва А.А., Рябова А.А., Миронова Е.В., Карелин А.Ф., Румянцев А.Г.Kasatkin V.N., Borodina I.D., Shurupova M.A., Dreneva A.A., Ryabova A.A., Mironova E.V., Karelin A.F., Rumyantsev A.G.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/313Введение

Введение. Исполнительные функции (ИФ) можно рассматривать как взаимосвязанную группу когнитивных навыков, ответственных за целевое поведение, которая включает в себя как высшие, так и низшие функции. К высшим функциям относится ингибирование, переключаемость, когнитивная гибкость, планирование, рабочая память и решение проблем. Нижний уровень ИФ – это скорость процессинга и когнитивная эффективность/беглость, которые обслуживают высшие ИФ. Снижение показателей ИФ и замедление процессинга у пациентов, получавших комплексную терапию при опухолях задней черепной ямки, приводят к ухудшению качества жизни и социального функционирования. Предполагается, что нарушения ИФ и процессинга связаны с неточностями в работе саккадической системы. Материалы и методы. В пилотном исследовании участвовали 5 пациентов в возрасте 10–14 лет с опухолями черепной ямки, на- ходившихся на реабилитации и получавших комплекс аппаратной коррекции с применением приборов Dynavision D2 и Neurotracker, направленный на модифицирование ИФ и процессинга. Две диагностические сессии, проводимые методами айтрекинга и батареи CANTAB, оценивали состояние саккадической системы и ИФ до и после реабилитационного процесса. Результаты. Первый опыт использования комплекса аппаратных методов коррекции ИФ продемонстрировал улучшение ра- боты саккадической системы, несмотря на разнообразные нарушения зрительного анализатора, которые имели место у всех детей. Полученные результаты указывают на перспективные пути в решении этой актуальной проблемы.

 

 

Rationale

Rationale. Executive functions (EF) can be considered as interrelated group of cognitive skills responsible for target behavior, including both higher and lower functions. Higher functions include inhibition, switching, cognitive flexibility, planning, working memory and solving of problems. Lower level of EF is a speed of processing and cognitive effectiveness/fluency which serve EF. Decreasing of EF and slowing of processing at patients received complex therapy in case of tumors of posterior cranial fossa lead to decreasing of quality of life and social functioning. It is supposed that disorder of EF and processing are connected to inaccuracies of saccadic system. Materials and methods. Five patients at age 10–14 years old with tumors of posterior cranial fossa were enrolled to this pilot study. These patients received rehabilitation and complex of hardware correction with the help of Dynavision D2 and Neurotracker equipment aimed to modify EF and processing. Two diagnostic sessions realized by itracking method and CANTAB battery to diagnose condition of saccadic system before and after rehabilitation process. Results. First experience of usage of a complex of hardware methods for EF correction showed improvement of function of saccadic system despite of different disturbances of visual analyzer which were diagnosed at all children. These results indicate the promising ways in solving of this actual problem.

 

 

