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Vernet M, Ducrot S, Chaix Y. A Systematic Review on Visual-Processing Deficits in Neurofibromatosis Type 1: What Possible Impact on Learning to Read? Dev Neuropsychol 2024; 49:111-137. [PMID: 38469855 DOI: 10.1080/87565641.2024.2326151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
This systematic review aimed to examine the possible implication of visual-perceptual, visuo-attentional and oculomotor processing in the reading deficits frequently experienced by children with Neurofibromatosis type 1 (NF1), as previously shown in dyslexia. Using PRISMA methodological guidelines, we examined 49 studies; most of these reported visual-processing deficits in this population, raising the importance of directly studying the visuo-perceptual and visuo-attentional processes and eye-movement control involved in the learning-to-read process in NF1. The discussion provides a reflection for a better understanding of how visual-processing skills interact with reading deficits in NF1, as well as new avenues for their screening and care.
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Affiliation(s)
- Marie Vernet
- Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France
- Centre de jour enfants, Centre hospitalier de Digne-les-Bains, Digne-les-Bains, France
- TONIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | | | - Yves Chaix
- TONIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
- Neuropediatric Department, Toulouse-Purpan University Hospital, Toulouse, France
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2
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Yao X, Wang B, Su Y, Bing Z, Li Q, Dong Q, Yin H, Wang J, Pan Y, Yuan G. SOX9 Promotes Collagen VI Secretion by Upregulating PCOLCE in Neurofibroma. Mol Neurobiol 2024:10.1007/s12035-024-04036-4. [PMID: 38436832 DOI: 10.1007/s12035-024-04036-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 02/09/2024] [Indexed: 03/05/2024]
Abstract
Neurofibromatosis type 1 (NF1) is caused by NF1 gene mutations. Patients with NF1 often have complications with tumors, such as neurofibroma. In order to investigate the pathogenesis of human neurofibroma, a systematic comparison of protein expression levels between Schwann cell-like sNF96.2 cells, which originated from malignant peripheral nerve sheath tumors (MPNST), and normal Schwann cells was performed using 4-D label-free proteomic analysis. In addition, the expression levels and localization of dysregulated proteins were confirmed using a Gene Expression Omnibus (GEO) transcriptomic dataset, Western blot analysis, and immunofluorescence labeling. The effects of SRY-box transcription factor 9 (SOX9) in the neurofibroma and surrounding microenvironment were evaluated in vivo using a tumor transplantation model. The present study observed that SOX9 and procollagen C-endopeptidase enhancer (PCOLCE) were significantly altered. NF1 mutation promoted the nuclear translocation and transcriptional activity of SOX9 in neurofibromas. SOX9 increased collagen VI secretions by enhancing the activation of PCOLCE in neurofibroma cells. These findings might provide new perspectives on the pathophysiological significance of SOX9 in neurofibromas and elucidate a novel molecular mechanism underlying neurofibromas.
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Affiliation(s)
- Xuan Yao
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
- The Second Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, China
| | - Bo Wang
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
- The Second Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, China
| | - Yuanping Su
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
- The Second Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, China
| | - Zhitong Bing
- Institute of modern physics, Chinese Academy of Science, Lanzhou, 730000, Gansu, China
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou, 516000, China
| | - Qiao Li
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
- The Second Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, China
| | - Qiang Dong
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Hang Yin
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China
| | - Jianying Wang
- The Second Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, China
| | - Yawen Pan
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China.
- The Second Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, China.
| | - Guoqiang Yuan
- Department of Neurosurgery and Laboratory of Neurosurgery, Lanzhou University Second Hospital, Lanzhou, 730030, Gansu, China.
- The Second Clinical Medical School, Lanzhou University, Lanzhou, 730030, Gansu, China.
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3
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Pardej SK, Casnar CL, Yund BD, Klein-Tasman BP. An evaluation of computerized attention and executive function measures for use with school age children with neurofibromatosis type 1. Child Neuropsychol 2024:1-16. [PMID: 38214530 DOI: 10.1080/09297049.2024.2302634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
The present study investigated the performance of children with neurofibromatosis type 1 on computerized assessments of attention and executive function. Relations to ADHD symptomatology were also examined. Participants included 37 children (20 male) with NF1 (9-13 years; Mage = 11.02). Participants completed the NIH Toolbox Dimensional Change Card Sort, List Sort Working Memory (LSWM), and Flanker tasks, as well as Cogstate Identification and One Back tests. ADHD symptomatology was assessed using the K-SADS. Average performance was significantly different from the normative mean on every measure, except LSWM. The NIH Toolbox Flanker and Cogstate Identification tasks detected the highest proportion of participants with at least mild difficulty, and the Cogstate Identification task detected the highest proportion of participants with severe difficulty. Analyses revealed significant relations with ADHD symptomatology for two NIH toolbox tasks. The various computerized measures of attention and executive function offer different information when working with school age children with NF1. The NIH Flanker may offer the most room for change and offers face validity, which may be beneficial for clinical trials research. However, the LSWM shows most support for relations with behavioral indicators of attention and executive challenges.
