The Autism Constellation and Neurodiversity: Long-Term and Adult Outcomes in Autism Spectrum Disorder

Research on autistic adults suggests significant heterogeneity in outcomes. A significant proportion of individuals struggle with intellectual disability and limited communication skills. Of the 67% who have age-appropriate cognitive skills, around half are expected to attain a college education, and 25% are likely to hold a full-time job. Outcomes have been improving over time, in part because of earlier diagnosis and earlier intervention. Indeed, an estimated 10% to 20% are expected to lose all symptoms of autism by adolescence.

Maternal e-cigarette use can disrupt postnatal blood-brain barrier (BBB) integrity and deteriorates motor, learning and memory function: influence of sex and age

Electronic nicotine delivery systems (ENDS), also commonly known as electronic cigarettes (e-cigs) are considered in most cases as a safer alternative to tobacco smoking and therefore have become extremely popular among all age groups and sex. It is estimated that up to 15% of pregnant women are now using e-cigs in the US which keeps increasing at an alarming rate. Harmful effects of tobacco smoking during pregnancy are well documented for both pregnancy and postnatal health, however limited preclinical and clinical studies exist to evaluate the long-term effects of prenatal e-cig exposure on postnatal health. Therefore, the aim of our study is to evaluate the effect of maternal e-cig use on postnatal blood-brain barrier (BBB) integrity and behavioral outcomes of mice of varying age and sex. In this study, pregnant CD1 mice (E5) were exposed to e-Cig vapor (2.4% nicotine) until postnatal day (PD) 7. Weight of the offspring was measured at PD0, PD7, PD15, PD30, PD45, PD60 and PD90. The expression of structural elements of the BBB, tight junction proteins (ZO-1, claudin-5, occludin), astrocytes (GFAP), pericytes (PDGFRβ) and the basement membrane (laminin α1, laminin α4), neuron specific marker (NeuN), water channel protein (AQP4) and glucose transporter (GLUT1) were analyzed in both male and female offspring using western blot and immunofluorescence. Estrous cycle was recorded by vaginal cytology method. Long-term motor and cognitive functions were evaluated using open field test (OFT), novel object recognition test (NORT) and morris water maze test (MWMT) at adolescence (PD 40-45) and adult (PD 90-95) age. In our study, significantly reduced expression of tight junction proteins and astrocyte marker were observed in male and female offspring until PD 90 (P < 0.05). Additionally, prenatally e-cig exposed adolescent and adult offspring showed impaired locomotor, learning, and memory function compared to control offspring (P < 0.05). Our findings suggest that prenatal e-cig exposure induces long-term neurovascular changes of neonates by disrupting postnatal BBB integrity and worsening behavioral outcomes.

Preclinical animal models of mental illnesses to translate findings from the bench to the bedside: Molecular brain mechanisms and peripheral biomarkers associated to early life stress or immune challenges

Animal models are useful preclinical tools for studying the pathogenesis of mental disorders and the effectiveness of their treatment. While it is not possible to mimic all symptoms occurring in humans, it is however possible to investigate the behavioral, physiological and neuroanatomical alterations relevant for these complex disorders in controlled conditions and in genetically homogeneous populations. Stressful and infection-related exposures represent the most employed environmental risk factors able to trigger or to unmask a psychopathological phenotype in animals. Indeed, when occurring during sensitive periods of brain maturation, including pre, postnatal life and adolescence, they can affect the offspring's neurodevelopmental trajectories, increasing the risk for mental disorders. Not all stressed or immune challenged animals, however, develop behavioral alterations and preclinical animal models can explain differences between vulnerable or resilient phenotypes. Our review focuses on different paradigms of stress (prenatal stress, maternal separation, social isolation and social defeat stress) and immune challenges (immune activation in pregnancy) and investigates the subsequent alterations in several biological and behavioral domains at different time points of animals' life. It also discusses the "double-hit" hypothesis where an initial early adverse event can prime the response to a second negative challenge. Interestingly, stress and infections early in life induce the activation of the hypothalamic-pituitary-adrenal (HPA) axis, alter the levels of neurotransmitters, neurotrophins and pro-inflammatory cytokines and affect the functions of microglia and oxidative stress. In conclusion, animal models allow shedding light on the pathophysiology of human mental illnesses and discovering novel molecular drug targets for personalized treatments.

