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Gosling CJ, Caparos S, Pinabiaux C, Schwarzer G, Rücker G, Agha SS, Alrouh H, Ambler A, Anderson P, Andiarena A, Arnold LE, Arseneault L, Asherson P, Babinski L, Barbati V, Barkley R, Barros AJD, Barros F, Bates JE, Bell LJ, Berenguer C, van Bergen E, Biederman J, Birmaher B, B⊘e T, Boomsma DI, Brandt VC, Bressan RA, Brocki K, Broughton TR, Bufferd SJ, Bussing R, Cao M, Cartigny A, Casas AM, Caspi A, Castellanos FX, Caye A, Cederkvist L, Collishaw S, Copeland WE, Cote SM, Coventry WL, Debes NMM, Denyer H, Dodge KA, Dogru H, Efron D, Eller J, Abd Elmaksoud M, Ercan ES, Faraone SV, Fenesy M, Fernández MF, Fernández-Somoano A, Findling R, Fombonne E, Fossum IN, Freire C, Friedman NP, Fristad MA, Galera C, Garcia-Argibay M, Garvan CS, González-Safont L, Groenman AP, Guxens M, Halperin JM, Hamadeh RR, Hartman CA, Hill SY, Hinshaw SP, Hipwell A, Hokkanen L, Holz N, Íñiguez C, Jahrami HA, Jansen PW, Jónsdóttir LK, Julvez J, Kaiser A, Keenan K, Klein DN, Klein RG, Kuntsi J, Langfus J, Langley K, Lansford JE, Larsen SA, Larsson H, Law E, Lee SS, Lertxundi N, Li X, Li Y, Lichtenstein P, Liu J, Lundervold AJ, Lundström S, Marks DJ, Martin J, Masi G, Matijasevich A, Melchior M, Moffitt TE, Monninger M, Morrison CL, Mulraney M, Muratori P, Nguyen PT, Nicholson JM, Øie MG, O'Neill S, O'Connor C, Orri M, Pan PM, Pascoe L, Pettit GS, Price J, Rebagliato M, Riaño-Galán I, Rohde LA, Roisman GI, Rosa M, Rosenbaum JF, Salum GA, Sammallahti S, Santos IS, Schiavone NS, Schmid L, Sciberras E, Shaw P, Silk TJ, Simpson JA, Skogli EW, Stepp S, Strandberg-Larsen K, Sudre G, Sunyer J, Tandon M, Thapar A, Thomson P, Thorell LB, Tinchant H, Torrent M, Tovo-Rodrigues L, Tripp G, Ukoumunne O, Van Goozen SHM, Vos M, Wallez S, Wang Y, Westermaier FG, Whalen DJ, Yoncheva Y, Youngstrom EA, Sayal K, Solmi M, Delorme R, Cortese S. Association between relative age at school and persistence of ADHD in prospective studies: an individual participant data meta-analysis. Lancet Psychiatry 2023; 10:922-933. [PMID: 37898142 DOI: 10.1016/s2215-0366(23)00272-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND The youngest children in a school class are more likely than the oldest to be diagnosed with ADHD, but this relative age effect is less frequent in older than in younger school-grade children. However, no study has explored the association between relative age and the persistence of ADHD diagnosis at older ages. We aimed to quantify the association between relative age and persistence of ADHD at older ages. METHODS For this meta-analysis, we searched MEDLINE, Embase, CINAHL, PsycINFO, and PubPsych up to April 1, 2022, with terms related to "cohort" and "ADHD" with no date, publication type, or language restrictions. We gathered individual participant data from prospective cohorts that included at least ten children identified with ADHD before age 10 years. ADHD was defined by either a clinical diagnosis or symptoms exceeding clinical cutoffs. Relative age was recorded as the month of birth in relation to the school-entry cutoff date. Study authors were invited to share raw data or to apply a script to analyse data locally and generate anonymised results. Our outcome was ADHD status at a diagnostic reassessment, conducted at least 4 years after the initial assessment and after age 10 years. No information on sex, gender, or ethnicity was collected. We did a two-stage random-effects individual participant data meta-analysis to assess the association of relative age with persistence of ADHD at follow-up. This study was registered with PROSPERO, CRD42020212650. FINDINGS Of 33 119 studies generated by our search, we identified 130 eligible unique studies and were able to gather individual participant data from 57 prospective studies following up 6504 children with ADHD. After exclusion of 16 studies in regions with a flexible school entry system that did not allow confident linkage of birthdate to relative age, the primary analysis included 41 studies in 15 countries following up 4708 children for a period of 4 to 33 years. We found that younger relative age was not statistically significantly associated with ADHD persistence at follow-up (odds ratio 1·02, 95% CI 0·99-1·06; p=0·19). We observed statistically significant heterogeneity in our model (Q=75·82, p=0·0011, I2=45%). Participant-level sensitivity analyses showed similar results in cohorts with a robust relative age effect at baseline and when restricting to cohorts involving children with a clinical diagnosis of ADHD or with a follow-up duration of more than 10 years. INTERPRETATION The diagnosis of ADHD in younger children in a class is no more likely to be disconfirmed over time than that of older children in the class. One interpretation is that the relative age effect decreases the likelihood of children of older relative age receiving a diagnosis of ADHD, and another is that assigning a diagnostic label of ADHD leads to unexplored carryover effects of the initial diagnosis that persist over time. Future studies should be conducted to explore these interpretations further. FUNDING None.
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Brown RN, Burnett AC, Thompson DK, Spittle AJ, Ellis R, Cheong JLY, Doyle LW, Pascoe L, Anderson PJ. Motor performance and attention outcomes in children born very preterm. Dev Med Child Neurol 2023; 65:1501-1510. [PMID: 37060580 DOI: 10.1111/dmcn.15620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/16/2023] [Accepted: 03/20/2023] [Indexed: 04/17/2023]
Abstract
AIM To examine the relationship between motor performance and attention in children born very preterm and at term, and investigate the presence of individual profiles of motor and attention performance. METHOD Attention and motor performance at 7 and 13 years were assessed in 197 children born very preterm (52.5% male) and 69 children born at term (47.8% male) between 2001 and 2003. Linear regression models were fitted including an interaction term for birth group. Subgroups of children with similar attention and motor performance profiles were identified using latent profile analysis. RESULTS Balance was positively associated with all attention outcomes at both ages (p < 0.006). There were specific birth group interactions for aiming and catching and manual dexterity with attention at 13 years, with positive associations observed only for children born very preterm (p < 0.001). At 7 years, three profiles were observed: average attention and motor functioning; average motor functioning and low attention functioning; and low attention and motor functioning. At 13 years, two profiles of average attention and motor functioning emerged, as well as one profile of below-average attention and motor functioning. Children born very preterm were overrepresented in the lower functioning profiles (born very preterm 56%; born at term 29%). INTERPRETATION Motor functioning at age 7 years may be a useful marker of later attention skills, particularly for children born very preterm who are at greater risk of poorer long-term cognitive outcomes. WHAT THIS PAPER ADDS Balance was positively associated with attention in children born very preterm and at term. Relationships between motor performance and attention at age 13 years differed between children born very preterm and at term. Heterogeneous motor functioning and attention outcomes were noted for children born very preterm and at term. Children born very preterm were more likely to have lower attention and motor functioning profiles than children born at term. There was greater movement in motor functioning and attention profiles between the ages of 7 and 13 years in children born very preterm.
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Affiliation(s)
- Rebecca N Brown
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Alice C Burnett
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Premature Infant Follow-up Program, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
- Department of Physiotherapy, University of Melbourne, Melbourne, Victoria, Australia
| | - Rachel Ellis
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Leona Pascoe
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Spencer‐Smith M, Weinman A, Quach J, Pascoe L, Mensah F, Wake M, Roberts G, Anderson PJ. Grit and working memory training outcomes for children with low working memory. Acta Paediatr 2023; 112:1938-1940. [PMID: 37166432 PMCID: PMC10952299 DOI: 10.1111/apa.16835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Megan Spencer‐Smith
- Turner Institute for Brain and Mental Health and School of Psychological SciencesMonash UniversityMelbourneVictoriaAustralia
- Clinical Sciences ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Amber Weinman
- Turner Institute for Brain and Mental Health and School of Psychological SciencesMonash UniversityMelbourneVictoriaAustralia
| | - Jon Quach
- Population Health ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Melbourne Graduate School of EducationThe University of MelbourneMelbourneVictoriaAustralia
| | - Leona Pascoe
- Turner Institute for Brain and Mental Health and School of Psychological SciencesMonash UniversityMelbourneVictoriaAustralia
- Clinical Sciences ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Fiona Mensah
- Population Health ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
| | - Melissa Wake
- Population Health ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
- Liggins InstituteThe University of AucklandAucklandNew Zealand
| | - Gehan Roberts
- Population Health ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsThe University of MelbourneMelbourneVictoriaAustralia
- The Centre for Community Child HealthRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Peter J. Anderson
- Turner Institute for Brain and Mental Health and School of Psychological SciencesMonash UniversityMelbourneVictoriaAustralia
- Clinical Sciences ThemeMurdoch Children's Research InstituteMelbourneVictoriaAustralia
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Gilchrist CP, Thompson DK, Alexander B, Kelly CE, Treyvaud K, Matthews LG, Pascoe L, Zannino D, Yates R, Adamson C, Tolcos M, Cheong JLY, Inder TE, Doyle LW, Cumberland A, Anderson PJ. Growth of prefrontal and limbic brain regions and anxiety disorders in children born very preterm. Psychol Med 2023; 53:759-770. [PMID: 34105450 DOI: 10.1017/s0033291721002105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Children born very preterm (VP) display altered growth in corticolimbic structures compared with full-term peers. Given the association between the cortiocolimbic system and anxiety, this study aimed to compare developmental trajectories of corticolimbic regions in VP children with and without anxiety diagnosis at 13 years. METHODS MRI data from 124 VP children were used to calculate whole brain and corticolimbic region volumes at term-equivalent age (TEA), 7 and 13 years. The presence of an anxiety disorder was assessed at 13 years using a structured clinical interview. RESULTS VP children who met criteria for an anxiety disorder at 13 years (n = 16) displayed altered trajectories for intracranial volume (ICV, p < 0.0001), total brain volume (TBV, p = 0.029), the right amygdala (p = 0.0009) and left hippocampus (p = 0.029) compared with VP children without anxiety (n = 108), with trends in the right hippocampus (p = 0.062) and left medial orbitofrontal cortex (p = 0.079). Altered trajectories predominantly reflected slower growth in early childhood (0-7 years) for ICV (β = -0.461, p = 0.020), TBV (β = -0.503, p = 0.021), left (β = -0.518, p = 0.020) and right hippocampi (β = -0.469, p = 0.020) and left medial orbitofrontal cortex (β = -0.761, p = 0.020) and did not persist after adjusting for TBV and social risk. CONCLUSIONS Region- and time-specific alterations in the development of the corticolimbic system in children born VP may help to explain an increase in anxiety disorders observed in this population.
