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Effect of Different Durations of Eye-Covering Pretreatment on Emergence Delirium after Ophthalmic Surgery in Preschool-Aged Children: A Randomized Controlled Study. J Ophthalmol 2022; 2022:3656148. [PMID: 36157681 PMCID: PMC9507720 DOI: 10.1155/2022/3656148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/05/2022] [Accepted: 08/20/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Preoperative eye-covering training for 3 hours has been reported to effectively reduce the incidence of emergence delirium (ED) in preschool children. However, most children can only maintain the eye being covered for less than 60 min, and shortening eye-covering duration can also achieve similar clinical effects as long duration of eye-covering. This study was designed to compare the effects of 30-min and 60-min eye-covering pretreatment based on cartoon education only on preoperative anxiety, postoperative ED, and pain score after ophthalmic surgery with general anesthesia in preschool-aged children. Methods. Preschool-aged children (3–7 years) who were diagnosed with cataract, blepharoptosis, trichiasis, strabismus, eyelid tumor, and underwent ophthalmic surgery with general anesthesia from August 2021 to January 2022 were recruited. A total of 228 patients were randomly assigned at a 1 : 1:1 ratio to receive 30-min eye covering (30-min group), 60-min eye covering (60-min group) pretreatment, or programmed education only (C group). The preoperative anxiety, postoperative emergence delirium, and pain were compared between the groups. Results. The preoperative anxiety score, postoperative ED score, and incidence of ED in the 30-min group (n = 76) and 60-min group (n = 72) were significantly lower than those in the C group (n = 76), demonstrating a significant between-group difference (
). However, the 30-min group and 60-min group had no significant difference in the abovementioned outcome measures (
). Moreover, no significant difference was found in postoperative pain scores among the three groups (H = 0.274,
). Conclusion. Both 30-min and 60-min eye-covering pretreatments significantly reduce preoperative anxiety and postoperative ED after ophthalmic surgery with general anesthesia in preschool-aged children. The effects of the two groups show no intergroup difference, but the 30-min eye-covering pretreatment may be more convenient for practicing. Trial Registration. This study was registered with the No. NCT04973150.
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Dimitropoulos A, Doernberg EA, Russ SW, Zyga O. Intervention Response by Genetic Subtype: PRETEND-Preschool Program for Children with Prader-Willi Syndrome via Remote Parent Training. J Autism Dev Disord 2022; 52:5191-5206. [PMID: 35932366 PMCID: PMC9361891 DOI: 10.1007/s10803-022-05695-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/30/2022]
Abstract
Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.
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Affiliation(s)
| | | | | | - Olena Zyga
- Cleveland Clinic Center for Autism, Rocky River, OH, USA
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3
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Key AP. Searching for a "Brain Signature" of Neurodevelopmental Disorders: Event-Related Potentials and the Quest for Biomarkers of Cognition. J Clin Neurophysiol 2022; 39:113-120. [PMID: 34366396 DOI: 10.1097/wnp.0000000000000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SUMMARY This review summarizes main applications of event-related potentials (ERPs) to the study of cognitive processes in persons with neurodevelopmental disorders, for whom traditional behavioral assessments may not be suitable. A brief introduction to the ERPs is followed by a review of empirical studies using passive ERP paradigms to address three main questions: characterizing individual differences, predicting risk for poor developmental outcomes, and documenting treatment effects in persons with neurodevelopmental disorders. Evidence across studies reveals feasibility of ERP methodology in a wide range of clinical populations and notes consistently stronger brain-behavior associations involving ERP measures of higher-order cognition compared with sensory-perceptual processes. The final section describes the current limitations of ERP methodology that need to be addressed before it could be used as a clinical tool and highlights the needed steps toward translating ERPs from group-level research applications to individually interpretable clinical use.