Trajectories of prenatal alcohol exposure and behavioral outcomes: Findings from a community-based sample

OBJECTIVE

To characterize patterns of prenatal alcohol exposure (PAE), and determine whether PAE trajectories were associated with behavior from a community-based sample of first-grade children.

METHODS

Using data collected as part of the Collaboration of Fetal Alcohol Spectrum Disorders Prevalence study (n = 1663), we performed longitudinal cluster analysis on prenatal alcohol use reported for four time points around conception and pregnancy. From the sample, 638 respondents reported any alcohol use in pregnancy and were included in trajectories for average daily and maximum drinks per drinking day (max DDD). We then estimated the association with behavioral problems measured by the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF) with multivariable linear regression. The reference group had 1025 children with no reported PAE.

RESULTS

Five trajectories were selected to describe max DDD patterns: very low/discontinuing (n = 186), low/discontinuing (n = 111), very low/continuing (n = 47), med/high (n = 245), and high (n = 49). Six trajectories best described average daily alcohol use: very low/discontinuing (n = 378), very low/continuing (n = 98), low/continuing (n = 56), low/discontinuing (n = 37), medium/high (n = 35), and high (n = 31). When assessing max DDD trajectories for both the CBCL and TRF, individuals with PAE in the two highest trajectories and the very low/continuing trajectory had more behavioral problems relative to children with no PAE, although confidence intervals for most estimates included the null. PAE modeled as average drinks per day did not predict behavior in any consistent pattern.

CONCLUSIONS

In this community-based sample, select PAE trajectories were associated with behavior, even at relatively low levels of PAE that continued later in gestation.

Toward controlling of a pandemic: How self-control ability influences willingness to take the COVID-19 vaccine

What influences people's vaccine attitudes and intentions in the combat against the COVID-19 pandemic? Extending beyond health factors, the present research examines whether non-health-specific factors—such as one's self-control ability—influence individual attitudes toward vaccination. Drawing on the social psychology literature, we propose that self-control, which is often associated with adherence to social norms and with engagement in socially desirable behaviors, can lead to more favorable attitudes toward vaccines. Study 1 provided correlational evidence for our theoretical perspective that students scoring high on trait self-control expressed less vaccine hesitancy than students scoring low on self-control. Employing a more representative population, Study 2 examined the relationship with behaviors. It was found that non-student adults with higher self-control strength levels were more likely to accept vaccine appointments opportunities than those with lower self-control strength levels. Using an experimental design, Study 3 found that participants exerting a high level of effort for attentional self-control in the incongruent Stroop task condition showed lower COVID-19 vaccine acceptance than participants in the congruent condition. In sum, our research provides the first experimental evidence that high self-control can have a reliable impact on individual perceptions of vaccination.

The association between early reports to Child Protective Services and developmental trajectories through middle childhood

BACKGROUND

Longitudinal studies on resilience among children who have experienced maltreatment indicate that resilience is multi-dimensional. However, most research consolidates diverse developmental domains comprising resilience into a single score, which does not allow for detection of potentially heterogeneous associations between risk factors and outcomes of resilience processes.

OBJECTIVE

This study seeks to improve our understanding of the association between early child maltreatment and development through middle childhood (6-12 years) using individual domains considered to be outcomes of resilience processes.

PARTICIPANTS AND SETTING

Participants are 499 children from the Longitudinal Studies of Child Abuse and Neglect.

METHODS

We used latent growth curve models to explore patterns of socialization and daily living skills, and internalizing and externalizing behaviors - outcomes of resilience processes - across three time points in middle childhood, and their association with early maltreatment, defined as referral to Child Protective Services (CPS) before age 6.

RESULTS

In fully adjusted models, children experiencing early maltreatment had poorer baseline scores in activities of daily living (-4.22, 95% CI [-7.38, -1.46]) and externalizing behavior (2.95, 95% CI [1.05, 4.86]), but maltreatment was not associated with change over time in these domains. However, maltreatment was associated with increases in internalizing behavior over time (0.42, 95% CI [0.06, 0.77]).

CONCLUSION

Heterogeneity in patterns of association between maltreatment and outcomes of resilience processes support the utility of examining developmental domains individually, versus as a composite, to identify specific targets for intervention.