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Affiliation(s)
- Courtney P Gilchrist
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Bonnie Alexander
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Neurosurgery, Royal Children's Hospital, Melbourne, Australia
| | - Claire E Kelly
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Karli Treyvaud
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- La Trobe University, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Lillian G Matthews
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Leona Pascoe
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Diana Zannino
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Rosemary Yates
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Chris Adamson
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Mary Tolcos
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Terrie E Inder
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
| | - Angela Cumberland
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
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Brown RN, Pascoe L, Treyvaud K, McMahon G, Nguyen TNN, Ellis R, Stedall P, Haebich K, Collins SE, Cheong J, Doyle LW, Thompson DK, Burnett A, Anderson PJ. Early parenting behaviour is associated with complex attention outcomes in middle to late childhood in children born very preterm. Child Neuropsychol 2023; 29:165-182. [PMID: 35549808 DOI: 10.1080/09297049.2022.2075334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Attention deficits are common in children born very preterm (VP), especially for children with higher social risk. The aim of this study was to examine the association between parenting behavior and attention in children born VP, and whether this association is influenced by familial social risk. Two hundred and twenty-four children born <30 weeks' gestation and/or with a birth weight <1250 g were recruited at birth. At 2 years, social risk was calculated and parenting behaviors were observed during a parent-child interaction task, with children's attention skills assessed at 7 and 13 years using standardized assessments. Higher levels of sensitive parenting at 2 years were positively associated with divided attention at age 7 years, and higher levels of intrusive parenting were negatively associated with divided attention at 13 years. Children born VP with higher social risk were more positively influenced by sensitive parenting behavior for sustained attention at 7 years, selective attention at 13 years, and divided attention at 7 and 13 years than children born VP with lower social risk. Additionally, children born VP with higher social risk were more negatively influenced by intrusive parenting for sustained attention outcomes at 7 years than those with lower social risk. In summary, the evidence for a contribution of early parenting to attention outcomes in children born VP was stronger for more complex attention (divided attention) compared with basic attention domains. Our findings also suggest that early parenting behavior has a particular influence on children born VP from socially disadvantaged environments for attention outcomes.
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Affiliation(s)
- Rebecca N Brown
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Leona Pascoe
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Karli Treyvaud
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Psychology and Counselling, La Trobe University, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Victoria, Australia
| | - Grace McMahon
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Thi-Nhu-Ngoc Nguyen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Rachel Ellis
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Paulina Stedall
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Kristina Haebich
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Simonne E Collins
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
| | - Jeanie Cheong
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,Neonatal Services, Royal Women's Hospital, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Victoria, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Alice Burnett
- Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Victoria, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.,Victorian Infant Brain Studies, Murdoch Children's Research Institute, Victoria, Australia
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Collins SE, Thompson DK, Kelly CE, Gilchrist CP, Matthews LG, Pascoe L, Lee KJ, Inder TE, Doyle LW, Cheong JL, Burnett AC, Anderson PJ. Development of regional brain gray matter volume across the first 13 years of life is associated with childhood math computation ability for children born very preterm and full term. Brain Cogn 2022; 160:105875. [DOI: 10.1016/j.bandc.2022.105875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 03/02/2022] [Accepted: 04/11/2022] [Indexed: 11/02/2022]
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Spittle AJ, Olsen JE, FitzGerald TL, Cameron KL, Albesher RA, Mentiplay BF, Treyvaud K, Burnett A, Lee KJ, Pascoe L, Roberts G, Doyle LW, Anderson P, Cheong JLY. School Readiness in Children Born <30 Weeks' Gestation at Risk for Developmental Coordination Disorder: A Prospective Cohort Study. J Dev Behav Pediatr 2022; 43:e312-e319. [PMID: 34723933 DOI: 10.1097/dbp.0000000000001031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 08/18/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The objective of this study was to determine whether school readiness differs between children born <30 weeks' gestation who are classified as at risk for developmental coordination disorder (DCD) and those who are not. METHODS This study was a prospective cohort study of children born <30 weeks' gestation. Children were classified as at risk for DCD at a corrected age of 4 to 5 years if they scored <16th centile on the Movement Assessment Battery for Children-Second Edition (MABC-2), had a full scale IQ score of ≥80 on the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV), and had no cerebral palsy. Children were assessed on 4 school readiness domains: (1) health/physical development [Physical Health domain of Pediatric Quality of Life Inventory (PedsQL), Pediatric Evaluation of Disability Inventory Computer Adaptive Test, and Little Developmental Coordination Disorder Questionnaire], (2) social-emotional development (Strengths and Difficulties Questionnaire and PedsQL psychosocial domains), (3) cognitive skills/general knowledge (WPPSI-IV), and (4) language skills (WPPSI-IV). RESULTS Of 123 children assessed, 16 were ineligible (IQ < 80 or cerebral palsy: n = 15; incomplete MABC-2: n = 1); 28 of 107 (26%) eligible children were at risk for DCD. Children at risk for DCD had poorer performance on all school readiness domains, with group differences of more than 0.4 SD in health/physical development, social-emotional development, and language skills and up to 0.8 SD for cognitive skills/general knowledge compared with those not at risk of DCD. CONCLUSION Being at risk for DCD in children born <30 weeks' gestation is associated with challenges in multiple school readiness domains, not only the health/physical domain.
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Affiliation(s)
- Alicia J Spittle
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Australia
| | - Joy E Olsen
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Australia
| | - Tara L FitzGerald
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Kate L Cameron
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Reem A Albesher
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Benjamin F Mentiplay
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Australia
| | - Karli Treyvaud
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
| | - Alice Burnett
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Katherine J Lee
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Leona Pascoe
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Gehan Roberts
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - Peter Anderson
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Studies, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Neonatal Services, Royal Women's Hospital, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
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Abstract
Extremely preterm birth is associated with increased risk for a spectrum of neurodevelopmental problems. This review describes the nature of cognitive and academic outcomes of extremely preterm survivors across childhood and adolescence. Evidence across meta-analyses and large prospective birth cohorts indicate that early developmental difficulties in children born extremely preterm do not resolve with age and are not improving over time despite advancements in neonatal care. While extremely preterm birth confers increased risk of widespread cognitive difficulties, considerable heterogeneity in outcomes is evident across individuals. There is a continued need for high-quality longitudinal studies to understand the developmental progression of cognitive and academic skills following extremely preterm birth, and greater focus on understanding contributing factors that may help to explain the individual variability in cognitive and academic outcomes of extremely preterm survivors.
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Affiliation(s)
- Leona Pascoe
- Turner Institute for Brain and Mental Health, Monash University, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Alice C Burnett
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, Monash University, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
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Collins SE, Thompson DK, Kelly CE, Yang JYM, Pascoe L, Inder TE, Doyle LW, Cheong JLY, Burnett AC, Anderson PJ. Development of brain white matter and math computation ability in children born very preterm and full-term. Dev Cogn Neurosci 2021; 51:100987. [PMID: 34273749 PMCID: PMC8319459 DOI: 10.1016/j.dcn.2021.100987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 07/07/2021] [Accepted: 07/11/2021] [Indexed: 11/08/2022] Open
Abstract
Children born very preterm (VPT; <32 weeks' gestation) have alterations in brain white matter and poorer math ability than full-term (FT) peers. Diffusion-weighted magnetic resonance imaging studies suggest a link between white matter microstructure and math in VPT and FT children, although longitudinal studies using advanced modelling are lacking. In a prospective longitudinal cohort of VPT and FT children we used Fixel-Based Analysis to investigate associations between maturation of white matter fibre density (FD), fibre-bundle cross-section (FC), and combined fibre density and cross-section (FDC) and math computation ability at 7 (n = 136 VPT; n = 32 FT) and 13 (n = 130 VPT; n = 44 FT) years, as well as between change in white matter and math computation ability from 7 to 13 years (n = 103 VPT; n = 21 FT). In both VPT and FT children, higher FD, FC and FDC in visual, sensorimotor and cortico-thalamic/thalamo-cortical white matter tracts were associated with better math computation ability at 7 and 13 years. Longitudinally, accelerated maturation of the posterior body of the corpus callosum (FDC) was associated with greater math computation development. White matter-math associations were similar for VPT and FT children. In conclusion, white matter maturation is associated with math computation ability across late childhood, irrespective of birth group.
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Affiliation(s)
- Simonne E Collins
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Deanne K Thompson
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Claire E Kelly
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia
| | - Joseph Y M Yang
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Neuroscience Advanced Clinical Imaging Suite (NACIS), Department of Neurosurgery, The Royal Children's Hospital, Melbourne, Australia; Neuroscience Research, Murdoch Children's Research Institute, Melbourne, Australia
| | - Leona Pascoe
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia
| | - Terrie E Inder
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Lex W Doyle
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia; Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Australia
| | - Jeanie L Y Cheong
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia; Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Australia
| | - Alice C Burnett
- Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Premature Infant Follow-Up Program, Royal Women's Hospital, Melbourne, Australia; Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia; Victorian Infant Brain Study (VIBeS), Murdoch Children's Research Institute, Melbourne, Australia.
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10
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Haebich KM, Willmott C, Scratch SE, Pascoe L, Lee KJ, Spencer-Smith MM, Cheong JLY, Inder TE, Doyle LW, Thompson DK, Anderson PJ. Neonatal brain abnormalities and brain volumes associated with goal setting outcomes in very preterm 13-year-olds. Brain Imaging Behav 2021; 14:1062-1073. [PMID: 30684152 DOI: 10.1007/s11682-019-00039-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Executive dysfunction including impaired goal setting (i.e., planning, organization skills, strategic reasoning) is documented in children born very preterm (VP; <30 weeks/<1250 g), however the neurological basis for this impairment is unknown. This study sought to examine the relationship between brain abnormalities and brain volumes on neonatal magnetic resonance imaging (MRI) and goal setting abilities of VP 13-year-olds. Participants were 159 children born VP in a prospective longitudinal study. Qualitative brain abnormality scores and quantitative brain volumes were derived from neonatal MRI brain scans (40 weeks' gestational age ± 2 weeks). Goal setting at 13 years was assessed using the Delis-Kaplan Executive Function Systems Tower Test, the Rey Complex Figure, and the Behavioural Assessment of the Dysexecutive System for Children Zoo Map and Six Part Test. A composite score was generated denoting overall performance on these goal setting measures. Separate regression models examined the association of neonatal brain abnormality scores and brain volumes with goal setting performance. There was evidence that higher neonatal white matter, deep grey matter and cerebellum abnormality scores were associated with poorer goal setting scores at 13 years. There was also evidence of positive associations between total brain volume, cerebellum, thalamic and cortical grey matter volumes and goal setting performance. Evidence for the associations largely persisted after controlling for potential confounders. Neonatal brain abnormality and brain volumes are associated with goal setting outcome in VP 13-year-olds. Used in conjunction with other clinical indicators, neonatal MRI may help to identify VP children at risk for later executive dysfunction.