исполнительные функцииопухоли задней черепной ямкисаккадическая системапроцессингаппаратная коррекцияреабилитацияайтрекингDynavision D2NeurotrackerCANTABexecutive functionstumors of the posterior cranial fossasaccadic systemprocessinginstrumental correctionrehabilitationeye-trackingDynavision D2NeurotrackerCANTABReferencesKühl J., Doz F., Taylor R. Embryonic tumors. In: Brain and spinal tumors of childhood. Walker D.A., Perilongo G., Punt J.A.G., Taylor R.E., eds. Arnold, 2004. Pp. 314–330.Kühl J., Doz F., Taylor R. Embryonic tumors. In: Brain and spinal tumors of childhood. Walker D.A., Perilongo G., Punt J.A.G., Taylor R.E., eds. Arnold, 2004. Pp. 314–330.Packer R.J., MacDonald T., Vezina G. Central nervous system tumors. Pediatr Clin North Am 2008;55(1):121–45. doi: 10.1016/j.pcl.2007.10.010.Packer R.J., MacDonald T., Vezina G. Central nervous system tumors. Pediatr Clin North Am 2008;55(1):121–45. doi: 10.1016/j.pcl.2007.10.010.Aziz N.M. Long-term survivorship: late effects. In: Principles and Practice of Palliative Care and Supportive Oncology, 2nd ed. Berger A.M., Portenoy R.K. & Weissman D.E., eds. Lippincott Williams & Wilkins, Philadelphia, PA, 2002. Pp. 1019–1033.Aziz N.M. Long-term survivorship: late effects. In: Principles and Practice of Palliative Care and Supportive Oncology, 2nd ed. Berger A.M., Portenoy R.K. & Weissman D.E., eds. Lippincott Williams & Wilkins, Philadelphia, PA, 2002. Pp. 1019–1033.Anderson D.M., Rennie K.M., Ziegler R.S. et al. Medical and neurocognitive late effects among survivors of childhood central nervous system tumors. Cancer 2001;92(10):2709–19. PMID: 11745207.Anderson D.M., Rennie K.M., Ziegler R.S. et al. Medical and neurocognitive late effects among survivors of childhood central nervous system tumors. Cancer 2001;92(10):2709–19. PMID: 11745207.Nathan P.C., Patel S.K., Dilley K. et al.; Children’s Oncology Group Long-term Follow-up Guidelines Task Force on Neurocognitive/Behavioral Complications After Childhood Cancer. Guidelines for identification of, advocacy for, and intervention in neurocognitive problems in survivors of childhood cancer: a report from the Children’s Oncology Group. Arch Pediatr Adolesc Med 2007;161(8):798–806. doi: 10.1001/archpedi.161.8.798.Nathan P.C., Patel S.K., Dilley K. et al.; Children’s Oncology Group Long-term Follow-up Guidelines Task Force on Neurocognitive/Behavioral Complications After Childhood Cancer. Guidelines for identification of, advocacy for, and intervention in neurocognitive problems in survivors of childhood cancer: a report from the Children’s Oncology Group. Arch Pediatr Adolesc Med 2007;161(8):798–806. doi: 10.1001/archpedi.161.8.798.Butler R.W., Haser J.K. Neurocognitive effects of treatment for childhood cancer. Ment Retard Dev Disabil Res Rev 2006;12(3):184– 91. doi: 10.1002/mrdd.20110.Butler R.W., Haser J.K. Neurocognitive effects of treatment for childhood cancer. Ment Retard Dev Disabil Res Rev 2006;12(3):184– 91. doi: 10.1002/mrdd.20110.Niendam T.A., Laird A.R., Ray K.L. et al. Meta-analytic evidence for a superordinate cognitive control network subserving diverse executive functions. Cogn Affect Behav Neurosci 2012;12(2):241–68. doi: 10.3758/ s13415-011-0083-5.Niendam T.A., Laird A.R., Ray K.L. et al. Meta-analytic evidence for a superordinate cognitive control network subserving diverse executive functions. Cogn Affect Behav Neurosci 2012;12(2):241–68. doi: 10.3758/ s13415-011-0083-5.Makris N., Biederman J., Valera E.M. et al. Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder. Cereb Cortex 2007;17(6):1364–75. doi: 10.1093/ cercor/bhl047.Makris N., Biederman J., Valera E.M. et al. Cortical thinning of the attention and executive function networks in adults with attention-deficit/hyperactivity disorder. Cereb Cortex 2007;17(6):1364–75. doi: 10.1093/ cercor/bhl047.Gorin S.S., McAuliffe P. Implications of childhood cancer survivors in the classroom and the school. Health Educ 2009;109(1):25–48.Gorin S.S., McAuliffe P. Implications of childhood cancer survivors in the classroom and the school. Health Educ 2009;109(1):25–48.Herrmann D.S., Thurber J.R., Miles K., Gilbert G. Childhood leukemia survivors and their