Latent effects of early-life methylmercury exposure on motor function in Drosophila

The developmental toxicant, methylmercury (MeHg), can elicit motor deficits that last well into adulthood. Recent studies using Drosophila showed that the developing musculature is sensitive to high doses of MeHg, where a larval feeding paradigm resulted in compromised myotendinous junction (MTJ) formation during development, by a mechanism involving the NG2 homologue, kon-tiki (kon). Low-dose exposures to MeHg that do not produce muscle pathology during development, nevertheless result in impaired flight behavior later in adult life. The present study evaluated the potential for relatively low-dose exposure to produce latent adult muscle pathology and motor impairments, as assayed by climbing and flight, as well as to evaluate molecular mechanisms that may contribute to motor deficits. Wildtype larvae were fed 0, 2, 2.5, or 5 μM MeHg laden food until eclosion. The effect of 5 μM MeHg on MTJ-related gene expression during pupal development was assessed via quantitative RT-qPCR analysis. Upon eclosion, adults were transferred to standard food bottles for 4, 11, or 30 days prior to motor testing. Survivorship (%) was determined from a subset of 200 flies per treatment. Average climbing speed (cm/s) was quantified 4-days post-eclosion (PE). Flight ability was assayed 11- or 30-days PE by measuring landing height (cm) of flies dropped into an adhesive-lined vertical column. In parallel, total body mercury was measured to estimate the influence of residual MeHg at the time of motor testing. Muscle morphology was assessed using immuno-fluorescence microscopy. Exposure to 5uM MeHg significantly reduced climbing speed, and flight ability 4 and 11 - days PE, respectively. While age-related flight deficits were seen in each sex, flight deficits due to MeHg persisted to 30-day PE timepoints exclusively in males. Expression of kon was upregulated across the window of pupal development essential to establishing adult MTJ. However, experimentally restricting the induction of comparable levels of kon to muscle during the same periods did not recapitulate the flight deficits, indicating that muscle-specific induction of kon alone is not sufficient to contribute to latent flight impairments. Adult flight muscle morphology of 11-day PE flies treated with 5 μM MeHg was indistinct from controls, implying muscle structure is not grossly perturbed to impair flight. Collectively, the current data suggest that developmental exposure to 5 μM MeHg reduces flight ability in each sex at 11 day-PE and that latent deficits at 30-day PE are male-specific. It remains to be determined whether the developing MTJ of Drosophila is a sensitive target of MeHg, and whether or not kon acts in conjunction with additional MTJ factors to constitute a MeHg target.

A Systematic Review and Meta-analysis of Relationships Between Religiosity and Employees Constructive and Destructive Behaviors

There is substantial literature on the relationship of religiosity with constructive and destructive behaviors, and it is about time to consolidate the knowledge through a systematic review and meta-analysis among organizational members. For this, meta-analysis studies published between 2000 and 2018 were included with a total sample of 3714. Results show a weak and significant association between religiosity and employee' behavioral outcomes (ř = 0.07). Moreover, a relatively stronger relationship is reported with employees' constructive behavioral outcome (ř = 0.12). In contrast, a negative and insignificant relationship is reported with employees' destructive behavioral outcome (ř = - 0.03, LL = - 0.08 and UL = 0.02). Study limitation and direction for future research has been presented for this investigation.

Developmental and behavioral outcomes of preschool-aged children with biotinidase deficiency identified by newborn screening

Biotinidase deficiency (BD) may cause neurological symptoms and developmental problems. However, newborn screening of BD and early biotin treatment prevent the manifestation of the majority of symptoms. This study intended to examine the developmental and behavioral outcomes as well as maternal anxiety and depressive symptoms of preschool-aged children with BD and to compare these with the outcomes of healthy preschool-aged children. In total, 49 children with BD and 23 healthy children are included. All children were screened for developmental and behavioral problems. Moreover anxiety and depressive symptomatology of their mothers were evaluated. Despite the high percentage of developmental delay in BD group, the numbers of children screened positive for a developmental delay were statistically similar in children with BD and healthy children. Among patients with BD, children with risk of developmental delay had more unfavorable socio-demographic features compared to typically developing ones. Behavioral problem scores, maternal anxiety, and depressive symptoms scores of children with BD were not higher than the healthy children.Conclusion: Children with BD were not different from their healthy peers in terms of developmental and behavioral outcomes. Developmental problems of children with BD may be related to the unfavorable socio-demographic features, not the BD itself. What is known: • Biotinidase deficiency (BD) may result in neurological symptoms and developmental problems. • Newborn screening and early biotin supplementation prevent the manifestation of the majority of symptoms. What is new: • Preschool-aged children with BD identified by newborn screening are not different from their healthy peers in terms of developmental and behavioral outcomes. • Maternal anxiety and depressive symptoms scores of children with BD are similar to scores of healthy children.