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Affiliation(s)
- Kristina M Haebich
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Catherine Willmott
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Shannon E Scratch
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.,Department of Pediatrics, University of Toronto, Toronto, Canada
| | - Leona Pascoe
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Katherine J Lee
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Megan M Spencer-Smith
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Jeanie L Y Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Premature Infant Follow-up Programme, Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, Royal Women's Hospital, Melbourne, Australia
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Lex W Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Premature Infant Follow-up Programme, Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, Royal Women's Hospital, Melbourne, Australia
| | - Deanne K Thompson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Pediatrics, University of Toronto, Toronto, Canada.,Florey Institute of Neurosciences and Mental Health, Melbourne, Australia
| | - Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia. .,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
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11
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Kelly CE, Harding R, Lee KJ, Pascoe L, Josev EK, Spencer-Smith MM, Adamson C, Beare R, Nosarti C, Roberts G, Doyle LW, Seal ML, Thompson DK, Anderson PJ. Investigating the brain structural connectome following working memory training in children born extremely preterm or extremely low birth weight. J Neurosci Res 2021; 99:2340-2350. [PMID: 33624327 DOI: 10.1002/jnr.24818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/06/2021] [Indexed: 11/07/2022]
Abstract
Children born extremely preterm (EP, <28 weeks' gestation) or extremely low birth weight (ELBW, <1,000 g) are a vulnerable population at high risk of working memory impairments. We aimed to examine changes in the brain structural connectivity networks thought to underlie working memory performance, after completion of a working memory training program (Cogmed) compared with a placebo program in EP/ELBW children. This was a double-blind, placebo-controlled randomized trial (the Improving Memory in a Preterm Randomised Intervention Trial). Children born EP/ELBW received either the Cogmed or placebo program at 7 years of age (n = 91). A subset of children had magnetic resonance imaging of the brain immediately pre- and 2 weeks post-training (Cogmed n = 28; placebo n = 27). T1 -weighted and diffusion-weighted images were used to perform graph theoretical analysis of structural connectivity networks. Changes from pre-training to post-training in structural connectivity metrics were generally similar between randomized groups. There was little evidence that changes in structural connectivity metrics were related to changes in working memory performance from pre- to post-training. Overall, our results provide little evidence that the Cogmed working memory training program has training-specific effects on structural connectivity networks in EP/ELBW children.
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Affiliation(s)
- Claire E Kelly
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Rebecca Harding
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Katherine J Lee
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Leona Pascoe
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Elisha K Josev
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Megan M Spencer-Smith
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Chris Adamson
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Richard Beare
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Gehan Roberts
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Health Services, Population Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Newborn Research, The Royal Women's Hospital, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, Australia
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
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12
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Kelly CE, Thompson DK, Chen J, Josev EK, Pascoe L, Spencer-Smith MM, Adamson C, Nosarti C, Gathercole S, Roberts G, Lee KJ, Doyle LW, Seal ML, Anderson PJ. Working memory training and brain structure and function in extremely preterm or extremely low birth weight children. Hum Brain Mapp 2019; 41:684-696. [PMID: 31713952 PMCID: PMC6977425 DOI: 10.1002/hbm.24832] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/05/2019] [Accepted: 10/08/2019] [Indexed: 01/31/2023] Open
Abstract
This study in children born extremely preterm (EP; <28 weeks' gestational age) or extremely low birth weight (ELBW; <1,000 g) investigated whether adaptive working memory training using Cogmed® is associated with structural and/or functional brain changes compared with a placebo program. Ninety-one EP/ELBW children were recruited at a mean (standard deviation) age of 7.8 (0.4) years. Children were randomly allocated to Cogmed or placebo (45-min sessions, 5 days a week over 5-7 weeks). A subset had usable magnetic resonance imaging (MRI) data pretraining and 2 weeks posttraining (structural, n = 48; diffusion, n = 43; task-based functional, n = 18). Statistical analyses examined whether cortical morphometry, white matter microstructure and blood oxygenation level-dependent (BOLD) signal during an n-back working memory task changed from pretraining to posttraining in the Cogmed and placebo groups separately. Interaction analyses between time point and group were then performed. There was a significant increase in neurite density in several white matter regions from pretraining to posttraining in both the Cogmed and placebo groups. BOLD signal in the posterior cingulate and precuneus cortices during the n-back task increased from pretraining to posttraining in the Cogmed but not placebo group. Evidence for group-by-time interactions for the MRI measures was weak, suggesting that brain changes generally did not differ between Cogmed and placebo groups. Overall, while some structural and functional MRI changes between the pretraining and posttraining period in EP/ELBW children were observed, there was little evidence of training-induced neuroplasticity, with changes generally identified in both groups. Trial registration Australian New Zealand Clinical Trials Registry, anzctr.org.au; ACTRN12612000124831.
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Affiliation(s)
- Claire E Kelly
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jian Chen
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Elisha K Josev
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Leona Pascoe
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Megan M Spencer-Smith
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Chris Adamson
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Chiara Nosarti
- Centre for the Developing Brain, Department of Perinatal Imaging and Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - Susan Gathercole
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Gehan Roberts
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Health Services, Population Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Katherine J Lee
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Clinical Epidemiology & Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia
| | - Lex W Doyle
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.,Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies (VIBeS), Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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13
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Rahman M, McDonald E, Edvardsson K, Pascoe L, Lood Q, Jokwiro Y, Edvardsson D. PSYCHOMETRIC ANALYSES OF THE PERSON-CENTRED CLIMATE QUESTIONNAIRE–FAMILY (PCQ-F) IN AUSTRALIA, NORWAY AND SWEDEN. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Rahman
- Austin Clinical School of Nursing, La Trobe University, Heidelberg, VIC, Australia
| | - E McDonald
- Austin Clinical School of Nursing, La Trobe University, Heidelberg, VIC, Australia
| | - K Edvardsson
- Northern Centre for Health Education and Research, La Trobe University, Epping, VIC, Australia
| | - L Pascoe
- Austin Clinical School of Nursing, La Trobe University, Heidelberg, VIC, Australia
| | - Q Lood
- Austin Clinical School of Nursing, La Trobe University, Heidelberg, VIC, Australia
| | - Y Jokwiro
- Northern Centre for Health Education and Research, La Trobe University, Epping, VIC, Australia
| | - D Edvardsson
- Austin Clinical School of Nursing, La Trobe University, Heidelberg, VIC, Australia
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14
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Anderson PJ, Lee KJ, Roberts G, Spencer-Smith MM, Thompson DK, Seal ML, Nosarti C, Grehan A, Josev EK, Gathercole S, Doyle LW, Pascoe L. Long-Term Academic Functioning Following Cogmed Working Memory Training for Children Born Extremely Preterm: A Randomized Controlled Trial. J Pediatr 2018; 202:92-97.e4. [PMID: 30177350 DOI: 10.1016/j.jpeds.2018.07.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/06/2018] [Accepted: 07/02/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the effectiveness of Cogmed Working Memory Training compared with a placebo program in improving academic functioning 24 months post-training in extremely preterm/extremely low birth weight 7-year-olds. STUDY DESIGN A multicenter double-blind, placebo-controlled randomized controlled trial was conducted across all tertiary neonatal hospitals in the state of Victoria, Australia. Participants were 91 extremely preterm/extremely low birth weight 7-year-old children born in Victoria in 2005. Children were randomly assigned to either the Cogmed or placebo arm and completed the Cogmed or placebo program (20-25 sessions of 35-40 minutes duration) at home over 5-7 weeks. Academic achievement (word reading, spelling, sentence comprehension, and mathematics) was assessed 24 months post-training, as well as at 2 weeks and 12 months post-training, via standardized testing inclusive of working memory, attention, and executive behavior assessments. Data were analyzed using an intention-to-treat approach with mixed-effects modeling. RESULTS There was little evidence of any benefits of Cogmed on academic functioning 24 months post-training, as well as on working memory, attention, or executive behavior at any age up to 24 months post-training compared with the placebo program. CONCLUSIONS We currently do not recommend administration of Cogmed for early school-aged children born extremely preterm/extremely low birth weight to improve academic functioning. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12612000124831.
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Affiliation(s)
- Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
| | - Katherine J Lee
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Gehan Roberts
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Megan M Spencer-Smith
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
| | - Deanne K Thompson
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Marc L Seal
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | | | - Andrea Grehan
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Elisha K Josev
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | | | - Lex W Doyle
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, The University of Melbourne, Melbourne, Australia; Neonatal Services, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Australia
| | - Leona Pascoe
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia; Murdoch Children's Research Institute, Melbourne, Australia
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15
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Matthews LG, Inder TE, Pascoe L, Kapur K, Lee KJ, Monson BB, Doyle LW, Thompson DK, Anderson PJ. Longitudinal Preterm Cerebellar Volume: Perinatal and Neurodevelopmental Outcome Associations. Cerebellum 2018; 17:610-627. [PMID: 29949094 PMCID: PMC6126980 DOI: 10.1007/s12311-018-0946-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Impaired cerebellar development is an important determinant of adverse motor and cognitive outcomes in very preterm (VPT) infants. However, longitudinal MRI studies investigating cerebellar maturation from birth through childhood and associated neurodevelopmental outcomes are lacking. We aimed to compare cerebellar volume and growth from term-equivalent age (TEA) to 7 years between VPT (< 30 weeks' gestation or < 1250 g) and full-term children; and to assess the association between these measures, perinatal factors, and 7-year outcomes in VPT children, and whether these relationships varied by sex. In a prospective cohort study of 224 VPT and 46 full-term infants, cerebellar volumes were measured on MRI at TEA and 7 years. Useable data at either time-point were collected for 207 VPT and 43 full-term children. Cerebellar growth from TEA to 7 years was compared between VPT and full-term children. Associations with perinatal factors and 7-year outcomes were investigated in VPT children. VPT children had smaller TEA and 7-year volumes and reduced growth. Perinatal factors were associated with smaller cerebellar volume and growth between TEA and 7 years, namely, postnatal corticosteroids for TEA volume, and female sex, earlier birth gestation, white and deep nuclear gray matter injury for 7-year volume and growth. Smaller TEA and 7-year volumes, and reduced growth were associated with poorer 7-year IQ, language, and motor function, with differential relationships observed for male and female children. Our findings indicate that cerebellar growth from TEA to 7 years is impaired in VPT children and relates to early perinatal factors and 7-year outcomes.
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Affiliation(s)
- Lillian G Matthews
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA.
- Murdoch Children's Research Institute, Melbourne, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.
| | - T E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - L Pascoe
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - K Kapur
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - K J Lee
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - B B Monson
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - L W Doyle
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Royal Women's Hospital, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
| | - D K Thompson
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - P J Anderson
- Murdoch Children's Research Institute, Melbourne, Australia
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
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16
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Pascoe L, Thompson D, Spencer-Smith M, Beare R, Adamson C, Lee KJ, Kelly C, Georgiou-Karistianis N, Nosarti C, Josev E, Roberts G, Doyle LW, Seal ML, Anderson PJ. Efficiency of structural connectivity networks relates to intrinsic motivation in children born extremely preterm. Brain Imaging Behav 2018; 13:995-1008. [DOI: 10.1007/s11682-018-9918-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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17
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Nguyen TNN, Spencer-Smith M, Zannino D, Burnett A, Scratch SE, Pascoe L, Ellis R, Cheong J, Thompson D, Inder T, Doyle LW, Anderson PJ. Developmental Trajectory of Language From 2 to 13 Years in Children Born Very Preterm. Pediatrics 2018; 141:peds.2017-2831. [PMID: 29632253 PMCID: PMC5914491 DOI: 10.1542/peds.2017-2831] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The objective of this study was to describe language functioning at 13 years of age and examine its developmental trajectory from 2 to 13 years of age in children born very preterm (VP) compared with term controls. METHODS Two hundred and twenty-four children born VP (<30 weeks' gestation) and 77 term controls had language skills assessed by using performance-based and/or parent-report measures at 2, 5, 7, and 13 years of age. Regression models were used to compare verbal memory, grammar, semantics, and pragmatic skills between the VP and term groups at 13 years of age. Linear mixed effects regression models were used to assess language trajectories from 2 to 13 years of age. RESULTS Compared with term controls, children born VP had poorer functioning across all components of language (mean group differences ranged from -0.5 SD to -1 SD; all P < .05) at 13 years of age. At each follow-up age, the VP group displayed poorer language functioning than the term controls, with the groups exhibiting similar developmental trajectories (slope difference = -0.01 SD per year; P = .55). CONCLUSIONS Children born VP continue to display language difficulties compared with term controls at 13 years of age, with no evidence of developmental "catch-up." Given the functional implications associated with language deficits, early language-based interventions should be considered for children born VP.