return to school: A literature review, case study, and recommendations. J Appl Sch Psychol 2011;7:252–75.Herrmann D.S., Thurber J.R., Miles K., Gilbert G. Childhood leukemia survivors and their return to school: A literature review, case study, and recommendations. J Appl Sch Psychol 2011;7:252–75.Biederman J., Monuteaux M.C., Doyle A.E. et al. Impact of executive function deficits and attention-deficit/hyperactivity disorder (ADHD) on academic outcomes in children. J Consult Clin Psychol 2004;72(5):757–66. doi: 10.1037/0022-006X.72.5.757.Biederman J., Monuteaux M.C., Doyle A.E. et al. Impact of executive function deficits and attention-deficit/hyperactivity disorder (ADHD) on academic outcomes in children. J Consult Clin Psychol 2004;72(5):757–66. doi: 10.1037/0022-006X.72.5.757.Denckla M.B. A theory and model of executive function: A neuropsychological perspective. In: Lyon G.R. and Krasnegor N.A. (eds.). Attention, Memory, and Executive Function. Paul H. Brookes, Baltimore, MD. Pp. 263–277.Denckla M.B. A theory and model of executive function: A neuropsychological perspective. In: Lyon G.R. and Krasnegor N.A. (eds.). Attention, Memory, and Executive Function. Paul H. Brookes, Baltimore, MD. Pp. 263–277.Isquith P.K., Crawford J.S., Espy K.A., Gioia G.A. Assessment of executive function in preschool-aged children. Ment Retard Dev Disabil Res Rev 2005;11(3):209–15. doi: 10.1002/mrdd.20075.Isquith P.K., Crawford J.S., Espy K.A., Gioia G.A. Assessment of executive function in preschool-aged children. Ment Retard Dev Disabil Res Rev 2005;11(3):209–15. doi: 10.1002/mrdd.20075.Welsh M.C., Pennington B.F., Groisser D.B. A normative-developmental study of executive function: A window on prefrontal function in children. Develop Neuropsychol 1991;7(2):131–49.Welsh M.C., Pennington B.F., Groisser D.B. A normative-developmental study of executive function: A window on prefrontal function in children. Develop Neuropsychol 1991;7(2):131–49.Baron I.S. Neuropsychological evaluation of the child. NY: Oxford University Press, 2004.Baron I.S. Neuropsychological evaluation of the child. NY: Oxford University Press, 2004.Miller M., Hinshaw S.P. Does childhood executive function predict adolescent functional outcomes in girls with ADHD? J Abnorm Child Psychol 2010;38(3):315–26. doi: 10.1007/s10802-009-9369-2.Miller M., Hinshaw S.P. Does childhood executive function predict adolescent functional outcomes in girls with ADHD? J Abnorm Child Psychol 2010;38(3):315–26. doi: 10.1007/s10802-009-9369-2.Netson K.L., Ashford J.M., Skinner T. et al. Executive dysfunction is associated with poorer health-related quality of life in pediatric brain tumor survivors. J Neurooncol 2016;128(2):313–21. doi: 10.1007/s11060- 016-2113-1.Netson K.L., Ashford J.M., Skinner T. et al. Executive dysfunction is associated with poorer health-related quality of life in pediatric brain tumor survivors. J Neurooncol 2016;128(2):313–21. doi: 10.1007/s11060- 016-2113-1.Thurtell M.J., Tomsak R.L., Leigh R.J. Disorders of saccades. Curr Neurol Neurosci Rep 2007;7(5):407–16. PMID: 17764631.Thurtell M.J., Tomsak R.L., Leigh R.J. Disorders of saccades. Curr Neurol Neurosci Rep 2007;7(5):407–16. PMID: 17764631.Filippopulos F., Eggert T., Straube A. Effects of cerebellar infarcts on cortical processing of saccades. J Neurol 2013;260(3):805– 14. doi: 10.1007/s00415-012-6708-y.Filippopulos F., Eggert T., Straube A. Effects of cerebellar infarcts on cortical processing of saccades. J Neurol 2013;260(3):805– 14. doi: 10.1007/s00415-012-6708-y.Goldstein S., Jack A. Naglieri J.A. Handbook of executive functioning. Springer Science + Business Media NY, 2014.Goldstein S., Jack A. Naglieri J.A. Handbook of executive functioning. Springer Science + Business Media NY, 2014.Касаткин В.Н., Бочавер К.А., Грушко А.И. и др. Исследование перцептивно- когнитивных функций спортсменов игровых видов спорта, их диагностика и коррекция. Методическое пособие. М.: ФМБА, 2014. [Kasatkin V.N., Bochaver K.A., Grushko A.I. et al. Research of perceptively-cognitive functions of sportsmen of game kinds of sports, their diagnostics and correction. Methodical manual. M.: FMBA, 2014. (In Russ.)].Касаткин В.