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Zhu J, Dong X, Zhao FQ, Gu XY, Dong Y, Ding L. [Event-related potentials of working memory impairment in children with primary nocturnal enuresis]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20:1040-1043. [PMID: 30572995 PMCID: PMC7389494 DOI: 10.7499/j.issn.1008-8830.2018.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 09/30/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To study the cognitive neural mechanism of working memory impairment in children with primary nocturnal enuresis using event-related potential (ERP). METHODS A total of 14 children with primary nocturnal enuresis were enrolled as enuresis group, and 14 normal children were enrolled as control group. The learning-recognition task test was applied, and the ERP components (P2, N2, and P3) at Fz lead while identifying old pictures (learned) and new ones (unlearned) were measured and compared between the two groups. RESULTS While identifying the old pictures, the enuresis group had a lower amplitude of P2 and N2 than the control group (P<0.05). There were no significant differences between the two groups in the latency of P2, N2, and P3 and the amplitude of P3. While identifying the new pictures, the enuresis group had a longer latency of P2 and a significantly lower amplitude of N2 than the control group (P<0.05). There were no significant differences between the two groups in the amplitude of P2 and P3 and the latency of N2 and P3. CONCLUSIONS Compared with normal children, the children with primary nocturnal enuresis have reduced abilities of classified information extraction, a prolonged reaction time, and reductions in memory capacity, memory consolidation, and conflict monitoring, which causes working memory impairment.
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Affiliation(s)
- Jie Zhu
- Department of Pediatric Nephrology, Changzhou Children's Hospital, Changzhou, Jiangsu 213002, China.
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KHAZAIE H, EGHBALI F, AMIRIAN H, MORADI MR, GHADAMI MR. Risk Factors of Nocturnal Enuresis in Children with Attention Deficit Hyperactivity Disorder. SHANGHAI ARCHIVES OF PSYCHIATRY 2018; 30:20-26. [PMID: 29719355 PMCID: PMC5925595 DOI: 10.11919/j.issn.1002-0829.216088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Presence of attention deficit hyperactivity disorder (ADHD) has a negative effect on the resolution of incontinence; however, there are few studies which investigated the risk factors of nocturnal enuresis (NE) in patients with ADHD. AIMS This study was conducted to investigate the prevalence of NE and its risk factors in children with ADHD. METHODS 331 children, aged 6 to 10 years, diagnosed as having ADHD were enrolled in this study. The diagnosis of ADHD was confirmed by an experienced child and adolescent psychiatrist according to DSM-IV-TR. NE was defined as nighttime wetting with or without daytime incontinence, at least twice a week over a period of 3 months or longer in children 5 years old and older without anatomical abnormalities. Details on demographic data, perinatal history, medical history and developmental history were collected from parents or medical records. RESULTS Most of the ADHD patients with inattentional subtype (77.5%) had NE, compared to 31.7% in the hyperactive/Impulsive subtype and 22.5% in the combined subtype (p<0.001, t=42.71). Among children with enuresis, there were significantly higher rates of history of familial enuresis (26% vs. 18 %, p<0.001, t=16.9), cesarean delivery (47% vs. 33%, p=0.019, t=5.84) and history of neonatal sepsis (16% vs. 7%, p=0.018, t=5.62) than non-NE children. Moreover, patients with NE had lower birth weight than non-NE patients (2.93(0.65) vs. 3.09 (0.46), p=0.026, t=2.51). Also, low parental education was associated with increase in the rate of NE. CONCLUSION Children with ADHD have a high prevalence of NE. Male sex, low education level of parents, history of neonatal sepsis, positive family history of NE, low birth weight and caesarian delivery may be risk factors for NE in ADHD children. Most ADHD patients with inattentional subtype had NE.