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Affiliation(s)
- Thi-Nhu-Ngoc Nguyen
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
| | - Megan Spencer-Smith
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
| | - Diana Zannino
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Alice Burnett
- Murdoch Children’s Research Institute, Melbourne, Australia;,Departments of Paediatrics and,Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia;,Newborn Research Centre, The Royal Women’s Hospital and University of Melbourne, Melbourne, Australia
| | - Shannon E. Scratch
- Murdoch Children’s Research Institute, Melbourne, Australia;,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada;,Department of Paediatrics, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Leona Pascoe
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
| | - Rachel Ellis
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Jeanie Cheong
- Murdoch Children’s Research Institute, Melbourne, Australia;,Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia;,Newborn Research Centre, The Royal Women’s Hospital and University of Melbourne, Melbourne, Australia
| | - Deanne Thompson
- Murdoch Children’s Research Institute, Melbourne, Australia;,Departments of Paediatrics and,Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; and
| | - Terrie Inder
- Department of Pediatrics Newborn Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Lex W. Doyle
- Departments of Paediatrics and,Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia;,Newborn Research Centre, The Royal Women’s Hospital and University of Melbourne, Melbourne, Australia
| | - Peter J. Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
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Taylor R, Pascoe L, Scratch S, Doyle LW, Anderson P, Roberts G. A simple screen performed at school entry can predict academic under-achievement at age seven in children born very preterm. J Paediatr Child Health 2016; 52:759-64. [PMID: 27189705 DOI: 10.1111/jpc.13186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 10/16/2015] [Accepted: 02/14/2016] [Indexed: 11/30/2022]
Abstract
AIM We aimed to compare the academic outcomes of a cohort of children born very preterm (VPT, <32 weeks of gestation) and children born at term at age 7 years and assess the ability of a pre-academic skill screen at age five to predict later academic impairment in children born VPT at age seven. METHODS One hundred ninety-four children born VPT (born with either gestational age <30 weeks or birthweight <1250 g) and 70 controls born at term from a prospective birth cohort were compared on academic outcomes (Wide Range Achievement Test, WRAT4) at age seven using regression analyses. Receiver-operating characteristic curves were used to determine whether pre-academic skills (Kaufman Survey of Early Academic and Language Skills, K-SEALS) at age five predicted academic impairment at age seven in 174 of the VPT cohort. RESULTS At the age of 7 years, children born VPT had lower mean word reading (-9.7, 95% CI: -14.7 to -4.6), spelling (-8.3, 95% CI: -13.3 to -3.3) and math computation (-10.9, 95% CI: -15.3 to -6.5) scores (all P-values ≤0.001) compared with controls born at term, even after adjusting for social risk and time since school commencement. In terms of pre-academic screening, the Numbers, Letters and Words subtest of the K-SEALS had adequate sensitivity and specificity (70-80%) for predicting children with academic impairment at age seven. CONCLUSIONS Children born VPT underperformed in academic outcomes at age seven compared with controls born at term. A pre-academic screening tool used at school entry can predict children born VPT at risk of academic impairment at age seven who could benefit from targeted early intervention.
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Affiliation(s)
- Rebecca Taylor
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia
| | - Leona Pascoe
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Shannon Scratch
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia.,Newborn Research, The Royal Women's Hospital, Melbourne, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter Anderson
- Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Gehan Roberts
- Centre for Community Child Health, Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
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Ure AM, Treyvaud K, Thompson DK, Pascoe L, Roberts G, Lee KJ, Seal ML, Northam E, Cheong JL, Hunt RW, Inder T, Doyle LW, Anderson PJ. Neonatal brain abnormalities associated with autism spectrum disorder in children born very preterm. Autism Res 2015; 9:543-52. [PMID: 26442616 DOI: 10.1002/aur.1558] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/08/2015] [Accepted: 08/15/2015] [Indexed: 11/11/2022]
Abstract
Very preterm (VP) survivors are at increased risk of autism spectrum disorder (ASD) compared with term-born children. This study explored whether neonatal magnetic resonance (MR) brain features differed in VP children with and without ASD at 7 years. One hundred and seventy-two VP children (<30 weeks' gestation or <1250 g birth weight) underwent structural brain MR scans at term equivalent age (TEA; 40 weeks' gestation ±2 weeks) and were assessed for ASD at 7 years of age. The presence and severity of white matter, cortical gray matter, deep nuclear gray matter, and cerebellar abnormalities were assessed, and total and regional brain volumes were measured. ASD was diagnosed using a standardized parent report diagnostic interview and confirmed via an independent assessment. Eight VP children (4.7%) were diagnosed with ASD. Children with ASD had more cystic lesions in the cortical white matter at TEA compared with those without ASD (odds ratio [OR] 8.7, 95% confidence interval [CI] 1.5, 51.3, P = 0.02). There was also some evidence for smaller cerebellar volumes in children with ASD compared with those without ASD (OR = 0.82, CI = 0.66, 1.00, P = 0.06). Overall, the results suggest that VP children with ASD have different brain structure in the neonatal period compared with those who do not have ASD. Autism Res 2016, 9: 543-552. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Alexandra M Ure
- Murdoch Childrens Research Institute, Melbourne, Australia.,The Royal Children's Hospital, Melbourne, Australia
| | - Karli Treyvaud
- Murdoch Childrens Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Leona Pascoe
- Murdoch Childrens Research Institute, Melbourne, Australia
| | - Gehan Roberts
- Murdoch Childrens Research Institute, Melbourne, Australia.,The Royal Children's Hospital, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Katherine J Lee
- Murdoch Childrens Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Marc L Seal
- Murdoch Childrens Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Elisabeth Northam
- Murdoch Childrens Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Jeanie L Cheong
- Murdoch Childrens Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia.,The Royal Women's Hospital, Melbourne, Australia
| | - Rod W Hunt
- Murdoch Childrens Research Institute, Melbourne, Australia.,The Royal Children's Hospital, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | - Terrie Inder
- Brigham and Women's Hospital, Boston, United States of America
| | - Lex W Doyle
- University of Melbourne, Melbourne, Australia.,The Royal Women's Hospital, Melbourne, Australia
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Murray AL, Thompson DK, Pascoe L, Leemans A, Inder TE, Doyle LW, Anderson JFI, Anderson PJ. White matter abnormalities and impaired attention abilities in children born very preterm. Neuroimage 2015; 124:75-84. [PMID: 26318524 DOI: 10.1016/j.neuroimage.2015.08.044] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/16/2015] [Accepted: 08/20/2015] [Indexed: 12/23/2022] Open
Abstract
While attention impairments are commonly observed in very preterm (<32weeks' gestational age) children, neuroanatomical correlates of these difficulties are unclear. We aimed to determine whether the microstructural organization of key white matter tracts thought to be involved in attention (cingulum bundle, superior longitudinal fasciculi, reticular activating system, and corpus callosum) were altered in very preterm children compared with term-born controls. We also aimed to determine whether alterations in microstructural organization of these tracts were associated with attention functioning in very preterm children. One hundred and forty-nine very preterm children and 36 term-born controls underwent neuroimaging and assessment of their attention abilities at 7years. Constrained spherical deconvolution and probabilistic tractography was used to identify the key white matter tracts. Altered microstructural organization and reduced tract volume within reticular activating system and corpus callosum were found in the very preterm group compared with the control group. Diffusion and volume changes in the cingulum bundle, superior longitudinal fasciculi, reticular activating system, and corpus callosum were related to variations in attention functioning in the very preterm children. These findings emphasize that white matter tract integrity is associated with later attentional abilities in very preterm children.
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Affiliation(s)
- Andrea L Murray
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Australia
| | - Leona Pascoe
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Alexander Leemans
- Image Sciences Institute, University Medical Center, Utrecht, The Netherlands
| | - Terrie E Inder
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Lex W Doyle
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Research Office, The Royal Women's Hospital, Grattan Street, Melbourne, Australia; Department of Obstetrics & Gynaecology, The University of Melbourne, Royal Women's Hospital, Melbourne, Australia
| | - Jacqueline F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Department of Psychology, The Alfred, Alfred Health, Melbourne, Australia
| | - Peter J Anderson
- Victorian Infant Brain Studies, Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Melbourne, Australia.
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21
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Thompson DK, Lee KJ, van Bijnen L, Leemans A, Pascoe L, Scratch SE, Cheong J, Egan GF, Inder TE, Doyle LW, Anderson PJ. Accelerated corpus callosum development in prematurity predicts improved outcome. Hum Brain Mapp 2015; 36:3733-48. [PMID: 26108187 DOI: 10.1002/hbm.22874] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 06/01/2015] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To determine: (1) whether corpus callosum (CC) size and microstructure at 7 years of age or their change from infancy to 7 years differed between very preterm (VP) and full-term (FT) children; (2) perinatal predictors of CC size and microstructure at 7 years; and (3) associations between CC measures at 7 years or trajectories from infancy to 7 years and neurodevelopmental outcomes. EXPERIMENTAL DESIGN One hundred and thirty-six VP (gestational age [GA] <30 weeks and/or birth weight <1,250 g) and 33 FT children had usable magnetic resonance images at 7 years of age, and of these, 76 VP and 16 FT infants had usable data at term equivalent age. The CC was traced and divided into six sub-regions. Fractional anisotropy, mean, axial, radial diffusivity and volume were measured from tractography. Perinatal data were collected, and neurodevelopmental tests administered at 7 years' corrected age. PRINCIPAL OBSERVATIONS VP children had smaller posterior CC regions, higher diffusivity and lower fractional anisotropy compared with FT 7-year-olds. Reduction in diffusivity over time occurred faster in VP than FT children (P ≤ 0.002). Perinatal brain abnormality and earlier GA were associated with CC abnormalities. Microstructural abnormalities at 7 years or slower development of the CC were associated with motor dysfunction, poorer mathematics and visual perception. CONCLUSIONS This study is the first to demonstrate an accelerated trajectory of CC white matter diffusion following VP birth, associated with improved neurodevelopmental functioning. Findings suggest there is a window of opportunity for neurorestorative intervention to improve outcomes. Hum Brain Mapp 36:3733-3748, 2015. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Deanne K Thompson
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine J Lee
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Loeka van Bijnen
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Alexander Leemans
- Imaging Science Institute, University Medical Center, Utrecht, Netherlands
| | - Leona Pascoe
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Shannon E Scratch
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Jeanie Cheong
- Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Gary F Egan
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Biomedical Imaging, Monash University, Melbourne, Victoria, Australia
| | - Terrie E Inder
- Brigham and Women's Hospital, Boston, Massachusetts.,Department of Pediatrics, Washington University in St Louis Medical School, St Louis, Missouri
| | - Lex W Doyle
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Royal Women's Hospital, Melbourne, Victoria, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Peter J Anderson
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Department of Pediatrics, Washington University in St Louis Medical School, St Louis, Missouri
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22
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Wilson-Ching M, Pascoe L, Doyle LW, Anderson PJ. Effects of correcting for prematurity on cognitive test scores in childhood. J Paediatr Child Health 2014; 50:182-8. [PMID: 24617343 DOI: 10.1111/jpc.12475] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2013] [Indexed: 11/26/2022]
Abstract
AIMS The American Academy of Pediatrics recommends that test scores should be corrected for prematurity up to 3 years of age, but this practice varies greatly in both clinical and research settings. The aim of this study was to contrast the effects of using chronological age and those of using corrected age on measures of cognitive outcome across childhood. METHODS A theoretical model was constructed using norms from the Bayley Scales of Infant and Toddler Development, Third Edition; the Wechsler Preschool and Primary Scale of Intelligence, Third Edition Australian; and the Wechsler Intelligence Scales for Children, Fourth Edition Australian. Baseline scores representing different levels of functioning (70, below average; 85, borderline; and 100, average) were recalculated using the normative data for ages 6 months to 16 years to account for 1, 2, 3 and 4 months of prematurity. The model created depicted the difference in standardised scores between chronological and corrected age. RESULTS Compared with scores corrected for prematurity, the absolute reduction in scores using chronological age was greater for increasing degree of prematurity, younger ages at assessment and higher baseline scores and was substantial even beyond 3 years of age. However, the pattern was erratic, with considerable fluctuation evident across different ages and baseline scores. CONCLUSIONS Chronological age results in a lowering of scores at all ages for preterm-born subjects that is greater in the first few years and in those born at earlier gestational ages. Whether or not to correct for prematurity depends upon the context of the assessment.