Association between postnatal second-hand smoke exposure and ADHD in children: a systematic review and meta-analysis

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which is caused by the interplay of genetic and environmental risk factors such as second-hand smoke (SHS). The association between postnatal exposure to SHS and ADHD risk in children was still inconclusive. We performed a systematic review and meta-analysis to explore the definite association. We searched for relevant studies from PubMed, Embase, Ovid, and Web of Science databases up to January 2020. We used random effect models to calculate pooled odds ratio (OR) with 95% confidence interval (CI). Subgroup analyses and sensitive analyses were also performed to solve the heterogeneity. According to our inclusion criteria, 9 studies including 6 cross-sectional studies, 2 cohort studies, and 1 case-control study were included in the final analysis. Postnatal exposure to SHS increased the risk of ADHD in children (OR: 1.60; 95% CI: 1.37-1.87). Children who exposed to SHS were found a slight risk for conduct problems (OR: 1.33, 95% CI: 1.00-1.77). Among the studies which used cotinine as a biomarker for SHS exposure, a lower pooled OR (OR = 1.16, 95%CI = 1.01, 1.33) was observed between cotinine and ADHD in children. Our meta-analysis results suggested that SHS exposure may be a risk factor for ADHD. We also found that SHS exposure may be associated with some adverse behavioral outcomes. More prospective studies should be conducted to confirm the relationship between SHS exposure and ADHD in children.

One Roof, Three Generations: Grandparental Co-residence and Child Outcomes in China

This study examined the association between grandparental co-residence and child academic and behavioral outcomes using a sample from Shanghai, China (n = 1,763), and was built on two theoretical perspectives: intergenerational solidarity theory and the contextual model of family stress. These models integrate the impact of residential and relational proximity to grandparents on child well-being and underscore the importance of family context. This study also explored the moderating effects of family resources using proxies that prior theoretical and empirical studies have found to be important to such associations: family income, parental education, hukou status, and subjective social status. Results indicated that among families without co-residing grandparents, rural and low-income parents reported their children to have more externalizing behavioral issues than their respective urban and non-low-income counterparts. In addition, children who resided in poorly resourced families (i.e., low family income, low parental education, low subjective social status, or rural hukou status) tended to benefit from living with grandparents compared to their well-resourced counterparts in terms of lower externalizing and internalizing behaviors reported by teachers. These results do not negate the potential beneficial effects of living with grandparents for children in well-resourced environments. Implications for practice and policy, as well as future research directions, are discussed.

Optimistic bias and preventive behavioral engagement in the context of COVID-19

Background

The coronavirus (COVID-19) pandemic presents a global crisis. To remain safe, individuals must take preventive measures. Health behavior theories suggest that perceived risk is a key determinant of engagement in preventive behavior. People often underestimate their risk for disease compared with similar others’, a phenomenon known as optimistic bias (OB).

Objective

This study aimed to explore how OB affected individuals' engagement in COVID-19 preventive behavior/intentions. Based on health behavior theories, this study considered risk perception and risk response as mediators of the relationship between OB and individuals’ preventive health behaviors and intentions.

Methods

This study used a cross-sectional survey design. Online survey platforms were used to recruit U.S. adults. A total of 293 valid responses were included in the analyses. Multivariate regression analyses were conducted to determine the relationship of OB to the respondents’ health information seeking intention and related behavioral outcomes.

Results

Results from the first regression model showed that OB was negatively related to risk perception. In other words, optimistically biased respondents perceived their risk of COVID-19 to be low. The second model demonstrated that perceived risk was related positively to affective responses to risk (e.g., worry and fear). That is, the lower their perceived risk of COVID-19, the less likely respondents were to feel anxiety and fear about this disease. Models 3 and 4 revealed positive relationships between risk response and respondents’ intentions and behaviors. Finally, the results supported a fully mediated pathway: OB → risk perception → risk response → information seeking intention and behavioral outcomes.

Conclusions

The study findings suggest that by decreasing their perceived risk and subsequent responses, optimistic bias can undermine individuals’ motivation to take precautions. To reduce this bias, the actual risk of COVID-19 should be reinforced.

