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Editor - The paper by Hall et al (1) is of special interest, because
of the lack of data on the effects of low doses of radiation on cognitive
functions, especially in children. However, the presented data allow an
alternative interpretation in contrast to the proposed causal relationship
of increasing radiation dose and decreasing rates of high school
attendance.
Because the sizes of the hemangiomas are not presented in the paper,
one may speculate that the patients receiving higher doses to the brain
had larger hemangiomas. The cosmetic results after treatment were often
not satisfactory, potentially leading to stigmatisation and reduced self-
esteem. This may limit the school performance of these children despite
normal intelligence scores especially in blue collar worker families (as
shown in the study)lacking the respective social support.
School performance is dependend on intelligence, but also on various
other personality factors like motivation, fear, self-esteem, and self
concept. The primary intellectual performance of the presented cohort was
basically average with transformed IQ scores in the range of 98 - 105
suggesting as well that behaviour and/or personal characteristics rather
than cognitive functions explain the presented results.
Therefore, the conclusion that "low doses of ionising radiation to
the brain in infancy influence cognitive abilities in adulthood" is not
the only way to interpret the presented data. One may as well conclude
that "cranial hemangioma treated with radiotherapy can impair school
performance by stigmatisation without influencing intelligence functions."
Reference:
1. Hall P, Adami HO, Trichopoulos D, Pedersen NL, Lagiou P, Ekbom A, et
al. Effect of low doses of ionising radiation in infancy on cognitive
function in adulthood: Swedish population based cohort study. BMJ
2004;328: 19-24. (3 January.)
Ionising radiation for pediatric hemangioma and poor school performance - is stigmatisation rather than radiation the cause?
Editor - The paper by Hall et al (1) is of special interest, because
of the lack of data on the effects of low doses of radiation on cognitive
functions, especially in children. However, the presented data allow an
alternative interpretation in contrast to the proposed causal relationship
of increasing radiation dose and decreasing rates of high school
attendance.
Because the sizes of the hemangiomas are not presented in the paper,
one may speculate that the patients receiving higher doses to the brain
had larger hemangiomas. The cosmetic results after treatment were often
not satisfactory, potentially leading to stigmatisation and reduced self-
esteem. This may limit the school performance of these children despite
normal intelligence scores especially in blue collar worker families (as
shown in the study)lacking the respective social support.
School performance is dependend on intelligence, but also on various
other personality factors like motivation, fear, self-esteem, and self
concept. The primary intellectual performance of the presented cohort was
basically average with transformed IQ scores in the range of 98 - 105
suggesting as well that behaviour and/or personal characteristics rather
than cognitive functions explain the presented results.
Therefore, the conclusion that "low doses of ionising radiation to
the brain in infancy influence cognitive abilities in adulthood" is not
the only way to interpret the presented data. One may as well conclude
that "cranial hemangioma treated with radiotherapy can impair school
performance by stigmatisation without influencing intelligence functions."
Reference:
1. Hall P, Adami HO, Trichopoulos D, Pedersen NL, Lagiou P, Ekbom A, et
al. Effect of low doses of ionising radiation in infancy on cognitive
function in adulthood: Swedish population based cohort study. BMJ
2004;328: 19-24. (3 January.)
Competing interests:
None declared
Competing interests: No competing interests