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Affiliation(s)
| | | | | | | | - Mohammad Rasoul GHADAMI
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Equit M, Becker A, El Khatib D, Rubly M, Becker N, von Gontard A. Central nervous system processing of emotions in children with nocturnal enuresis and attention-deficit/hyperactivity disorder. Acta Paediatr 2014; 103:868-78. [PMID: 24799133 DOI: 10.1111/apa.12676] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/30/2013] [Accepted: 04/28/2014] [Indexed: 12/27/2022]
Abstract
AIM Nocturnal enuresis (NE) and attention-deficit/hyperactivity disorder (ADHD) are common in childhood. We analysed the central processing of emotions in children with NE, ADHD, NE + ADHD and controls. METHODS We examined 13 children with NE, 13 with ADHD, 14 with NE + ADHD and 14 controls. Acoustic evoked potentials were recorded using standardised methodology. For the event-related potentials, positive, negative and neutral pictures were presented and time intervals of 250-450, 450-650 and 650-850 msec evaluated. Hypotheses were tested with repeated-measures analyses of variance. RESULTS In the frontal region, children with NE showed more intense responses to positive and negative pictures than controls measured with event-related potentials. Viewing positive pictures, children with NE + ADHD differed from children with ADHD in the central and parietal and for all types of stimuli in the parietal region. Children with NE + ADHD elicited the strongest responses. Children with ADHD did not differ from controls. There was an unspecific interaction effect of the acoustic evoked potentials in children with NE compared to the controls. CONCLUSION Children with NE processed emotions differently from children with ADHD and controls. Children with NE + ADHD processed emotions the most intense, displaying interaction effects of the central nervous system that cannot be explained by each disorder alone.
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Affiliation(s)
- Monika Equit
- Department of Child and Adolescent Psychiatry; Saarland University Hospital; Homburg Germany
| | - Anna Becker
- Department of Child and Adolescent Psychiatry; Saarland University Hospital; Homburg Germany
| | - Diana El Khatib
- Department of Child and Adolescent Psychiatry; Saarland University Hospital; Homburg Germany
| | - Mathias Rubly
- Department of Child and Adolescent Psychiatry; Saarland University Hospital; Homburg Germany
| | - Nicolas Becker
- Department of Child and Adolescent Psychiatry; Saarland University Hospital; Homburg Germany
- Department of Personality Psychology and Psychological Diagnostics; Saarland University; Saarbrücken Germany
| | - Alexander von Gontard
- Department of Child and Adolescent Psychiatry; Saarland University Hospital; Homburg Germany
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Esposito M, Gallai B, Parisi L, Roccella M, Marotta R, Lavano SM, Mazzotta G, Patriciello G, Precenzano F, Carotenuto M. Visuomotor competencies and primary monosymptomatic nocturnal enuresis in prepubertal aged children. Neuropsychiatr Dis Treat 2013; 9:921-6. [PMID: 23847418 PMCID: PMC3700782 DOI: 10.2147/ndt.s46772] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Primary monosymptomatic nocturnal enuresis (PMNE) is a common problem in the developmental ages; it is the involuntary loss of urine during the night in children older than 5 years of age. Several clinical observations have suggested an association between bedwetting and developmental delays in motricity, language development, learning disability, physical growth, and skeletal maturation. The aim of the present study is to evaluate the prevalence of fine motor coordination and visuomotor integration abnormalities in prepubertal children with PMNE. METHODS The study population included 31 children (16 males, 15 females; mean age 8.14 years ± 1.36 years), and the control group comprised 61 typical developing children (32 males, 29 females; mean age 8.03 years ± 1.44 years). The whole population underwent a clinical evaluation to assess total intelligence quotient level, visuomotor integration (VMI) skills, and motor coordination performance (using the Movement Assessment Battery for Children, or M-ABC). RESULTS No significant differences between the two study groups were found for age (P = 0.725), gender (P = 0.886), z-body mass index (P = 0.149), or intellectual abilities (total intelligence quotient) (P = 0.163). The PMNE group showed a higher prevalence of borderline performance on M-ABC evaluation and in pathologic performance on VMI Total Task compared to controls (P < 0.001). No significant differences between the two study groups were found for pathologic performances on the M-ABC (P = 0.07), VMI Visual Task (P = 0.793), and VMI Motor Task (P = 0.213). CONCLUSION Our findings pinpointed that PMNE should not be considered as a voiding disorder alone and, consequently, the children affected should be referred to specific rehabilitative programs that aim to improve motor coordination and visuomotor integration.