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Affiliation(s)
- Michelle Wilson-Ching
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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23
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Spencer-Smith MM, Spittle AJ, Doyle LW, Lee KJ, Lorefice L, Suetin A, Pascoe L, Anderson PJ. Long-term benefits of home-based preventive care for preterm infants: a randomized trial. Pediatrics 2012; 130:1094-101. [PMID: 23129084 DOI: 10.1542/peds.2012-0426] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND We have previously reported improved caregiver mental health and infant behavior at 2 years following a home-based preventive care program for very preterm infants and their caregivers. This study aimed to determine the longer-term effectiveness of the program by reviewing caregivers and children at preschool age. METHODS One hundred twenty very preterm infants (<30 weeks' gestation) were randomly allocated to intervention (n = 61) or control (n = 59) groups. The intervention included 9 home visits over the first year of life targeting infant development, parent mental health, and the parent-infant relationship. The control group received standard care. At 4 years' corrected age, child cognitive, behavioral, and motor functioning and caregiver mental health were assessed. RESULTS At age 4 years, 105 (89%) children were reviewed. There was little evidence of differences in cognitive or motor functioning between groups. The intervention group had lower scores for child internalizing behaviors than the control group (mean difference -5.3, 95% confidence interval [CI] -9.6 to -0.9, P = .02). Caregivers in the intervention group had fewer anxiety symptoms (mean difference -1.8, 95% CI -3.3 to -0.4, P = .01) and were less likely to exhibit "at-risk" anxiety (odds ratio 0.3, 95% CI 0.1 to 0.7, P = .01) than those in the control group. CONCLUSIONS This home-based preventive care program for very preterm infants has selective long-term benefits, including less caregiver anxiety and reduced preschooler internalizing behaviors.
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Affiliation(s)
- Megan M Spencer-Smith
- Critical Care and Neurosciences, Murdoch Childrens Research Institute, Victoria, Australia.
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24
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Thiébaut R, Douchin V, Jung C, Merlin F, Colombel JF, Lemann M, Almer S, Tysk C, O'Morain C, Gassull M, Finkel Y, Zouali H, Pascoe L, Hugot JP. RIP2 polymorphisms in inflammatory bowel diseases. Inflamm Bowel Dis 2011; 17:1055. [PMID: 20645315 DOI: 10.1002/ibd.21406] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Leech NJ, O'Sullivan J, Avery P, Howey C, Burling K, Iyer S, Pascoe L, Walker M, Cheetham T. Increased maternal Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) associated with older age at diagnosis of Type 1 diabetes in offspring. Diabet Med 2010; 27:1450-3. [PMID: 21105490 DOI: 10.1111/j.1464-5491.2010.03130.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIMS Obesity and insulin resistance have been linked to rising incidence and earlier onset of Type 1 diabetes. Inherited differences in insulin action might also influence the evolution of Type 1 diabetes.Our aim was to determine whether parental BMI and insulin resistance influences age of onset of Type 1 diabetes in their offspring. METHODS BMI standard deviation score and age at diagnosis of Type 1 diabetes was examined in 227 children, and in 206 of these was compared with local matched control subjects. Non-diabetic parents of a subgroup of 80 children with Type 1 diabetes were recruited. Parental BMI was compared with local adult control subjects. The relationship between parental BMI, waist-hip ratio, homeostasis model assessment of insulin resistance (HOMA-IR), leptin and adiponectin levels and age at diagnosis of Type 1 diabetes in offspring was examined. RESULTS We found no relationship between age at diagnosis of Type 1 diabetes in children and BMI standard deviation score (P = 0.5). Children with Type 1 diabetes and their parents were heavier than matched control subjects (mean BMI standard deviation score sd in children = 0.66 1.06 vs. 0.32 1.16 in control subjects, P = 0.002; mean parental BMI sd 27.7 0.4 vs. 25.5 0.4 kg ⁄m2 in control subjects; P < 0.0001). Maternal HOMA-IR accounted for 20% of variation in age at diagnosis (P < 0.001) with increasing maternal insulin resistance associated with later age at diagnosis of Type 1 diabetes. CONCLUSIONS Childrenwith Type 1 diabetes and their parents have an increased BMI at diagnosis.Maternal insulin resistance is associated with later onset of Type 1 diabetes in children.
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Affiliation(s)
- N J Leech
- Department of Medicine, Newcastle upon Tyne Hospitals Foundation Trust, Newcastle University, Newcastle upon Tyne, UK.
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Langenberg C, Pascoe L, Mari A, Tura A, Laakso M, Frayling TM, Barroso I, Loos RJF, Wareham NJ, Walker M. Common genetic variation in the melatonin receptor 1B gene (MTNR1B) is associated with decreased early-phase insulin response. Diabetologia 2009; 52:1537-42. [PMID: 19455304 PMCID: PMC2709880 DOI: 10.1007/s00125-009-1392-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Accepted: 04/09/2009] [Indexed: 02/02/2023]
Abstract
AIMS/HYPOTHESIS We investigated whether variation in MTNR1B, which was recently identified as a common genetic determinant of fasting glucose levels in healthy, diabetes-free individuals, is associated with measures of beta cell function and whole-body insulin sensitivity. METHODS We studied 1,276 healthy individuals of European ancestry at 19 centres of the Relationship between Insulin Sensitivity and Cardiovascular disease (RISC) study. Whole-body insulin sensitivity was assessed by euglycaemic-hyperinsulinaemic clamp and indices of beta cell function were derived from a 75 g oral glucose tolerance test (including 30 min insulin response and glucose sensitivity). We studied rs10830963 in MTNR1B using additive genetic models, adjusting for age, sex and recruitment centre. RESULTS The minor (G) allele of rs10830963 in MTNR1B (frequency 0.30 in HapMap Centre d'Etude du Polymorphisme [Utah residents with northern and western European ancestry] [CEU]; 0.29 in RISC participants) was associated with higher levels of fasting plasma glucose (standardised beta [95% CI] 0.17 [0.085, 0.25] per G allele, p = 5.8 x 10(-5)), consistent with recent observations. In addition, the G-allele was significantly associated with lower early insulin response (-0.19 [-0.28, -0.10], p = 1.7 x 10(-5)), as well as with decreased beta cell glucose sensitivity (-0.11 [-0.20, -0.027], p = 0.010). No associations were observed with clamp-assessed insulin sensitivity (p = 0.15) or different measures of body size (p > 0.7 for all). CONCLUSIONS/INTERPRETATION Genetic variation in MTNR1B is associated with defective early insulin response and decreased beta cell glucose sensitivity, which may contribute to the higher glucose levels of non-diabetic individuals carrying the minor G allele of rs10830963 in MTNR1B.
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Affiliation(s)
- C Langenberg
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
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27
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Thiébaut R, Kotti S, Jung C, Merlin F, Colombel JF, Lemann M, Almer S, Tysk C, O'Morain M, Gassull M, Binder V, Finkel Y, Pascoe L, Hugot JP. TNFSF15 polymorphisms are associated with susceptibility to inflammatory bowel disease in a new European cohort. Am J Gastroenterol 2009; 104:384-91. [PMID: 19174806 DOI: 10.1038/ajg.2008.36] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Inflammatory bowel disease (IBD), e.g., Crohn's disease (CD) and ulcerative colitis (UC), is a complex genetic disorder. Tumor necrosis factor (ligand) superfamily, member 15 (TNFSF15) has been previously identified as a susceptibility gene for CD in Japanese and UK cohorts. This replication study was designed in order to confirm and further validate the role of TNFSF15 in IBD. METHODS A total of 666 IBD families (corresponding to 2,982 relatives) with European ancestry were genotyped for the rs6478108 and rs7869487 polymorphisms, which define the main TNFSF15 haplotypes previously associated with CD. An association between the main haplotypes and CD, UC and IBD was tested using the Genehunter TDT and Unphased statistics. Caspase recruitment domain 15 (CARD15)/TNFSF15 interaction and genotype/phenotype correlations were also studied. RESULTS The previously reported "high-risk" haplotype (A) was associated with IBD (P=0.001) (OR=1.25 (1.05-1.50)) and CD (P=0.02) (OR=1.31 (1.03-1.67)) whereas the "protective" (B) haplotype was significantly less transmitted to IBD and CD patients. No interaction between CARD15 and TNFSF15 was detected. We also failed to define a clinical subgroup of CD patients specifically associated with TNFSF15 haplotype A. CONCLUSIONS This study confirms that TNFSF15 or a closely linked gene is involved in the genetic predisposition to CD.
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Affiliation(s)
- R Thiébaut
- INSERM, U843, Hôpital Robert Debré, Université Paris Diderot, Paris, France
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Pascoe L, Frayling TM, Weedon MN, Mari A, Tura A, Ferrannini E, Walker M. Beta cell glucose sensitivity is decreased by 39% in non-diabetic individuals carrying multiple diabetes-risk alleles compared with those with no risk alleles. Diabetologia 2008; 51:1989-92. [PMID: 18719881 DOI: 10.1007/s00125-008-1124-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Accepted: 07/09/2008] [Indexed: 10/21/2022]
Abstract
AIMS/HYPOTHESIS Novel type 2 diabetes-susceptibility loci have been identified with evidence that individually they mediate the increased diabetes risk through altered pancreatic beta cell function. The aim of this study was to test the cumulative effects of diabetes-risk alleles on measures of beta cell function in non-diabetic individuals. METHODS A total of 1,211 non-diabetic individuals underwent metabolic assessment including an OGTT, from which measures of beta cell function were derived. Individuals were genotyped at each of the risk loci and then classified according to the total number of risk alleles that they carried. Initial analysis focused on CDKAL1, HHEX/IDE and TCF7L2 loci, which were individually associated with a decrease in beta cell function in our cohort. Risk alleles for CDKN2A/B, SLC30A8, IGF2BP2 and KCNJ11 loci were subsequently included into the analysis. RESULTS The diabetes-risk alleles for CDKAL1, HHEX/IDE and TCF7L2 showed an additive model of association with measures of beta cell function. Beta cell glucose sensitivity was decreased by 39% in those individuals with five or more risk alleles compared with those individuals with no risk alleles (geometric mean [SEM]: 84 [1.07] vs 137 [1.11] pmol min(-1) m(-2) (mmol/l)(-1), p = 1.51 x 10(-6)). The same was seen for the 30 min insulin response (p = 4.17 x 10(-7)). The relationship remained after adding in the other four susceptibility loci (30 min insulin response and beta cell glucose sensitivity, p < 0.001 and p = 0.003, respectively). CONCLUSIONS/INTERPRETATION This study shows how individual type 2 diabetes-risk alleles combine in an additive manner to impact upon pancreatic beta cell function in non-diabetic individuals.