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Affiliation(s)
- Sara K Pardej
- Department of Psychology, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | | | - Brianna D Yund
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Pardej SK, Lee KM, Glad DM, Klein-Tasman BP. Psychometric Properties of Attention Measures in Young Children with Neurofibromatosis Type 1: Preliminary Findings. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2022; 8:123-136. [PMID: 36032331 PMCID: PMC9397181 DOI: 10.1007/s40817-022-00129-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/06/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022]
Abstract
Children with neurofibromatosis type 1 (NF1) often demonstrate difficulties with attention and executive functioning that can be evident starting at a young age. There has been little research about which measures of attention are most suitable for use with young children with NF1. This pilot study explored several computerized measures of attention, a digits forward task, and parent report measures of attention to compare their reliability, validity, and the degree to which they capture attention difficulty in this population. Participants with NF1 ages 4 to 6 years were seen for one (n=2) or two (n=18) time points. Statistical analyses for evaluating evidence for test-retest reliability, convergent and discriminant validity, practice effects, and identification of difficulties were conducted. Each measure demonstrated relative strengths and weaknesses, and there may not be a “one size fits all” measure for use with young children with NF1. However, the Behavior Rating Inventory of Executive Function Preschool/Second Edition, Conners Early Childhood Inattention/Hyperactivity Scale, and the Conners Kiddie Continuous Performance Test Second Edition generally had the highest reliability and most evidence of validity. More specific recommendations are provided for the appropriate measure to use in clinical and research batteries.
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Affiliation(s)
- Sara K. Pardej
- Department of Psychology, University of Wisconsin – Milwaukee, 2441 E Hartford Ave, Milwaukee, WI 53211 USA
| | - Kristin M. Lee
- Department of Psychology, University of Wisconsin – Milwaukee, 2441 E Hartford Ave, Milwaukee, WI 53211 USA
| | - Danielle M. Glad
- Department of Psychology, University of Wisconsin – Milwaukee, 2441 E Hartford Ave, Milwaukee, WI 53211 USA
| | - Bonita P. Klein-Tasman
- Department of Psychology, University of Wisconsin – Milwaukee, 2441 E Hartford Ave, Milwaukee, WI 53211 USA
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Vernet M, Jover M, Bellocchi S, Maziero S, Jucla M, Tallet J, Danna J, Chaix Y, Ducrot S. Visual-processing deficits in children with neurofibromatosis type 1: A clinical marker of reading difficulties. Eur J Paediatr Neurol 2022; 38:25-32. [PMID: 35381410 DOI: 10.1016/j.ejpn.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 03/07/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022]
Abstract
Today's estimates indicate that nearly 50% of children with Neurofibromatosis type 1 (NF1) suffer from reading disabilities, with a high impact on their academic achievement. In addition to the well-documented importance of phonological skills in reading acquisition and neurodevelopmental disorders, visual-attention processes also appear as important factors in learning to read. The present study aimed at assessing the role of visual-processing dysfunction in the high prevalence of reading disabilities in NF1 children and providing a useful tool for clinician in the early detection of reading impairment in this neurogenetic disorder. Forty-two children with NF1 and 42 typically developing children (TD) participated in the study. All were right-handed and did not present intellectual disability or attention deficit hyperactivity disorder. Visual-attention processes were assessed with the Developmental Eye Movement (DEM) test, together with the NF1 children's reading level. NF1 children with and without reading disabilities were then compared. The results showed that visual-processing deficits were highly present among the NF1 children included in our study. Furthermore, poor readers with NF1 presented an increased risk of visual-processing deficits compared to peers. This finding supports the role of visual-processing deficits in the reading difficulties encountered in nearly half of children with NF1. Finally, in NF1 children without intellectual or attention disability, visual-processing deficits emerge as one of the clinical markers of reading disabilities. The study holds important clinical implications both for the identification, by providing a useful screening tool, and the management of reading disabilities in NF1 children.