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Affiliation(s)
- Maria Esposito
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
| | - Beatrice Gallai
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Italy
| | - Rosa Marotta
- Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
| | | | - Giovanni Mazzotta
- Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy
| | - Giuseppina Patriciello
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
| | - Francesco Precenzano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
| | - Marco Carotenuto
- Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy
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Esposito M, Gallai B, Parisi L, Roccella M, Marotta R, Lavano SM, Mazzotta G, Carotenuto M. Primary nocturnal enuresis as a risk factor for sleep disorders: an observational questionnaire-based multicenter study. Neuropsychiatr Dis Treat 2013; 9:437-43. [PMID: 23579788 PMCID: PMC3621720 DOI: 10.2147/ndt.s43673] [Citation(s) in RCA: 28] [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] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Primary nocturnal enuresis (PNE) is a common problem in developmental age with an estimated overall prevalence ranging from 1.6% to 15%, and possible persistence during adolescence. There is a growing interest in the sleep habits of children affected by PNE, which is derived from the contradictory data present in clinical literature. The aim of the present study was to evaluate the presence of sleep disturbances in a population of children affected by PNE, and to identify whether PNE could be considered as a risk factor for sleep disturbances among children. MATERIALS AND METHODS A total of 190 PNE children (97 males, 93 females) aged 7-15 years, (mean 9.64 ± 1.35 years), and 766 typically developing children matched for age (P = 0.131) and gender (P = 0.963) were enrolled. To evaluate the presence of sleep habits and disturbances, all of the subjects' mothers filled out the Sleep Disturbances Scale for Children (SDSC), a questionnaire consisting of six subscales: Disorders in Initiating and Maintaining Sleep (DIMS), Sleep Breathing Disorders (SBD), Disorders of Arousal (DA), Sleep-Wake Transition Disorders (SWTD), Disorders of Excessive Somnolence (DOES), and Nocturnal Hyperhidrosis (SHY). The results were divided into "pathological" and "normal" scores using a cut-off value (pathological score = at least three episodes per week), according to the validation criteria of the test. Then, the Chi-square test was used to calculate the statistical difference and a univariate logistic regression analysis was applied to determine the role of PNE as a risk factor for the development of each category of sleep disorders and to calculate the odds ratio (OR). RESULTS PNE children show a higher prevalence of all sleep disturbances (41.03% DIMS; 85.12% SBD; 63.29% DA; 67.53% SWTD; 31.28% DOES; 37.92% SHY; 25.33% SDSC total score), and according to OR results (SDSC total score OR = 8.293, 95% confidence interval [CI] = 5.079-13.540; DIMS OR = 7.639, 95% CI = 5.192-11.238; SBD OR = 35.633, 95% CI = 22.717-55.893; DA OR = 13.734, 95% CI = 9.476-19.906; SWTD OR = 14.238, 95% CI = 9.829-20.625; DOES OR = 5.602, 95% CI = 3.721-8.432; SHY OR = 6.808, 95% CI = 4.608-10.059), PNE could be considered as a risk factor for the development of sleep disorders. CONCLUSION Among PNE children, sleep could be strongly altered, thus helping to affirm the hypothesis that PNE tends to alter sleep architecture, or it could itself be the consequence of an abnormal sleep structure. The findings also point to the existence of a potential increase in the risk of developing sleep disorders in the presence of PNE.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
| | - Beatrice Gallai
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy
| | - Rosa Marotta
- Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
| | | | - Giovanni Mazzotta
- Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy
| | - Marco Carotenuto
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy
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Yang TK, Huang KH, Chen SC, Chang HC, Yang HJ, Guo YJ. Correlation between clinical manifestations of nocturnal enuresis and attentional performance in children with attention deficit hyperactivity disorder (ADHD). J Formos Med Assoc 2013; 112:41-7. [DOI: 10.1016/j.jfma.2012.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 01/14/2012] [Accepted: 01/16/2012] [Indexed: 11/29/2022] Open
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Xiang B, Biji S, Liu JX, Chu WC, Yeung DK, Yeung CK. Functional brainstem changes in response to bladder function alteration elicited by surgical reduction in bladder capacity: a functional magnetic resonance imaging study. J Urol 2010; 184:2186-91. [PMID: 20850835 DOI: 10.1016/j.juro.2010.06.095] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Indexed: 02/03/2023]