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Affiliation(s)
- Alexandra P Key
- Vanderbilt University Medical Center, Vanderbilt Kennedy Center, Nashville, Tennessee, U.S.A
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4
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Chevalère J, Camblats AM, Laurier V, Mourre F, Estival S, Postal V. The influence of emotional contexts on mental flexibility in Prader-Willi syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:133-150. [PMID: 33491829 DOI: 10.1111/jir.12817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 10/15/2020] [Accepted: 12/18/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The present study investigated the influence of emotional contexts on mental flexibility in adults with Prader-Willi syndrome (PWS) using a voluntary task-switching paradigm that was implemented with emotionally valenced pictures. The study aims were to assess whether adults with PWS have impaired switching abilities, whether the deficit is specific to PWS or linked to intellectual disabilities, and the influence of emotional contexts on performance. METHOD The task-switching performance of 30 adults with PWS was compared with that of 30 healthy adults matched on chronological age, and to that of 30 adults with intellectual disabilities but without PWS, matched on intellectual quotient level and chronological age. Indicators of switching performance were switching cost and repetition bias. Emotional contexts were operationalised with positive, neutral and negative task-irrelevant pictures. RESULTS Adults with PWS showed a large increase in switching costs compared with the two control groups, and this effect did not vary across emotional contexts. More fine-tuned examination revealed subtle performance modulations: negative contexts tended to increase the repetition bias in all three groups while positive contexts slowed down global performance in PWS. CONCLUSIONS The results confirmed previous studies, showing impaired switching abilities in PWS over and beyond the influence of intellectual level, but revealed no robust variations in switching deficits across emotional contexts.
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Affiliation(s)
- J Chevalère
- Laboratoire de Psychologie Sociale et Cognitive (LAPSCO), UMR 6024, CNRS & Univ. Clermont-Auvergne, Clermont-Ferrand, France
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - A-M Camblats
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - V Laurier
- AP-HP Hôpital Marin, Hendaye, France
| | - F Mourre
- AP-HP Hôpital Marin, Hendaye, France
| | - S Estival
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
| | - V Postal
- Laboratoire de Psychologie, Univ. Bordeaux, Bordeaux, France
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5
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Minio-Paluello I, Porciello G, Pascual-Leone A, Baron-Cohen S. Face individual identity recognition: a potential endophenotype in autism. Mol Autism 2020; 11:81. [PMID: 33081830 PMCID: PMC7576748 DOI: 10.1186/s13229-020-00371-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Accepted: 08/11/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Face individual identity recognition skill is heritable and independent of intellectual ability. Difficulties in face individual identity recognition are present in autistic individuals and their family members and are possibly linked to oxytocin polymorphisms in families with an autistic child. While it is reported that developmental prosopagnosia (i.e., impaired face identity recognition) occurs in 2-3% of the general population, no prosopagnosia prevalence estimate is available for autism. Furthermore, an autism within-group approach has not been reported towards characterizing impaired face memory and to investigate its possible links to social and communication difficulties. METHODS The present study estimated the prevalence of prosopagnosia in 80 autistic adults with no intellectual disability, investigated its cognitive characteristics and links to autism symptoms' severity, personality traits, and mental state understanding from the eye region by using standardized tests and questionnaires. RESULTS More than one third of autistic participants showed prosopagnosia. Their face memory skill was not associated with their symptom's severity, empathy, alexithymia, or general intelligence. Face identity recognition was instead linked to mental state recognition from the eye region only in autistic individuals who had prosopagnosia, and this relationship did not depend on participants' basic face perception skills. Importantly, we found that autistic participants were not aware of their face memory skills. LIMITATIONS We did not test an epidemiological sample, and additional work is necessary to establish whether these results generalize to the entire autism spectrum. CONCLUSIONS Impaired face individual identity recognition meets the criteria to be a potential endophenotype in autism. In the future, testing for face memory could be used to stratify autistic individuals into genetically meaningful subgroups and be translatable to autism animal models.
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Affiliation(s)
- Ilaria Minio-Paluello
- Department of Psychology, Sapienza University of Rome, Rome, Italy.
- IRCCS Fondazione Santa Lucia, Rome, Italy.