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Affiliation(s)
- Marie Vernet
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France.
| | | | - Stéphanie Bellocchi
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA, 4556, Montpellier, France
| | - Stéphanie Maziero
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Octogone-Lordat, University of Toulouse, Toulouse, France
| | - Mélanie Jucla
- Octogone-Lordat, University of Toulouse, Toulouse, France
| | - Jessica Tallet
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
| | - Jérémy Danna
- Aix Marseille Univ, CNRS, LNC, Marseille, France
| | - Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
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6
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Pardej SK, Glad DM, Lee KM, Casnar CL, Klein-Tasman BP. Patterns of performance of children with neurofibromatosis type 1 on the K-CPT and K-CPT 2. Child Neuropsychol 2022; 28:701-708. [PMID: 35168479 DOI: 10.1080/09297049.2022.2037539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Children with neurofibromatosis type 1 (NF1) often have attention difficulties with emerging evidence that these difficulties can be seen even in early childhood. This study aimed to explore the relative utility of two versions of a commonly used computerized attention measure for young children with NF1 and to explore relations with parent-reported attention in young children with NF1. Two independent samples of young children with NF1 participated. One sample (Study 1; N = 22; Mage = 4.95 (SD = 0.66)) completed the Conner's Kiddie Continuous Performance Test (K-CPT). A second and separate sample (Study 2; N = 19; Mage = 5.46 (SD = 0.74)) completed the K-CPT second edition (K-CPT 2). Relations of the K-CPT and K-CPT 2 with concurrent parent-reported attention (Kiddie Disruptive Behavior Disorder Schedule; Conners parent report questionnaires) were explored. The K-CPT sample's scores significantly differed from the normative median on Commissions, Hit Rate Standard Error, Variability, Detectability, Perseverations, and Hit Rate Inter Stimulus Interval. No relations with parent-report were identified. The K-CPT 2 sample's scores were significantly worse than normative data on every score except Hit Rate Block Change. Multiple scores on the K-CPT 2 were significantly related to parent-report of inattention and hyperactivity with some evidence of construct validity for the distinction between inattention and hyperactivity. The K-CPT 2 may be more useful for the assessment of attention problems in young children with NF1 as more challenges were observed and performance was more closely related to parent-reported attention difficulties than its predecessor the K-CPT.
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Affiliation(s)
- Sara K Pardej
- Department of Psychology, University of Wisconsin - Milwaukee, WI, USA
| | - Danielle M Glad
- Department of Psychology, University of Wisconsin - Milwaukee, WI, USA
| | - Kristin M Lee
- Department of Psychology, University of Wisconsin - Milwaukee, WI, USA
| | - Christina L Casnar
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Milwaukee, WI, USA
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Rance G, Zanin J, Maier A, Chisari D, Haebich KM, North KN, Dabscheck G, Seal ML, Delatycki MB, Payne JM. Auditory Dysfunction Among Individuals With Neurofibromatosis Type 1. JAMA Netw Open 2021; 4:e2136842. [PMID: 34870681 PMCID: PMC8649832 DOI: 10.1001/jamanetworkopen.2021.36842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE Neurofibromatosis type 1 (NF1) affects hearing through disruption of central auditory processing. The mechanisms, functional severity, and management implications are unclear. OBJECTIVE To investigate auditory neural dysfunction and its perceptual consequences in individuals with NF1. DESIGN, SETTING, AND PARTICIPANTS This case-control study included children and adults with NF1 and control participants matched on age, sex, and hearing level. Patients were recruited through specialist neurofibromatosis and neurogenetic outpatient clinics between April and September 2019. An evaluation of auditory neural activity, monaural/binaural processing, and functional hearing was conducted. Diffusion-weighted magnetic resonance imaging (MRI) data were collected from a subset of participants (10 children with NF1 and 10 matched control participants) and evaluated using a fixel-based analysis of apparent fiber density. MAIN OUTCOMES AND MEASURES Type and severity of auditory dysfunction evaluated via laboratory testing and questionnaire data. RESULTS A total of 44 participants (18 [41%] female individuals) with NF1 with a mean (SD) age of 16.9 (10.7) years and 44 control participants (18 [41%] female individuals) with a mean (SD) age of 17.2 (10.2) years were included in the study. Overall, 11 participants (25%) with NF1 presented with evidence of auditory neural dysfunction, including absent, delayed, or low amplitude electrophysiological responses from the auditory nerve and/or brainstem, compared with 1 participant (2%) in the control group (odds ratio [OR], 13.03; 95% CI, 1.59-106.95). Furthermore, 14 participants (32%) with NF1 showed clinically abnormal speech perception in background noise compared with 1 participant (2%) in the control group (OR, 20.07; 95% CI, 2.50-160.89). Analysis of diffusion-weighted MRI data of participants with NF1 showed significantly lower apparent fiber density within the ascending auditory brainstem pathways. The regions identified corresponded to the neural dysfunction measured using electrophysiological assessment. CONCLUSIONS AND RELEVANCE The findings of this case-control study could represent new neurobiological and clinical features of NF1. Auditory dysfunction severe enough to impede developmental progress in children and restrict communication in older participants is a common neurobiological feature of the disorder.