Abstract
PURPOSE Our previous results revealed a positive correlation between bladder dysfunction and cortical arousals in children with enuresis. This finding implied an interrelationship between bladder dysfunction and brainstem dysfunction. Thus, we used an animal model to characterize brainstem functional changes in response to altered bladder function. MATERIALS AND METHODS Adult male New Zealand rabbits weighing 3.0 to 3.5 kg underwent surgical bladder volume reduction (12) or sham operation (12). We performed conventional fill cystometry and brainstem functional magnetic resonance imaging in each group 4 weeks postoperatively. During scanning bladder stimulation was provided by bladder filling up to 70% of maximum capacity. We then compared brainstem activation area(s). RESULTS Results revealed voiding dysfunction in animals with altered bladder function. Bladder function was markedly altered in the reduced bladder volume vs the sham operated group, mainly as significantly increased maximum voiding detrusor pressure (mean ± 1 SD 24.4 ± 7.0 vs 0.16.5 ± 7.2 cm water, p <0.05) and markedly decreased cystometric bladder volume (mean 35.3 ± 8.2 vs 71.6 ± 12.9 ml, p <0.05). Functional magnetic resonance imaging results revealed activation of 2 brainstem regions, including in 1) the ventrolateral periaqueductal gray and 2) the dorsolateral pons, in response to bladder distention. Activation in the ventrolateral periaqueductal gray was significantly decreased in the reduced bladder vs the sham operated group with a corresponding decrease in signal size (25% vs 83.3%, signal size 0.7 ± 1.4 vs 3.3 ± 2.1 mm(2)). There was no significant difference in activation of the dorsolateral pons between the groups (83.3% vs 91.7%, signal size 3.7 ± 2.4 vs 0.4.7 ± 3.0 mm(2)). CONCLUSIONS Functional derangement in brainstem micturition centers can be evoked by bladder dysfunction. In response to bladder dysfunction the ventrolateral periaqueductal gray shows deactivation during bladder distention, suggesting that it has an important role in bladder dysfunction biofeedback.
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Affiliation(s)
- Bo Xiang
- Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region, People's Republic of China
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Joinson C, Heron J, Butler R, Von Gontard A, Butler U, Emond A, Golding J. A United Kingdom population-based study of intellectual capacities in children with and without soiling, daytime wetting, and bed-wetting. Pediatrics 2007; 120:e308-16. [PMID: 17609308 DOI: 10.1542/peds.2006-2891] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of this study was to examine differences in intellectual capacities between children with and without soiling, daytime wetting, and bed-wetting. METHODS This study was based on a population of >6000 children (age range: 7 years 6 months to 9 years 3 months; median: 7 years 6 months) from the United Kingdom-based Avon Longitudinal Study of Parents and Children. Data on wetting and soiling were obtained from a questionnaire completed by parents. The Wechsler Intelligence Scale for Children-Third Edition was administered at a research clinic. RESULTS Bed-wetting was associated with lower Wechsler Intelligence Scale for Children-Third Edition IQ scores compared with control subjects, particularly performance IQ. This difference remained after exclusion of children with an IQ of <70 and adjustment for gender, stressful life events, and sociodemographic background. There were fewer differences in IQ scores between children with and without soiling or daytime wetting. Co-occurring wetting and soiling were associated with lower IQ scores than isolated soiling, daytime wetting, or bed-wetting, but this was mostly attributable to an overrepresentation of children with an IQ of <70 in the co-occurrence group. CONCLUSIONS It is hypothesized that the differences in intellectual capacities between children with and without bed-wetting are associated with maturational deficits of the central nervous system. There was less evidence for differences in intellectual capacities between children with and without soiling and daytime wetting. The central nervous system is involved to a lesser extent in soiling and daytime wetting, because peripheral influences from the bladder and gut play a greater role.
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Affiliation(s)
- Carol Joinson
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom.
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