- Institute of Cognitive Sciences and Technologies, National Research Council, Rome, Italy.
| | - Giuseppina Porciello
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Guttmann Brain Health Institute, Institut Guttmann de Neurorehabilitació, Universitat Autonoma de Barcelona, Badalona, Spain
| | - Simon Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
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6
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Debladis J, Valette M, Strenilkov K, Mantoulan C, Thuilleaux D, Laurier V, Molinas C, Barone P, Tauber M. Face processing and exploration of social signals in Prader-Willi syndrome: a genetic signature. Orphanet J Rare Dis 2019; 14:262. [PMID: 31730500 PMCID: PMC6858697 DOI: 10.1186/s13023-019-1221-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/09/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Faces are critical social cues that must be perfectly processed in order to engage appropriately in everyday social interactions. In Prader-Willi Syndrome (PWS), a rare genetic disorder characterized by cognitive and behavioural difficulties including autism spectrum disorder, the literature referring to face processing is sparse. Given reports of poor social interactions in individuals with PWS, we sought to assess their face and emotion recognition skills during eyetracking recordings. RESULTS Compared with controls, patients with PWS performed more poorly on face/emotion recognition. We observed atypical facial exploration by patients with maternal disomy. These patients looked preferentially at the mouth region, whereas patients with a deletion and controls were more attracted to the eye region. During social scenes, the exploration became more atypical as the social content increased. CONCLUSIONS Our comprehensive study brings new insights into the face processing of patients with PWS. Atypical facial exploration was only displayed by patients with the maternal disomy subtype, corresponding to their higher rate of autism spectrum disorder. This finding strongly argues in favor of early identification of this genetic subgroup in order to optimize care by implementing tailored interventions for each patient as soon as possible.
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Affiliation(s)
- Jimmy Debladis
- Brain & Cognition Research Center (CerCo), University of Toulouse Paul Sabatier, Toulouse, France. .,Brain & Cognition Research Center (CerCo), CNRS, Purpan Faculty of Medicine, Toulouse, France. .,Cerveau & Cognition, CNRS UMR 5549, Pavillon Baudot, CHU Purpan, BP 25202, 31052, Toulouse Cedex, France.
| | - Marion Valette
- Prader-Willi Syndrome Reference Center, Children's Hospital, Toulouse, France
| | | | - Carine Mantoulan
- Prader-Willi Syndrome Reference Center, Children's Hospital, Toulouse, France
| | | | | | - Catherine Molinas
- Prader-Willi Syndrome Reference Center, Children's Hospital, Toulouse, France
| | - Pascal Barone
- Brain & Cognition Research Center (CerCo), University of Toulouse Paul Sabatier, Toulouse, France.,Brain & Cognition Research Center (CerCo), CNRS, Purpan Faculty of Medicine, Toulouse, France
| | - Maïthé Tauber
- Prader-Willi Syndrome Reference Center, Children's Hospital, Toulouse, France.,Toulouse-Purpan Physiopathology Center, INSERM, Toulouse, France
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Corbett BA, Ioannou S, Key AP, Coke C, Muscatello R, Vandekar S, Muse I. Treatment Effects in Social Cognition and Behavior following a Theater-based Intervention for Youth with Autism. Dev Neuropsychol 2019; 44:481-494. [PMID: 31589087 DOI: 10.1080/87565641.2019.1676244] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This randomized clinical trial ( www.clinicaltrials.gov ID# NCT02276534) examined the impact of a peer-mediated, theater-based social skills intervention, SENSE Theater®, on social cognition and behavior in 77 youth (ages 8-16) with high-functioning autism spectrum disorder. Analysis of Covariance models revealed that post-treatment, the experimental group (n = 44) performed significantly better than the controls (n = 33) on NEPSY theory of mind (verbal) subtest, demonstrated increased neural evidence of memory for faces, and engaged in more cooperative play and verbal interaction with novel peers. The study extends previous findings showing that SENSE Theater® contributes to improvement in social cognition and behavior.