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Affiliation(s)
- Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Julien Zanin
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Alice Maier
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Donella Chisari
- Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, Victoria, Australia
| | - Kristina M. Haebich
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Kathryn N. North
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Gabriel Dabscheck
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Melbourne
| | - Marc L. Seal
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Martin B. Delatycki
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- Victorian Clinical Genetics Services, The Royal Children’s Hospital, Parkville, Victoria, Australia
| | - Jonathan M. Payne
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia
- The Royal Children’s Hospital, Parkville, Victoria, Melbourne
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8
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Kehrer-Sawatzki H, Wahlländer U, Cooper DN, Mautner VF. Atypical NF1 Microdeletions: Challenges and Opportunities for Genotype/Phenotype Correlations in Patients with Large NF1 Deletions. Genes (Basel) 2021; 12:genes12101639. [PMID: 34681033 PMCID: PMC8535936 DOI: 10.3390/genes12101639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 09/30/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Patients with neurofibromatosis type 1 (NF1) and type 1 NF1 deletions often exhibit more severe clinical manifestations than patients with intragenic NF1 gene mutations, including facial dysmorphic features, overgrowth, severe global developmental delay, severe autistic symptoms and considerably reduced cognitive abilities, all of which are detectable from a very young age. Type 1 NF1 deletions encompass 1.4 Mb and are associated with the loss of 14 protein-coding genes, including NF1 and SUZ12. Atypical NF1 deletions, which do not encompass all 14 protein-coding genes located within the type 1 NF1 deletion region, have the potential to contribute to the delineation of the genotype/phenotype relationship in patients with NF1 microdeletions. Here, we review all atypical NF1 deletions reported to date as well as the clinical phenotype observed in the patients concerned. We compare these findings with those of a newly identified atypical NF1 deletion of 698 kb which, in addition to the NF1 gene, includes five genes located centromeric to NF1. The atypical NF1 deletion in this patient does not include the SUZ12 gene but does encompass CRLF3. Comparative analysis of such atypical NF1 deletions suggests that SUZ12 hemizygosity is likely to contribute significantly to the reduced cognitive abilities, severe global developmental delay and facial dysmorphisms observed in patients with type 1 NF1 deletions.
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Affiliation(s)
- Hildegard Kehrer-Sawatzki
- Institute of Human Genetics, University of Ulm, 89081 Ulm, Germany
- Correspondence: ; Tel.: +49-731-500-65421
| | - Ute Wahlländer
- Kliniken des Bezirks Oberbayern (KBO), Children Clinical Center Munich, 81377 Munich, Germany;
| | - David N. Cooper
- Institute of Medical Genetics, Cardiff University, Heath Park, Cardiff CF14 4XN, UK;
| | - Victor-Felix Mautner
- Department of Neurology, University Hospital Hamburg Eppendorf, 20246 Hamburg, Germany;
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9
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Al-Farsi FAH, Al-Alyani OBS, Al-Kumzari A, Al-Saadi T. Systemic Review and Meta-analysis of the Intellectual Integrity of Children with Neurofibromatosis Type 1. World Neurosurg 2021; 157:69-74. [PMID: 34648986 DOI: 10.1016/j.wneu.2021.10.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cognitive impairment is a common neurologic complication of neurofibromatosis type 1 (NF-1) in childhood. A great number of learning disabilities appear in 30%-65% of children with NF-1. The aim of the study is to compare intelligence quotient (IQ) scores between children with NF-1 and comparable control groups. METHODS A literature review was conducted using the following databases: Cochrane, PubMed, Wiley, Microsoft Academic, and Google Scholar. We identified 180 papers. The pertinence of any study to the inclusion criteria was determined by assessing the title, key words, and abstracts. Data were extracted using multiple variables that were formulated incongruent with the study aim and then further analyzed. RESULTS Eleven articles met our criteria, with the highest level of evidence of 3c. A total of 483 NF1 and 443 control participants were included in this meta-analysis. The average and standard deviation of the age was 9.15 ± 3.15 years with an age range of 3.3-18 including 488 male and 438 female. The pooled estimate of the mean difference in all 3 parameters used full-scale IQ, verbal IQ, and performance IQ. Statistically, there was a significantly lower IQ in the NF-1 group compared with the control group with a 95% CI and (P < 0.00001). CONCLUSION The current meta-analysis illustrated a significant intellectual deficit in children with NF-1 compared with their typically developed peers who were matched by age. Performance IQ was significantly impaired compared with verbal IQ in NF-1 children. The current findings may guide experts to tailor individualized educational programs for children with NF-1.