Н., Бочавер К.А., Грушко А.И. и др. Исследование перцептивно- когнитивных функций спортсменов игровых видов спорта, их диагностика и коррекция. Методическое пособие. М.: ФМБА, 2014. [Kasatkin V.N., Bochaver K.A., Grushko A.I. et al. Research of perceptively-cognitive functions of sportsmen of game kinds of sports, their diagnostics and correction. Methodical manual. M.: FMBA, 2014. (In Russ.)].www.cambridgecognition.com.www.cambridgecognition.com.Anisimov V., Shurupova M., Kasatkin V. The use of cognitive simulator in clinic patients with medulloblastoma and acute lymphoblastic leukaemia. The Russian Journal of Pediatric Hematology and Oncology. Abstract book. 10th SIOP Asia Congress, 2016 May 25–28, Moscow, Russia. P. 19.Anisimov V., Shurupova M., Kasatkin V. The use of cognitive simulator in clinic patients with medulloblastoma and acute lymphoblastic leukaemia. The Russian Journal of Pediatric Hematology and Oncology. Abstract book. 10th SIOP Asia Congress, 2016 May 25–28, Moscow, Russia. P. 19.Faubert J., Allard R. Effect of visual distortion on postural balance in a full immersion stereoscopic environment. In: Stereoscopic Displays and Virtual Reality Systems XI, Proceedings of SPIE-IS & T Electronic Imaging. Woods A.J., Merrit J.O., Benton S.A., Bolas M.T. (eds.). SPIE 2004;5291:491–500.Faubert J., Allard R. Effect of visual distortion on postural balance in a full immersion stereoscopic environment. In: Stereoscopic Displays and Virtual Reality Systems XI, Proceedings of SPIE-IS & T Electronic Imaging. Woods A.J., Merrit J.O., Benton S.A., Bolas M.T. (eds.). SPIE 2004;5291:491–500.Klavora P., Warren M. Rehabilitation of visuomotor skills in poststroke patients using the Dynavision apparatus. Percept Mot Skills 1998;86(1):23–30. doi: 10.2466/ pms.1998.86.1.23.Klavora P., Warren M. Rehabilitation of visuomotor skills in poststroke patients using the Dynavision apparatus. Percept Mot Skills 1998;86(1):23–30. doi: 10.2466/ pms.1998.86.1.23.Vesia M., Esposito J., Prime S.L., Klavora P. Correlations of selected psychomotor and visuomotor tests with initial Dynavision performance. Percept Mot Skills 2008;107(1):14–20. doi: 10.2466/ pms.107.1.14-20.Vesia M., Esposito J., Prime S.L., Klavora P. Correlations of selected psychomotor and visuomotor tests with initial Dynavision performance. Percept Mot Skills 2008;107(1):14–20. doi: 10.2466/ pms.107.1.14-20.Ismatullina V., Voronin I., Shelemetieva A., Malykh S. Cross-cultural Study of Working Memory in Adolescents. Third Annual International Conference “Early Childhood Care and Education” 2014;146:353–7.Ismatullina V., Voronin I., Shelemetieva A., Malykh S. Cross-cultural Study of Working Memory in Adolescents. Third Annual International Conference “Early Childhood Care and Education” 2014;146:353–7.Skaali T., Fosså S.D., Andersson S. et al. A prospective study of neuropsychological functioning in testicular cancer patients. Ann Oncol 2011;22(5):1062–70. doi: 10.1093/annonc/mdq553.Skaali T., Fosså S.D., Andersson S. et al. A prospective study of neuropsychological functioning in testicular cancer patients. Ann Oncol 2011;22(5):1062–70. doi: 10.1093/annonc/mdq553.Шурупова М.А., Анисимов В.Н., Касаткин В.Н. Глазодвигательные корреляты динамики психофизиологических и когнитивных нарушений у пациентов с медуллобластомой. Детская и подростковая реабилитация 2016;27(2):50–6. [Shurupova M.A., Anisimov V.N., Kasatkin V.N. Oculomotor correlates of dynamics of psychophysiological and cognitive impairments in patients with medulloblastoma. Detskaya i podrostkovaya reabilitaciya = Child and Adolescent Rehabilitation 2016;27(2):50–6. (In Russ.)].Шурупова М.А., Анисимов В.Н., Касаткин В.Н. Глазодвигательные корреляты динамики психофизиологических и когнитивных нарушений у пациентов с медуллобластомой. Детская и подростковая реабилитация 2016;27(2):50–6. [Shurupova M.A., Anisimov V.N., Kasatkin V.N. Oculomotor correlates of dynamics of psychophysiological and cognitive impairments in patients with medulloblastoma. Detskaya i podrostkovaya reabilitaciya = Child and Adolescent Rehabilitation 2016;27(2):50–6. (In Russ.)].

The authors declare that there are no conflicts of interest present.