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Affiliation(s)
- Blythe A Corbett
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Sara Ioannou
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Alexandra P Key
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA.,Department of Hearing and Speech Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Catherine Coke
- University School of Nashville, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Rachael Muscatello
- Vanderbilt Brain Institute, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Simon Vandekar
- Department of Biostatistics, Vanderbilt University Medical Center , Nashville , Tennessee , USA
| | - Ian Muse
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center , Nashville , Tennessee , USA
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The Unfulfilled Promise of the N170 as a Social Biomarker. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 5:342-353. [PMID: 31679960 DOI: 10.1016/j.bpsc.2019.08.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/05/2019] [Accepted: 08/31/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Greater affordability and accessibility of noninvasive brain imaging techniques have led to an increased interest in identifying biomarkers of various cognitive processes, particularly in the field of neurodevelopmental disabilities. Autism spectrum disorder (ASD) is one area of research in which strong claims in support of brain-based biomarkers, such as the face-sensitive N170 event-related potential response, are currently emerging. This study systematically examined the possibility of the N170 amplitude and latency measures serving as a biomarker of social information processing in ASD. METHODS The N170 response to faces and houses was recorded during passive picture viewing in 77 children with ASD, 7 to 16 years of age, at 2 time points (before and after a social skills intervention) 3 months apart. Social functioning was assessed using standardized behavioral tests, caregiver reports, and observational measures of naturalistic social interactions. RESULTS The results replicated prior findings of larger N170 amplitudes in response to faces than to houses, but the associations with the behavioral measures of social functioning were modest and not consistently present across the 2 assessment time points. Neither the amplitude nor the latency of the N170 response to faces was sensitive to the effects of a social skills intervention that produced behavioral improvements. CONCLUSIONS The N170 is a reliable event-related potential response reflecting the sensory-perceptual stage of face processing, but it does not fit the definition of a biomarker of social deficits in ASD because it is not sufficiently informative about heterogeneity of social functioning and is not sensitive to treatment effects.
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Key AP, Jones D, Peters S, Dold C. Feasibility of using auditory event-related potentials to investigate learning and memory in nonverbal individuals with Angelman syndrome. Brain Cogn 2018; 128:73-79. [PMID: 30471990 DOI: 10.1016/j.bandc.2018.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 12/21/2022]
Abstract
The combination of intellectual, communicative, and motor deficits limit the use of standardized behavioral assessments of cognition in individuals with Angelman syndrome (AS). The current study is the first to objectively evaluate learning and memory in AS using auditory event-related potentials (ERP) during passive exposure to spoken stimuli. Fifteen nonverbal individuals with the deletion subtype of AS (age 4-45 years) completed the auditory incidental memory paradigm. Auditory ERPs were recorded in response to a sequence of unfamiliar nonwords, in which one randomly selected stimulus was repeated multiple times and the rest were presented once. Larger parietal responses within 200-500 ms for the repeated nonword compared to novel distracters were associated with caregiver reports of more adaptive communication skills. These findings demonstrate good tolerability of ERP procedures (94% success rate) and indicate that persons with AS can acquire new information following repeated auditory exposure, even in the absence of explicit memorization instructions. Strong associations between the caregiver reports of adaptive functioning and neural indices of auditory learning and memory support the utility of brain-based measures for objectively evaluating higher-order information processing in nonverbal persons with neurodevelopmental disorders.
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Affiliation(s)
- Alexandra P Key
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, United States; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, United States.
| | - Dorita Jones
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, United States
| | - Sarika Peters
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, United States; Department of Pediatrics, Vanderbilt University Medical Center, United States
| | - Caitlin Dold
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, United States
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10
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Peters SU, Katzenstein A, Jones D, Key AP. Distinguishing response to names in Rett and MECP2 Duplication syndrome: An ERP study of auditory social information processing. Brain Res 2017; 1675:71-77. [DOI: 10.1016/j.brainres.2017.08.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/16/2017] [Accepted: 08/25/2017] [Indexed: 11/26/2022]
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