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Affiliation(s)
- L Pascoe
- The Medical School, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
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29
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30
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Portrat S, Mulatero P, Curnow KM, Chaussain JL, Morel Y, Pascoe L. Deletion hybrid genes, due to unequal crossing over between CYP11B1 (11beta-hydroxylase) and CYP11B2(aldosterone synthase) cause steroid 11beta-hydroxylase deficiency and congenital adrenal hyperplasia. J Clin Endocrinol Metab 2001; 86:3197-201. [PMID: 11443188 DOI: 10.1210/jcem.86.7.7671] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Chromosomal rearrangements are natural experiments that can provide unique insights into in vivo regulation of genes and physiological systems. We have studied a patient with congenital adrenal hyperplasia and steroid 11beta-hydroxylase deficiency who was homozygous for a deletion of the CYP11B1 and CYP11B2 genes normally required for cortisol and aldosterone synthesis, respectively. The genes were deleted by unequal recombination between the tandemly arranged CYP11B genes during a previous meiosis, leaving a single hybrid gene consisting of the promoter and exons 1-6 of CYP11B2 and exons 7-9 of CYP11B1. The hybrid gene also carried an I339T mutation formed by intracodon recombination at the chromosomal breakpoint. The mutant complementary DNA corresponding to this gene was expressed in COS-1 cells and was found to have relatively unimpaired 11beta-hydroxylase and aldosterone synthase activities. Apparently the 11beta-hydroxylase deficiency and the adrenal hyperplasia are due to the lack of expression of this gene in the adrenal zona fasciculata/reticularis resulting from replacement of the CYP11B1 promoter and regulatory sequences by those of CYP11B2.
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MESH Headings
- Adrenal Hyperplasia, Congenital/blood
- Adrenal Hyperplasia, Congenital/enzymology
- Adrenal Hyperplasia, Congenital/genetics
- Aldosterone/blood
- Androstenedione/blood
- Animals
- Blotting, Southern
- COS Cells
- Child, Preschool
- Cortodoxone/blood
- Crossing Over, Genetic
- Cyproterone Acetate/therapeutic use
- Cytochrome P-450 CYP11B2/genetics
- DNA, Complementary/genetics
- Exons
- Gene Deletion
- Gene Expression
- Homozygote
- Humans
- Male
- Polymerase Chain Reaction
- Promoter Regions, Genetic
- Puberty, Precocious/drug therapy
- Puberty, Precocious/genetics
- Renin/blood
- Steroid 11-beta-Hydroxylase/genetics
- Transfection
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Affiliation(s)
- S Portrat
- INSERM, U-342, Laboratoire de Biochimie Endocrinienne, Hopital Debrousse, 69322 Lyon, France
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31
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Asherson RA, Pascoe L. The use of botulinum toxin-A in the treatment of patients with fibromyalgia. J Rheumatol 2001; 28:1740. [PMID: 11469493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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32
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Mulatero P, Rabbia F, di Cella SM, Schiavone D, Plazzotta C, Pascoe L, Veglio F. Angiotensin-converting enzyme and angiotensinogen gene polymorphisms are non-randomly distributed in oral contraceptive-induced hypertension. J Hypertens 2001; 19:713-9. [PMID: 11330874 DOI: 10.1097/00004872-200104000-00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES AND METHODS Oral contraceptives (OC) usage increases serum angiotensinogen levels to three to five times normal and about 5% of these women develop arterial hypertension. The genetic contribution to this susceptibility to OC-induced hypertension is poorly understood. We have analyzed the genotypes of 149 hypertensive and 101 normotensive women using oral contraceptives, for three genetic polymorphisms in genes of the renin-angiotensin system: an insertion/deletion (I/ D) in the angiotensin converting enzyme (ACE) gene, the T235M polymorphism of the angiotensinogen gene (AGT) and a point mutation in its promoter. RESULTS After cessation of oral contraception the mean arterial pressures of the hypertensive women were separable into two non-overlapping groups; 88 of the women remained hypertensive and 61 returned to normal blood pressure. Both groups of hypertensive women had a similarly higher frequency of hypertensive relatives than the normotensive women, but were otherwise similar. The 235T allele of AGT was significantly increased in frequency in the 61 oral contraceptive-inducible hypertensive women compared with the controls and the 88 women that remained hypertensive. The ACE I/D genotypes were similarly distributed within the three groups of women, but were distinctly non-random in the oral contraceptive-induced hypertensive women when they were also classified by AGT genotype. CONCLUSION This statistical interaction of genotype frequencies suggests that the genetic basis of susceptibility to OC-induced hypertension is complex.
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Affiliation(s)
- P Mulatero
- Department of Medicine and Experimental Oncology, San Vito Hospital, University of Torino, Italy. mailto:
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33
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Nemani M, Sahbatou M, Blanché H, Thomas G, Pascoe L. The efficiency of genetic analysis of DNA from aged siblings to detect chromosomal regions implicated in longevity. Mech Ageing Dev 2000; 119:25-39. [PMID: 11040399 DOI: 10.1016/s0047-6374(00)00165-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Studies of the frequencies of different alleles in young adults and aged individuals have implicated several genes, such as ApoE and ACE, in longevity. However such association studies can easily give rise to spurious results through unsuspected population subdivision, and an approach making use of genetic relationships among relatives is desirable. We have studied the effectiveness of non-parametric genetic analysis to detect different types of loci affecting longevity. The non-parametric method has high statistical power to detect infrequent recessive alleles that are required for, or significantly increase the probability of, survival to advanced age. Statistical power is reduced if a proportion of carriers of the alternative allele is allowed to survive. The method is least effective in detecting alleles that occur at low frequency in young individuals and that subsequently experience high mortality, as is the case for carriers of the epsilon4 allele of ApoE. Genotyping errors will also reduce the value of the NPL statistic in a linear fashion with the error rate and the number of loci genotyped. We have also used the method to analyse genotypes of seven highly polymorphic markers near the ApoE gene in a sample of 188 sibships of nonagenarians and centenarians (n=434) and their children (n=124), however no excess sharing of alleles was detected.
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Affiliation(s)
- M Nemani
- Fondation Jean Dausset CEPH, 27 rue Juliette Dodu, 75010, Paris, France
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34
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Nikkila H, McMillan DR, Nunez BS, Pascoe L, Curnow KM, White PC. Sequence similarities between a novel putative G protein-coupled receptor and Na+/Ca2+ exchangers define a cation binding domain. Mol Endocrinol 2000; 14:1351-64. [PMID: 10976914 DOI: 10.1210/mend.14.9.0511] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
cDNA clones encoding a novel putative G protein-coupled receptor have been characterized. The receptor is widely expressed in normal solid tissues. Consisting of 1967 amino acid residues, this receptor is one of the largest known and is therefore referred to as a very large G protein-coupled receptor, or VLGR1. It is most closely related to the secretin family of G protein-coupled receptors based on similarity of the sequences of its transmembrane segments. As demonstrated by cell surface labeling with a biotin derivative, the recombinant protein is expressed on the surface of transfected mammalian cells. Whereas several other recently described receptors in this family also have large extracellular domains, the large extracellular domain of VLGR1 has a unique structure. It has nine imperfectly repeated units that are rich in acidic residues and are spaced at intervals of approximately 120 amino acid residues. These repeats resemble the regulatory domains of Na+/Ca2+ exchangers as well as a component of an extracellular aggregation factor of marine sponges. Bacterial fusion proteins containing two or four repeats specifically bind 45Ca in overlay experiments; binding is competed poorly by Mg2+ but competed well by neomycin, Al3+, and Gd3+. These results define a consensus cation binding motif employed in several widely divergent types of proteins. The ligand for VLGR1, its function, and the signaling pathway(s) it employs remain to be defined.
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Affiliation(s)
- H Nikkila
- Division of Pediatric Endocrinology, University of Texas Southwestern Medical Center, Dallas 75235-9063, USA
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35
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Abstract
Primary aldosteronism is characterized by autonomous production of aldosterone and arterial hypertension, and it occurs in 2 principal forms: aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA). APA can be cured through removal of the adenoma, whereas IHA leads to hypertension that must be treated with medication. The origin of the autonomous aldosterone production in IHA is poorly understood, but genetic factors may contribute to its cause. To test the hypothesis that variants of the aldosterone synthase gene may contribute to susceptibility to IHA, we compared genotypes at 3 polymorphic sites in the CYP11B2 gene in patients with IHA (n=90) with those found in patients with APA (n=38), in patients with essential hypertension (n=72), and in normotensive individuals (n=102). We observed significant linkage disequilibrium among the 3 polymorphisms with 2 frequent haplotypes in all groups studied. One haplotype (C2R) was found to be increased in frequency in the IHA group (47%) compared with the other groups, which had a similar haplotype frequency (36%). The 3 polymorphisms studied have been implicated in either essential hypertension or excess aldosterone production in previous studies. Because of the strong linkage disequilibrium, the observed results could be due to the action of any 1 of the 3 alleles or to another allele in linkage disequilibrium with them. Our results suggest that variations in the CYP11B2 gene may contribute to dysregulation of aldosterone synthesis and lead to susceptibility to IHA.
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Affiliation(s)
- P Mulatero
- Department of Medicine and Experimental Oncology, Hypertension Unit, University of Torino, Torino, Italy.
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36
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Morineau G, Marc JM, Boudi A, Galons H, Gourmelen M, Corvol P, Pascoe L, Fiet J. Genetic, biochemical, and clinical studies of patients with A328V or R213C mutations in 11betaHSD2 causing apparent mineralocorticoid excess. Hypertension 1999; 34:435-41. [PMID: 10489390 DOI: 10.1161/01.hyp.34.3.435] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Apparent mineralocorticoid excess is a recessively inherited hypertensive syndrome caused by mutations in the 11beta-hydroxysteroid dehydrogenase type 2 gene, which encodes the enzyme normally responsible for converting cortisol to inactive cortisone. Failure to convert cortisol to cortisone in mineralocorticoid-sensitive tissues permits cortisol to bind to and activate mineralocorticoid receptors, causing hypervolemic hypertension. Typically, these patients have increased ratios of cortisol to cortisone and of 5alpha- to 5beta-cortisol metabolites in serum and urine. We have studied 3 patients in 2 families with severe, apparent mineralocorticoid excess and other family members in terms of their genetic, biochemical, and clinical parameters, as well as normal controls. Two brothers were homozygous for an A328V mutation and the third patient was homozygous for an R213C mutation in the 11beta-hydroxysteroid dehydrogenase type 2 gene; both mutations caused a marked reduction in the activity of the encoded enzymes in transfection assays. The steroid profiles of the 7 heterozygotes and 2 other family members studied were completely normal. The results of a novel assay used to distinguish 5alpha- and 5beta-tetrahydrometabolites suggest that 5beta-reductase activity is reduced or inhibited in apparent mineralocorticoid excess. In 1 patient undergoing renal dialysis for chronic renal insufficiency, direct control of salt and water balance completely corrected the hypertension, emphasizing the importance of mineralocorticoid action in this syndrome.