Development and reliability of a quantitative personal hygiene assessment tool

Personal hygiene practices, including facewashing and handwashing, reduce transmission of pathogens, but are difficult to measure. Using color theory principles, we developed and tested a novel metric that generates quantitative measures of facial and hand cleanliness, proxy indicators of personal hygiene practices. In this cross-sectional study, conventional qualitative cleanliness metrics (e.g., presence or absence of nasal and ocular discharge, dirt under nails or on finger pads and palms) were also recorded. We generated Gwet’s agreement coefficients to determine the inter-rater reliability of novel and conventional metrics between various rating groups, where appropriate, including two non-blinded raters, non-blinded vs. blinded raters, three blinded raters, and blinded vs. computer raters. Inter-rater reliability of the novel metric was high across all rating groups, ranging from 0.98 (95% CI: 0.97, 0.99) to 0.90 (95% CI: 0.90, 0.91) for facial cleanliness, and 0.97 (95% CI: 0.96, 0.98) to 0.92 (95% CI: 0.91, 0.93) for hand cleanliness. Our novel metric generates more nuanced data than conventional qualitative metrics, and allows for quantifiable assessments of facial and hand cleanliness.

The nature and nurture of ADHD and its comorbidities: A narrative review on twin studies

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children worldwide, and also the recognition of its persistence into adulthood is increasing. While ADHD in childhood is highly heritable and mostly driven by familial factors, during adulthood it appears to show a lower heritability, even if there is not total agreement on this yet. This disorder often co-occurs with many other conditions, which also vary across the different stages of development, and several studies have used the twin design to investigate these comorbidities, giving valuable insights into the origins of the observed co-occurrence. This review aims to summarize the main results of twin research, according to the following domains: individual traits, cognitive impairment, behavioral manifestations, clinical conditions and psychosocial risk factors. Individual features seem to play a role in this symptomatology and include personality traits such as negative emotionality, personality disorders and temperamental dimensions with a predominance of novelty seeking. At a lower level, ADHD is associated with both functional and anatomic brain characteristics. ADHD is also associated with some forms of cognitive impairment, such as sluggish cognitive tempo, and learning disabilities, with a specific predisposition to reading disability. In addition, ADHD is strongly associated with externalizing disorders such as conduct disorder and oppositional defiant disorder, and some behavioral outcomes, particularly substance use and abuse both in adolescence and adulthood. Moreover, ADHD symptoms often overlap with other psychological disorders, namely affective and internalizing disorders, as well as autism spectrum disorder and autistic-like traits in a wider sense. Notably, a genetic overlap has been found between asthma and ADHD, particularly with respect to hyperactivity/impulsivity dimensions. ADHD also appears to represent a risk factor for disordered eating, and, more specifically, for binge eating and bulimia nervosa. Finally, among psychosocial factors, an association has been proposed between childhood maltreatment and ADHD symptoms.

Two-hit model of postintensive care syndrome induced by lipopolysaccharide challenge and subsequent chronic unpredictable stress in mice

Postintensive care syndrome (PICS) is defined as a new or worsening impairment in cognition, mental health, and physical function after critical illness. However, there is still a lack of a clinically relevant animal model. Thus, development of a PICS model is essential for understanding the mechanism underlying PICS and screening treatment methods for this neuropsychiatric disorder. The purpose of this study was to establish a clinically relevant PICS model based on the two-hit concept, in which lipopolysaccharide (LPS, 3 mg/kg) injection was served as the first hit and subsequent modified chronic unpredictable stress as the second hit. In order to pharmacologically verify the proposed model of PICS, we studied the effectiveness of fluoxetine to reverse the behavioral and molecular abnormalities in this model. In the present study, body- and adrenal weight changes proved our model was effective, as reflected by body weight loss, increased adrenals weight, and a significantly increased level of plasma corticosterone. Moreover, our PICS model displayed reproducible anxiety- and depression like behavior and cognitive impairments. Neurobiological investigations revealed a significant up-regulation of the microglial marker CD68 and pro-inflammatory cytokine IL-6 in the hippocampus of stressed mice. Notably, chronic treatment with fluoxetine for three weeks reversed most of the affected parameters. In summary, we believe that we have developed a new model of PICS that is clinically relevant, which could advance the mechanism research and the development of therapeutic strategies.

