WPPSI-IV and NEPSY-II performance in mono- and bilingual 5-6-year-old children: Findings from The FinSwed Study

Characterization of a unique patient cohort with spike-wave activation in sleep without cognitive decline or increased seizure burden: Considerations for a more conservative treatment approach

OBJECTIVE

The goal of this study is to better characterize a unique subset of patients who present with so-called "isolated SWAS" (Spike Wave Activation in Sleep) by analyzing electrographic and neuropsychological data.

METHODS

We evaluated our institution's population of patients with SWAS, defined as >/= 50 % spike-wave index potentiated during slow-wave sleep. Of this group, 26 patients were identified with no worsening cognitive performance or seizure burden at the time of diagnosis, deemed "isolated SWAS", in comparison to patients with Developmental and/or Epileptic Encephalopathy (D/EE)-SWAS. Paraclinical studies of this cohort were analyzed, including high-frequency oscillations, specifically on scalp electroencephalogram as well as comprehensive behavioral and neuropsychologic data at one-year follow-up.

RESULTS

We found that 80 % (n=21) of the cohort was started on a unique treatment for SWAS at the time of diagnosis, with the most common treatment being clobazam (n=12; 57 %) followed by valproic acid (n=9; 43 %). The cognitive performance of patients who received treatment and those who did not receive treatment was not statistically significant, and after one year of follow-up the patients who did not receive treatment for SWAS had no cognitive decline. Furthermore, the treatment group reported more medication side effects (n=14/21; 67 %). Seven patients (27 %) of the cohort continued to have SWAS at follow-up, and 11 patients (42 %) had ongoing seizures. The presence of ripples did not correlate with cognitive outcomes.

SIGNIFICANCE

This study suggests that if patients have "isolated-SWAS" at the time of diagnosis a more conservation approach may be considered.

A Longitudinal Study on the Influence of Parental Interaction on Preschool Children's Cognitive Development: A Retrospective Analysis

To investigate the impact of parental interaction on cognitive development in preschool children, a study was conducted involving 198 preschool children selected between June 2021 and January 2022. These children were divided into a control group and an observation group based on their participation in parent-child interaction education. The propensity score matching method was employed to ensure baseline equivalence between the 2 groups. Post-matching, comparisons were made regarding language ability, social communication skills, social life skills, intelligence, and neurodevelopment. No significant differences were observed between the groups at baseline. Following the intervention, the observation group demonstrated significantly higher scores in language ability (P < .05), communication and life skills (P < .05), as well as intelligence and neurodevelopment, compared with the control group (P < .05). These findings suggest that parental interaction interventions can effectively enhance language abilities, social skills, social life skills, intelligence, and neurodevelopment in preschool children, and thus, are recommended for adoption.

Generalizability of the Swedish WISC-V to the Finland-Swedish minority - the FinSwed study

International guidelines highlight the importance of using appropriate and culturally fair test materials when conducting clinical psychological assessments. In the present study, the generalizability of the Swedish WISC-V with Scandinavian normative data was explored in 6-16-year-old Swedish-speaking children in Finland (N = 134), as no local test versions or norms are available for this minority. First, metric measurement invariance was established, i.e., the constructs measured were equivalent between the standardization data and the present sample. Second, the performance of this minority group on the Swedish WISC-V was compared to the Scandinavian normative mean. The findings showed that the Finland-Swedish children performed overall higher than the normative mean on the Swedish WISC-V, with an FSIQ of 103. The performance was significantly higher also in the indexes VSI, FRI, and WMI as well as in several subtests. However, in the subtest Vocabulary, the Finland-Swedish children achieved significantly lower scores than the Scandinavian mean. Further analyses showed significant associations between cognitive performance and age as well as parental education. For the VCI and the FSIQ, performance increased significantly with age, despite the use of age-standardized scaled scores. The general high performance was suggested to relate to the overall high educational level of the Finland-Swedes as well as to other cultural and test-related factors. The results have implications for clinicians conducting assessments with this minority, but also highlight the importance of establishing test fairness by validating tests when used in different cultural groups.

The FinSwed study: Using verbal NEPSY-II subtests with a cultural minority group

While it has been established that cultural differences in test performance are common, few studies have compared groups from different countries that speak the same language. The aim of this study was to investigate the generalizability of selected linguistic and verbal memory subtests from the Swedish NEPSY-II to the Finland-Swedish minority group. The participants were 275 Swedish-speaking children from Finland aged 5-16-years. The performance was compared to the U.S. norms used in the test. The Finland-Swedish children scored around scaled score 12 and significantly higher than the normative mean on the subtests Comprehension of Instructions, Phonological Processing, Word Generation Semantic, List Memory, and Sentence Repetition, whereas no significant differences to the norms emerged for the subtests Word Generation Initial Letter, Narrative Memory, and Word List Interference. There was a significant age effect for two subtests, with scaled scores increasing with age. Lower parental education and male sex were associated with lower test scores on some subtests, whereas bilingualism was not. The findings were viewed in relation to previous comparison studies involving the NEPSY-II/NEPSY. The differences were suggested to relate to cultural, educational, and test-related differences between Finland, Sweden, and the U.S. The results add to the clinical utility of the NEPSY-II.

Clinical impact and in vitro characterization of ADNP variants in pediatric patients

BACKGROUND

Helsmoortel-Van der Aa syndrome (HVDAS) is a rare genetic disorder caused by variants in the activity-dependent neuroprotector homeobox (ADNP) gene; hence, it is also called ADNP syndrome. ADNP is a multitasking protein with the function as a transcription factor, playing a critical role in brain development. Furthermore, ADNP variants have been identified as one of the most common single-gene causes of autism spectrum disorder (ASD) and intellectual disability.

METHODS

We assembled a cohort of 15 Chinese pediatric patients, identified 13 variants in the coding region of ADNP gene, and evaluated their clinical phenotypes. Additionally, we constructed the corresponding ADNP variants and performed western blotting and immunofluorescence analysis to examine their protein expression and subcellular localization in human HEK293T and SH-SY5Y cells.

RESULTS

Our study conducted a thorough characterization of the clinical manifestations in 15 children with ADNP variants, and revealed a broad spectrum of symptoms including global developmental delay, intellectual disability, ASD, facial abnormalities, and other features. In vitro studies were carried out to check the expression of ADNP with identified variants. Two cases presented missense variants, while the remainder exhibited nonsense or frameshift variants, leading to truncated mutants in in vitro overexpression systems. Both overexpressed wildtype ADNP and all the different mutants were found to be confined to the nuclei in HEK293T cells; however, the distinctive pattern of nuclear bodies formed by the wildtype ADNP was either partially or entirely disrupted by the mutant proteins. Moreover, two variants of p.Y719* on the nuclear localization signal (NLS) of ADNP disrupted the nuclear expression pattern, predominantly manifesting in the cytoplasm in SH-SY5Y cells.

LIMITATIONS

Our study was limited by a relatively small sample size and the absence of a longitudinal framework to monitor the progression of patient conditions over time. Additionally, we lacked in vivo evidence to further indicate the causal implications of the identified ADNP variants.

CONCLUSIONS

Our study reported the first cohort of HVDAS patients in the Chinese population and provided systematic clinical presentations and laboratory examinations. Furthermore, we identified multiple genetic variants and validated them in vitro. Our findings offered valuable insights into the diverse genetic variants associated with HVDAS.