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Affiliation(s)
- G Morineau
- Biologie Hormonale, Hôpital Saint-Louis, Paris, France.
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37
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Cerame BI, Newfield RS, Pascoe L, Curnow KM, Nimkarn S, Roe TF, New MI, Wilson RC. Prenatal diagnosis and treatment of 11beta-hydroxylase deficiency congenital adrenal hyperplasia resulting in normal female genitalia. J Clin Endocrinol Metab 1999; 84:3129-34. [PMID: 10487675 DOI: 10.1210/jcem.84.9.5976] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Congenital adrenal hyperplasia (CAH) consists of autosomal recessive disorders of cortisol biosynthesis, which in the majority of cases result from 21-hydroxylase deficiency. Another enzymatic defect causing CAH is 11beta-hydroxylase deficiency. In both forms, the resulting excessive androgen secretion causes genital virilization of the female fetus. For over 10 yr female fetuses affected with 21-hydroxylase deficiency have been safely and successfully prenatally treated with dexamethasone. We report here the first successful prenatal treatment with dexamethasone of an affected female with 11beta-hydroxylase deficiency CAH. The family had two girls affected with 1beta-hydroxylase deficiency born with severe ambiguous genitalia who were both homozygous for the T318M mutation in the CYP11B1 gene, which codes for the 11beta-hydroxylase enzyme. In the third pregnancy in this family, the female fetus was treated in utero by administering dexamethasone to the mother, starting at 5 weeks gestation. The treatment was successful, as the newborn was not virilized and had normal female external genitalia. A second family with two affected sons was also studied in preparation for a future pregnancy. We report a novel 1-bp deletion in codon 394 (R394delta1) in the CYP11B1 gene in this family.
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Affiliation(s)
- B I Cerame
- Department of Pediatrics, Weill Medical College of Cornell University, New York, New York 10021, USA
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38
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Brand E, Kato N, Chatelain N, Krozowski ZS, Jeunemaitre X, Corvol P, Plouin PF, Cambien F, Pascoe L, Soubrier F. Structural analysis and evaluation of the 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) gene in human essential hypertension. J Hypertens 1998; 16:1627-33. [PMID: 9856363 DOI: 10.1097/00004872-199816110-00009] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM Mutations of the 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) gene cause the syndrome of apparent mineralocorticoid excess, a rare autosomal recessive form of hypertension. We therefore investigated the question of whether variants of the 11beta-HSD2 gene can contribute to genetic susceptibility to essential hypertension. SUBJECTS AND METHODS We performed a linkage study in 162 French hypertensive sibships using the affected sib-pair method on 347 sibling pairs and a polymorphic microsatellite marker that we identified in a 30 kb cosmid clone containing the 11beta-HSD2 gene. The coding sequence, introns 2-4 and 350 bp of the 5'-flanking region of the 11beta-HSD2 gene were screened for polymorphisms by polymerase chain reaction/single-strand conformation polymorphism, and a single polymorphism, Glu178/Glu (G534A), was identified in exon 3, which did not change the encoded amino acid sequence. A case-control study was conducted on 370 hypertensive subjects with a positive family history of hypertension and 783 French subjects with hypertension with or without a family history of hypertension, compared with 313 normotensive control subjects, all of whom were analyzed for the newly identified bi-allelic polymorphism. RESULTS Statistical analyses using the affected sib-pair method did not show significant linkage between the 11beta-HSD2 microsatellite marker and hypertension. Furthermore, no positive association with hypertension was found with the Glu178/Glu (G534A) polymorphism. CONCLUSION Our data do not suggest that variants of the 11beta-HSD2 gene contribute substantially to essential hypertension in Caucasians.
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Affiliation(s)
- E Brand
- INSERM U358, Hôpital Saint-Louis, Paris, France
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39
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Mulatero P, Curnow KM, Aupetit-Faisant B, Foekling M, Gomez-Sanchez C, Veglio F, Jeunemaitre X, Corvol P, Pascoe L. Recombinant CYP11B genes encode enzymes that can catalyze conversion of 11-deoxycortisol to cortisol, 18-hydroxycortisol, and 18-oxocortisol. J Clin Endocrinol Metab 1998; 83:3996-4001. [PMID: 9814482 DOI: 10.1210/jcem.83.11.5237] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CYP11B1 (11beta-hydroxylase) and CYP11B2 (aldosterone synthase) are 93% identical mitochondrial enzymes that both catalyze 11beta-hydroxylation of steroid hormones. CYP11B2 has the additional 18-hydroxylase and 18-oxidase activities required for conversion of 11-deoxycorticosterone to aldosterone. These two additional C18 conversions can be catalyzed by CYP11B1 if serine-288 and valine-320 are replaced by the corresponding CYP11B2 residues, glycine and alanine. Here we show that such a hybrid enzyme also catalyzes conversion of 11-deoxycortisol to cortisol, 18-hydroxycortisol, and 18-oxocortisol. These latter two steroids are present at elevated levels in individuals with glucocorticoid suppressible hyperaldosteronism (GSH) and some forms of primary aldosteronism. Their production by the recombinant CYP11B enzyme is enhanced by substitution of further amino acids encoded in exons 4, 5, and 6 of CYP11B2. A converted CYP11B1 gene, containing these exons from CYP11B2, would be regulated like CYP11B1, yet encode an enzyme with the activities of CYP11B2, thus causing GSH or essential hypertension. In a sample of 103 low renin hypertensive patients, 218 patients with primary aldosteronism, and 90 normotensive individuals, we found a high level of conversion of CYP11B genes and four cases of GSH caused by unequal crossing over but no gene conversions of the type expected to cause GSH.
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40
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Portrat-Doyen S, Tourniaire J, Richard O, Mulatero P, Aupetit-Faisant B, Curnow KM, Pascoe L, Morel Y. Isolated aldosterone synthase deficiency caused by simultaneous E198D and V386A mutations in the CYP11B2 gene. J Clin Endocrinol Metab 1998; 83:4156-61. [PMID: 9814506 DOI: 10.1210/jcem.83.11.5258] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Isolated deficiencies in aldosterone biosynthesis are caused by mutations in the CYP11B2 (aldosterone synthase) gene. Patients with this deficiency have impaired aldosterone synthesis, exhibit increased plasma renin activity, secrete increased amounts of the steroid precursors DOC, corticosterone, and 18OHDOC, and are subject to salt wasting and poor growth. Two forms are generally distinguished. The first, corticosterone methyloxidase type I (CMO I or type 1 deficiency), is characterized by no detectable aldosterone secretion, a low or normal secretion of the steroid 18OHB, and are always found to have mutations that completely inactivate the encoded CYP11B2 enzyme. The second form (CMO II or type 2 deficiency) may have low to normal levels of aldosterone, but at the expense of greatly increased secretion of its immediate precursor 18OHB. These patients usually have a CYP11B2 enzyme with some residual enzymatic activity, especially 11beta-hydroxylase activity. We have studied two twins with an isolated aldosterone synthase activity who have a clinical profile typical of the type 1 deficiency. Their CYP11B2 genes are homozygous for three sequence changes, R173K, E198D, and V386A. In transfection assays these substitutions individually have modest effects on the encoded enzyme, but when found together they result in an enzyme with a decreased 11beta-hydroxylase activity, a large decrease of 18-hydroxylase activity, and no detectable 18-oxidase activity. This residual activity is more typical of that observed in patients classified as having CMO II deficiency, rather than CMO I deficiency, where no activity is detectable. This disparity between the CYP11B2 enzyme with residual activity and a clinical phenotypic typical of the type 1 deficiency, suggests that phenotype genotype relationships are not yet fully understood.
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Affiliation(s)
- S Portrat-Doyen
- Laboratoire de Biochimie Endocrinienne, INSERM U329, Université de Lyon et Hôpital Debrousse, France
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41
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Brand E, Chatelain N, Mulatero P, Féry I, Curnow K, Jeunemaitre X, Corvol P, Pascoe L, Soubrier F. Structural analysis and evaluation of the aldosterone synthase gene in hypertension. Hypertension 1998; 32:198-204. [PMID: 9719043 DOI: 10.1161/01.hyp.32.2.198] [Citation(s) in RCA: 146] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Anomalies in either of the tightly linked genes encoding the enzymes CYP11B1 (11beta-hydroxylase) or CYP11B2 (aldosterone synthase) can lead to important changes in arterial pressure and are responsible for several monogenically inherited forms of hypertension. Mutations in these genes or their regulatory regions could thus contribute to genetic variation in susceptibility to essential hypertension. To test this hypothesis, we performed 2 complementary studies of the CYP11B1/CYP11B2 locus in essential hypertension. After characterizing a DNA contig containing the CYP11B1 gene and mapping the gene in the Centre d'Etudes du Polymorphisme Humain reference panel of families, we performed a linkage study with 292 hypertensive sibling pairs and a highly informative microsatellite marker near CYP11B1. We also analyzed the association of 2 frequent biallelic polymorphisms of the CYP11B2 gene, 1 in the promoter at position -344 (-344C/T) and the other, a common gene conversion in intron 2, with hypertension in 380 hypertensive patients and 293 normotensive individuals. Statistical analyses did not show significant linkage of the CYP11B1 microsatellite marker to hypertension. No positive association with hypertension was found with the gene conversion in intron 2, but a positive association with hypertension was found with the -344T allele. The hypertensive and normotensive samples differed significantly in both genotype (P=0.023) and allele frequencies (P=0.010). Our data suggest a modest contribution of the CYP11B2 gene to essential hypertension.
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Affiliation(s)
- E Brand
- INSERM U358, Hôpital Saint-Louis, Paris, France
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42
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Morineau G, Pascoe L, Marc JM, Caillette A, Krozowski Z, Corvol P, Fiet J. [A case of apparent mineralocorticoid excess caused by type 2 11 beta- hydroxysteroid dehydrogenase deficiency]. Arch Mal Coeur Vaiss 1997; 90:1111-5. [PMID: 9404418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The syndrome of apparent mineralocorticoid excess is a recessively inherited form of low renin hypertension. The syndrome is characterised by sodium retention and hypervolemia despite low plasma renin activity and aldosterone levels. Patients with this syndrome have mutations in the 11HSD2 gene which encodes the enzyme which normally converts cortisol in the renal tubule to its inactive form, cortisone. The unconverted cortisol is thus able to bind and activate the mineralocorticoid receptor, displacing its usual ligand, aldosterone, causing the apparent mineralocorticoid excess. We have studied a patient with severe hypertension, low renin and aldosterone, and a chronic hypokalemic alkalosis at age 4. The analysis of cortisone, cortisol and their metabolites showed the specific pattern of the apparent mineralocorticoid excess. In serum and urine, there was a dramatic decrease of cortisone and its metabolite, while cortisol and its metabolites were non affected.