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Affiliation(s)
| | | | - Ahmed Al-Kumzari
- Ahmed Al-Kumzari, Oman Medical Specialty Board, Muscat, Sultanate of Oman
| | - Tariq Al-Saadi
- Department of Neurology & Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
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10
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Klein-Tasman BP, Lee K, Thompson HL, Janusz J, Payne JM, Pardej S, de Blank P, Kennedy T, Janke KM, Castillo AD, Walsh KS. Recommendations for Measurement of Attention Outcomes in Preschoolers With Neurofibromatosis. Neurology 2021; 97:S81-S90. [PMID: 34230206 DOI: 10.1212/wnl.0000000000012423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 04/30/2021] [Indexed: 11/15/2022] Open
Abstract
Children with neurofibromatosis type 1 (NF1) are at increased risk for attention problems. While most research has been conducted with school-aged cohorts, preschool-aged children offer a novel developmental window for clinical studies, with the promise that treatments implemented earlier in the developmental trajectory may most effectively modify risk for later difficulties. Designing research studies around the youngest children with NF1 can result in intervention earlier in the developmental cascade associated with NF1 gene abnormalities. Furthermore, clinical trials for medications targeting physical and psychological aspects of NF1 often include individuals spanning a wide age range, including preschool-aged children. In a prior report, the REiNS Neurocognitive Subcommittee made recommendations regarding performance-based and observer-rated measures of attention for use in clinical trials and highlighted the need for separate consideration of assessment methods for young children. The observer-rated Attention-Deficit/Hyperactivity Disorder Rating Scale-Preschool version is recommended as a primary outcome measure. The NIH Toolbox Flanker, Dimensional Change Card Sort, and List Sort Working Memory tasks and Digits Forward from the Differential Ability Scales-2nd Edition (performance-based measures) are recommended as secondary outcome measures. Specific methodologic recommendations for inclusion of preschoolers in clinical trials research are also offered.
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Affiliation(s)
- Bonita P Klein-Tasman
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA.
| | - Kristin Lee
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Heather L Thompson
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Jennifer Janusz
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Jonathan M Payne
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Sara Pardej
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Peter de Blank
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Tess Kennedy
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Kelly M Janke
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Allison Del Castillo
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
| | - Karin S Walsh
- From the Department of Psychology (B.P.K.-T., K.L., S.P.), University of Wisconsin-Milwaukee; Department of Communication Sciences and Disorders (H.L.T.), California State University, Sacramento; University of Colorado School of Medicine (J.J.), Aurora; Murdoch Children's Research Institute and Department of Pediatrics (J.M.P.), University of Melbourne, Australia; University of Cincinnati Medical Center (P.d.B.), OH; Children's National Hospital (T.K., A.d.C., K.S.W.), Gilbert NF Institute, Washington, DC; and Division of Oncology (K.M.J.), Children's Hospital of Philadelphia, PA
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Abstract
OBJECTIVE Reading difficulties are one of the most significant challenges for children with neurofibromatosis type 1 (NF1). The aims of this study were to identify and categorize the types of reading impairments experienced by children with NF1 and to establish predictors of poor reading in this population. METHOD Children aged 7-12 years with NF1 (n = 60) were compared with typically developing children (n = 36). Poor word readers with NF1 were classified according to impairment type (i.e., phonological, surface, mixed), and their reading subskills were compared. A hierarchical multiple regression was conducted to identify predictors of word reading. RESULTS Compared to controls, children with NF1 demonstrated significantly poorer literacy abilities. Of the 49 children with NF1 classified as poor readers, 20 (41%) were classified with phonological dyslexia, 24 (49%) with mixed dyslexia, and 5 (10%) fell outside classification categories. Children with mixed dyslexia displayed the most severe reading impairments. Stronger working memory, better receptive language, and fewer inattentive behaviors predicted better word reading skills. CONCLUSIONS The majority of children with NF1 experience deficits in key reading skills which are essential for them to become successful readers. Weaknesses in working memory, receptive language, and attention are associated with reading difficulties in children with NF1.