Psychosocial and behavioral impact of breast cancer risk assessed by testing for common risk variants: protocol of a prospective study

Background

The ‘common variant, common disease’ model predicts that a significant component of hereditary breast cancer unexplained by pathogenic variants in moderate or high-penetrance genes is due to the cumulative effect of common risk variants in DNA (polygenic risk). Assessing a woman’s breast cancer risk by testing for common risk variants can provide useful information for women who would otherwise receive uninformative results by traditional monogenic testing. Despite increasing support for the utility of common risk variants in hereditary breast cancer, research findings have not yet been integrated into clinical practice. Translational research is therefore critical to ensure results are effectively communicated, and that women do not experience undue adverse psychological outcomes.

Methods

In this prospective study, 400 women with a personal and/or high risk family history of breast cancer will be recruited from six familial cancer centers (FCCs) in Australia. Eligible women will be invited to attend a FCC and receive their personal polygenic risk result for breast cancer. Genetic health professionals participating in the study will receive training on the return of polygenic risk information and a training manual and visual aids will be developed to facilitate patient communication. Participants will complete up to three self-administered questionnaires over a 12-months period to assess the short-and long-term psychological and behavioral outcomes of receiving or not receiving their personal polygenic risk result.

Discussion

This is the world’s first study to assess the psychological and behavioral impact of offering polygenic risk information to women from families at high risk of breast cancer. Findings from this research will provide the basis for the development of a new service model to provide polygenic risk information in familial cancer clinics.

Trial registration

The study was retrospectively registered on 27th April 2017 with the Australian and New Zealand Clinical Trials Group (Registration no: ACTRN12617000594325; clinical trial URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372743).

Electronic supplementary material

The online version of this article (doi:10.1186/s12885-017-3485-0) contains supplementary material, which is available to authorized users.

A longitudinal study of emotional adjustment, quality of life and adaptive function in attenuated MPS II

OBJECTIVES

The behavioral, adaptive and quality of life characteristics of attenuated mucopolysaccharidosis type II (MPS II) have not been well studied. Understanding changes over time in the attenuated phenotype may assist in helping achieve better outcomes in long-term function. This longitudinal study investigates these outcomes in relation to age, somatic disease burden, and IQ. Specifically, somatic disease burden is a major challenge for these patients, even with treatment with enzyme replacement therapy.

METHODS

15 patients, 10 between ages 6 and < 12 and 5 between ages ≥ 12 and 18, were selected who had at least 2 yearly visits. The occurrence of physical signs, the Physical Symptom Score, and IQ in these two groups was studied as well as the longitudinal association of age with standardized measures of quality of life, adaptive function, and behavioral symptoms as rated by parents and the child's self-report. Slopes by age across and within patients were calculated for these measures.

RESULTS

All but one child had hearing loss, most had joint contractures and short stature. Somatic disease burden increased with age. IQ, although normal for most, also improved with age in those under 12 years of age. Physical quality of life decreased while psychosocial quality of life increased with age. Although other adaptive skills were in the broad average range, daily living skills were low at baseline relative to normative data and decreased over time. Behavior ratings indicated improvement in attention and hyperactivity over time. No patient had severe psychopathology, but older children reported an increasing sense of inadequacy and low self-esteem on self-report, presumably due to increasing awareness of differences from peers over time.

CONCLUSIONS

Attenuated MPS II patients have increasing somatic disease burden and poor physical quality of life as they develop as well as decreasing self-esteem and sense of adequacy. Psychosocial quality of life, adaptive skills, and attention improve. Recognition of and intervention around these issues will be beneficial to MPS II attenuated patients who have the resources to use such assistance to improve their long-term outcomes.

Cognitive and behavioral outcomes in benign childhood epilepsy with centrotemporal spikes

We review the evidence that BECTS may be associated with cognitive dysfunction and behavioral problems, the extent to which these problems may be associated with patterns of EEG abnormalities in BECTS, and the impact of antiepileptic medication on cognition and behavior in BECTS. A growing literature examining cognitive and behavioral outcomes suggests that children with BECTS perform below the level of their peers. Consistent with this, neuroimaging studies reveal that BECTS has an impact on structural and functional brain development, but the potential influence of frequency and lateralization of centrotemporal spikes (CTS) on cognition and behavior is not well understood. Treatment with AEDs is an option in BECTS, but existing studies have not clearly shown a clear relationship between elimination of CTS and improved cognitive or behavioral outcomes.