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Affiliation(s)
- G Morineau
- Laboratoire de biologie hormonale, hôpital St-Louis, Parix
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43
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Curnow KM, Mulatero P, Emeric-Blanchouin N, Aupetit-Faisant B, Corvol P, Pascoe L. The amino acid substitutions Ser288Gly and Val320Ala convert the cortisol producing enzyme, CYP11B1, into an aldosterone producing enzyme. Nat Struct Biol 1997; 4:32-5. [PMID: 8989319 DOI: 10.1038/nsb0197-32] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Transfection studies with cDNAs encoding hybrids between the highly similar cytochrome P450 enzymes, CYP11B1 (steroid 11 beta-hydroxylase) and CYP11B2 (aldosterone synthase) have identified which amino acids determine the different activities of the enzymes.
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44
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Pascoe L, Jeunemaitre X, Lebrethon MC, Curnow KM, Gomez-Sanchez CE, Gasc JM, Saez JM, Corvol P. Glucocorticoid-suppressible hyperaldosteronism and adrenal tumors occurring in a single French pedigree. J Clin Invest 1995; 96:2236-46. [PMID: 7593610 PMCID: PMC185874 DOI: 10.1172/jci118279] [Citation(s) in RCA: 105] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Glucocorticoid-suppressible hyperaldosteronism is a dominantly inherited form of hypertension believed to be caused by the presence of a hybrid CYP11B1/CYP11B2 gene which has arisen from an unequal crossing over between the two CYP11B genes in a previous meiosis. We have studied a French pedigree with seven affected individuals in which two affected individuals also have adrenal tumors and two others have micronodular adrenal hyperplasia. One of the adrenal tumors and the surrounding adrenal tissue has been removed, giving a rare opportunity to study the regulation and action of the hybrid gene causing the disease. The hybrid CYP11B gene was demonstrated to be expressed at higher levels than either CYP11B1 or CYP11B2 in the cortex of the adrenal by RT-PCR and Northern blot analysis. In situ hybridization showed that both CYP11B1 and the hybrid gene were expressed in all three zones of the cortex. In cell culture experiments hybrid gene expression was stimulated by ACTH leading to increased production of aldosterone and the hybrid steroids characteristic of glucocorticoid-suppressible hyperaldosteronism. The genetic basis of the adrenal pathologies in this family is not known but may be related to the duplication causing the hyperaldosteronism.
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Affiliation(s)
- L Pascoe
- INSERM U36, Collège de France, Paris, France
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Jeunemaitre X, Charru A, Pascoe L, Guyene TT, Aupetit-Faisant B, Shackleton CH, Schambelan M, Plouin PF, Corvol P. [Hyperaldosteronism sensitive to dexamethasone with adrenal adenoma. Clinical, biological and genetic study]. Presse Med 1995; 24:1243-8. [PMID: 7501605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Dexamethasone-sensitive hyperaldosteronism is associated with early onset hypertension and primary hyperaldosteronism. Diagnosis is difficult but can be improved by genetic testing for the mutant gene. METHODS We collected the clinical, biological and genetic elements observed in a family with dexamethasone-sensible hyperaldosteronism. Complete data were obtained in 5 adult subjects with the disease. Degree of hypertension varied, more so in the second generations as did hypokaliaemia and hyperaldosteronism. In affected patients, there was a 10 to 50 fold increase in urinary 18-OH components and 18 oxocortisol. RESULTS Single dose (1.5 mg) dexamethasone led to a greater than 80% drop in aldosterone levels in the blood and urine, confirming the abnormal effect of ACTH on mineralocorticoid secretion. At the dose of 1 mg/d for 10 weeks, dexamethasone lowered mean 24-H ambulatory arterial pressure (11.8/9.6 mmHg) and corrected for the hypokaliaemia (+0.54 mmol/l) and the hyperaldosteronism (mean decrease -36% and -75% in blood and urine respectively). An adrenal tumour was identified in hyperplasic glands in two subjects and a micronodular formation was identified in two others. The specific molecular diagnosis of the disease was done with Southern blotting. Among the 18 families in 3 generations, 8 carried a 11 beta OHase-aldosterone synthetase chimeric gene. This mutation cosegregates with hormonal abnormalities and confirms the autosomal dominant inheritance of the disease. CONCLUSION The simplicity and rapidity of genetic testing allows early diagnosis of this disease among families with early onset hypertension and associated hyperaldosteronism with or without adrenal hyperplasia and/or a tumoral formation.
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Affiliation(s)
- X Jeunemaitre
- Laboratoire de Génétique moléculaire, Hôpital Broussais, Paris
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Curnow KM, Pascoe L, Davies E, White PC, Corvol P, Clauser E. Alternatively spliced human type 1 angiotensin II receptor mRNAs are translated at different efficiencies and encode two receptor isoforms. Mol Endocrinol 1995; 9:1250-62. [PMID: 7491117 DOI: 10.1210/mend.9.9.7491117] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The peptide hormone angiotensin II (AngII) plays a principal role in regulating blood pressure and fluid homeostasis. Most of its known effects are mediated by a guanine nucleotide-regulatory protein (G protein)-coupled receptor pharmacologically defined as the type-1 AngII receptor or AT1. Characterization of cDNA and genomic clones shows that the human AT1 gene contains five exons and encodes two receptor isoforms as a result of alternative splicing. Exon 5 contains the previously characterized open reading frame for AT1, and exons 1 to 3 are alternatively spliced upstream of it to generate several mRNA species, while transcripts containing exon 4 are of minor abundance. In an in vitro translation system, the presence of exon 1 was found to be extremely inhibitory to translation, probably because it can form a stable secondary structure at the RNA level. The alternatively spliced second exon also had a strong inhibitory effect on translation, presumably because it contains a minicistron commencing with an ATG in an optimal context for translation initiation. Exon 2 was similarly inhibitory to protein production in transfected cells, but exon 1 was found to enhance protein synthesis in this system. Transcripts containing exon 3 and 5, which comprise up to one-third of AT1 mRNAs in all tissues examined, encode a receptor with an amino-terminal extension of 32-35 amino acids. These transcripts were translated into a larger receptor isoform in vitro and produced a functional receptor with normal ligand binding and signaling properties in transfected cells.
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Affiliation(s)
- K M Curnow
- Institute National de la Santé et de la Recherche Médicale U36, Chaire de Médicine Expérimentale Collège de France, Paris
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Pascoe L. The biochemical phenotypes of two inborn errors in the biosynthesis of aldosterone. J Endocrinol Invest 1995; 18:571-5. [PMID: 9221276 DOI: 10.1007/bf03349769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- L Pascoe
- College de France, INSERM, Paris, France
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Abstract
The rate of decline in reproductive fitness in populations of Drosophila melanogaster inbred at an initial rate of approximately 1% per generation has been investigated under both competitive and noncompetitive conditions. Breeding population size was variable in the inbred lines with an estimated harmonic mean of 66.7 +/- 2.2. Of the 60 lines maintained without reserves, 75% survived a period of 210 generations of slow inbreeding and were then rapidly inbred by full-sib mating to near-homozygosity. The initial rate of inbreeding was estimated to be 0.96 +/- 0.16% per generation, corresponding to an effective population size of approximately 50. However, the rate of inbreeding declined significantly with time to average only 0.52 +/- 0.08% per generation over the 210 generation period, most likely due to associative overdominance built up by genetic sampling and selection in the small populations. The total inbreeding depression in fitness was estimated to be 87 +/- 3% for competitive ability and 27 +/- 5% for fitness under uncrowded conditions, corresponding to rates of decline of 2.0 +/- 0.3 and 0.32 +/- 0.07%, respectively, per 1% increase in the inbreeding coefficient. The frequency of lethal second chromosomes in the resultant near-homozygous lines was of the order of 5%, lethal free second chromosomes showed a mean viability under both crowded and uncrowded conditions of approximately 95%, and their population cage fitness was 60% that of Cy/+ heterozygotes. It can be concluded that homozygous genotypes from which deleterious genes of major effect have been eliminated during slow inbreeding may show far less depression in reproductive fitness than suggested by earlier studies of wild chromosome homozygotes. The loss in fitness due to homozygosity throughout the entire genome may be as little as 85-90% under competitive conditions, and 25-30% in an optimal environment.
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Affiliation(s)
- B D Latter
- School of Biological Sciences, Faculty of Agriculture, University of Sydney, Australia
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Pascoe L, Curnow KM. Genetic recombination as a cause of inherited disorders of aldosterone and cortisol biosynthesis and a contributor to genetic variation in blood pressure. Steroids 1995; 60:22-7. [PMID: 7792811 DOI: 10.1016/0039-128x(94)00003-u] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
CYP11B1 (11 beta-hydroxylase) and CYP11B2 (aldosterone synthase) are steroidogenic enzymes which mediate the final step (11 beta-hydroxylation) in cortisol synthesis and the final three steps (11 beta-hydroxylation, 18-hydroxylation, and 18-oxidation) in aldosterone synthesis, respectively. The enzymes share 93% identity in amino acid sequence and are encoded by two structurally similar genes which are located in tandem on chromosome 8q22, approximately 40 kb apart. Expression of the aldosterone synthase gene (CYP11B2) is limited to the zona glomerulosa of the adrenal cortex, thereby limiting the synthesis of aldosterone to that zone, where it is principally regulated by plasma levels of angiotensin II and potassium. The 11 beta-hydroxylase gene (CYP11B1) is expressed in the zona fasciculata, the zone which also expresses a 17-hydroxylase activity, where it mediates cortisol synthesis under the control of ACTH. Genetic recombination involving a mispairing of the two CYP11B genes can lead to duplications and deletions of the genes, creation of hybrid genes of several forms, or transfer of coding and regulatory sequences from one gene to the other. Since the two genes have related but different activities, are normally expressed in different zones, and respond to different physiological signals, such recombination has the potential to generate a variety of inherited disorders of steroid production. In this paper we review the range of mutations which can occur and the resulting disorders of steroid biosynthesis, and suggest some novel mutations which might be sought in variants of these endocrinological syndromes.
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Affiliation(s)
- L Pascoe
- INSERM U36, Collège de France, Paris
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Abstract
The most active corticosteroids are 11 beta-hydroxylated. Humans have two isozymes with 11 beta-hydroxylase activity that are respectively required for cortisol and aldosterone synthesis. CYP11B1 (11 beta-hydroxylase) is expressed at high levels and is regulated by ACTH, whereas CYP11B2 (aldosterone synthase) is normally expressed at low levels and is regulated by angiotensin II. In addition to 11 beta-hydroxylase activity, the latter enzyme has 18-hydroxylase and 18-oxidase activities and thus can synthesize aldosterone from deoxycorticosterone. Insights into the normal functioning of these enzymes are gained from studies of disorders involving them. Mutations in the CYP11B1 gene cause steroid 11 beta-hydroxylase deficiency, a form of congenital adrenal hyperplasia characterized by signs of androgen excess and by hypertension. Mutations in CYP11B2 result in aldosterone synthase (corticosterone methyloxidase) deficiency, an isolated defect in aldosterone biosynthesis that can cause hyponatremia, hyperkalemia, and hypovolemic shock in infancy and failure to thrive in childhood. These are both recessive disorders. Unequal crossing over between the CYP11B genes can generate a duplicated chimeric gene with the transcriptional regulatory region of CYP11B1 but sufficient coding sequences from CYP11B2 so that the encoded enzyme has aldosterone synthase (i.e. 18-oxidase) activity. This results in aldosterone biosynthesis being regulated by ACTH, a condition termed glucocorticoid-suppressible hyperaldosteronism. This form of genetic hypertension is inherited in an autosomal dominant manner.
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Affiliation(s)
- P C White
- Department of Pediatrics, Cornell University Medical College, New York, New York 10021
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