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Radtke HB, Bergner AL, Goetsch AL, McGowan C, Panzer K, Cannon A. Genetic Counseling for Neurofibromatosis 1, Neurofibromatosis 2, and Schwannomatosis—Practice Resource of the National Society of Genetic Counselors. J Genet Couns 2020; 29:692-714. [DOI: 10.1002/jgc4.1303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 05/06/2020] [Accepted: 05/18/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Heather B. Radtke
- Department of Pediatrics Medical College of Wisconsin Milwaukee Wisconsin USA
- Children’s Tumor Foundation New York New York USA
| | - Amanda L. Bergner
- Department of Genetics and Development Columbia University New York New York USA
| | - Allison L. Goetsch
- Division of Genetics Birth Defects and Metabolism, Ann and Robert H. Lurie Children’s Hospital of Chicago Chicago Illinois USA
- Department of Pediatrics Northwestern University Chicago Illinois USA
| | - Caroline McGowan
- Division of Genetics and Genomics Boston Children’s Hospital Boston Massachusetts USA
| | - Karin Panzer
- Department of Pediatrics University of Iowa Hospitals and Clinics Iowa City Iowa USA
| | - Ashley Cannon
- Department of Genetics University of Alabama at Birmingham Birmingham Alabama USA
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13
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Kehrer-Sawatzki H, Kluwe L, Salamon J, Well L, Farschtschi S, Rosenbaum T, Mautner VF. Clinical characterization of children and adolescents with NF1 microdeletions. Childs Nerv Syst 2020; 36:2297-2310. [PMID: 32533297 PMCID: PMC7575500 DOI: 10.1007/s00381-020-04717-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/28/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE An estimated 5-11% of patients with neurofibromatosis type 1 (NF1) harbour NF1 microdeletions encompassing the NF1 gene and its flanking regions. The purpose of this study was to evaluate the clinical phenotype in children and adolescents with NF1 microdeletions. METHODS We retrospectively analysed 30 children and adolescents with NF1 microdeletions pertaining to externally visible neurofibromas. The internal tumour load was determined by volumetry of whole-body magnetic resonance imaging (MRI) in 20 children and adolescents with NF1 microdeletions. Furthermore, the prevalence of global developmental delay, autism spectrum disorder and attention deficit hyperactivity disorder (ADHD) were evaluated. RESULTS Children and adolescents with NF1 microdeletions had significantly more often cutaneous, subcutaneous and externally visible plexiform neurofibromas than age-matched patients with intragenic NF1 mutations. Internal neurofibromas were detected in all 20 children and adolescents with NF1 microdeletions analysed by whole-body MRI. By contrast, only 17 (61%) of 28 age-matched NF1 patients without microdeletions had internal tumours. The total internal tumour load was significantly higher in NF1 microdeletion patients than in NF1 patients without microdeletions. Global developmental delay was observed in 28 (93%) of 30 children with NF1 microdeletions investigated. The mean full-scale intelligence quotient in our patient group was 77.7 which is significantly lower than that of patients with intragenic NF1 mutations. ADHD was diagnosed in 15 (88%) of 17 children and adolescents with NF1 microdeletion. Furthermore, 17 (71%) of the 24 patients investigated had T-scores ≥ 60 up to 75, indicative of mild to moderate autistic symptoms, which are consequently significantly more frequent in patients with NF1 microdeletions than in the general NF1 population. Also, the mean total T-score was significantly higher in patients with NF1 microdeletions than in the general NF1 population. CONCLUSION Our findings indicate that already at a very young age, NF1 microdeletions patients frequently exhibit a severe disease manifestation which requires specialized long-term clinical care.
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Affiliation(s)
- Hildegard Kehrer-Sawatzki
- Institute of Human Genetics, University of Ulm and University of Ulm Medical Center, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
| | - Lan Kluwe
- Department of Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Johannes Salamon
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lennart Well
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Said Farschtschi
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Victor-Felix Mautner
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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14
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Thompson HL. Evaluation of phonological processing skills of young children with neurofibromatosis type 1. Dev Med Child Neurol 2018; 60:642. [PMID: 29691847 DOI: 10.1111/dmcn.13794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Heather L Thompson
- Department of Communication Sciences and Disorders, California State University, Sacramento, Sacramento, CA, USA
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