1
|
Kiefer M, Simione M, Eichler FS, Townsend EL. Development of an Infantile GM2 Clinical Rating Scale: Remote Assessment of Clinically Meaningful Health-Related Function. J Child Neurol 2024:8830738241246703. [PMID: 38659405 DOI: 10.1177/08830738241246703] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
GM2 gangliosidoses (GM2) are a group of rare lysosomal storage disorders in which accumulation of GM2 gangliosides results in progressive central nervous system damage. The infantile GM2 phenotype is characterized by delays in milestones by 6 months of age, followed by rapid loss of motor, cognitive, and visual function. Advancements in early diagnosis and pharmacotherapies provide promise for improved outcomes. However, the lack of feasible and clinically meaningful clinical outcome assessments for GM2 poses a challenge to characterizing GM2 natural history and selecting clinical trial endpoints. The purpose of this study was to develop a remotely administered infantile GM2 rating scale to measure health-related function in children with infantile GM2. A 2-phase mixed methods design was employed. In phase 1 of the study, 8 families of children with Infantile GM2 completed a natural history survey and a 1:1 semistructured interview to provide caregiver perspectives on the impacts of GM2 on health-related function. In phase 2 of the study, 8 expert clinicians provided feedback via surveys and participated in videoconference-hosted focus groups to refine scale administration and scoring procedures. These methods guided the development of 16 scale items to assess function in 5 health-related function domains: vision, hand and arm use, communication, gross motor, and feeding. This study used caregiver perspectives and expert clinician feedback to develop a remotely administered clinical outcome assessment of clinically meaningful health-related function in children with infantile GM2. Future studies will further evaluate the feasibility, reliability, and validity of the Infantile GM2 Clinical Rating Scale.
Collapse
Affiliation(s)
- Michael Kiefer
- Department of Physical Therapy, College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| | - Meg Simione
- Division of General Academic Pediatrics, Mass General Hospital for Children, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Florian S Eichler
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Elise L Townsend
- School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| |
Collapse
|
2
|
Pike NA, Avedissian T, Halnon NH, Lewis AB, Kumar R. Low pre-albumin but not thiamine predicts cognitive deficits in adolescents post-Fontan and healthy controls. Cardiol Young 2024; 34:803-808. [PMID: 37850442 DOI: 10.1017/s1047951123003396] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND Low pre-albumin, body mass index, and thiamine levels have been associated with poor nutritional status and cognitive/memory deficits in adult heart failure patients. However, the relationship of these nutritional/dietary intake biomarkers to cognition has not been assessed in adolescents post-Fontan procedure and healthy controls. METHODS This is a cross-sectional study. Adolescents (14-21 years of age) post-Fontan completion were recruited from paediatric cardiology clinics and controls from the community. The Montreal Cognitive Assessment was administered (normal ≥ 26), and blood draw (thiamine [normal 70-110 nmol/L] and pre-albumin levels [adolescent normal 23-45 mg/dL]) and the Thiamine Food Frequency Questionnaire were completed by all participants. RESULTS Seventy subjects, 40 post-Fontan (mean age 16 ± 1.6, female 51%, Hispanic 44%, hypoplastic left heart syndrome 26%) and 30 controls (mean age 16.8 ± 1.9, female 52%, Hispanic 66%), were participated. Post-Fontan group had lower median total cognitive scores (23 versus 29, p < 0.001), pre-albumin levels (23 versus 27, p = 0.013), and body mass index (20 versus 24, p = 0.027) than controls. Post-Fontan group had higher thiamine levels than controls (127 versus 103, p = 0.033). Lower pre-albumin levels (< 23) and underweight body mass index were associated with abnormal total cognitive scores (p = 0.030). Low pre-albumin level (p = .038) was an independent predictor of worse cognition. CONCLUSION Lower pre-albumin was an independent predictor for worse cognition in adolescents post-Fontan. Lower pre-albumin levels may reflect chronic liver changes or protein-losing enteropathy seen in Fontan physiology. These findings highlight the possibility for nutrition-induced cognitive changes.
Collapse
Affiliation(s)
- Nancy A Pike
- University of California Los Angeles, School of Nursing, Los Angeles, CA, USA
- Department of Cardiothoracic Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Tamar Avedissian
- American University of Beirut, Hariri School of Nursing, Beirut, Lebanon
| | - Nancy H Halnon
- Department of Pediatric Cardiology, UCLA Mattel Children's Hospital, Los Angeles, CA, USA
| | - Alan B Lewis
- Department of Pediatric Cardiology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Rajesh Kumar
- Departments of Anesthesiology and Radiological Sciences, University of California, Los Angeles, CA, USA
| |
Collapse
|
3
|
Khalaf T, Al Ojaimi M, Saleh DA, Sulaiman A, Sohal AP, Khan A, El-Hattab AW. The utility of exome sequencing in diagnosing pediatric neurodevelopmental disorders in a highly consanguineous population. Clin Genet 2024. [PMID: 38438125 DOI: 10.1111/cge.14508] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/06/2024]
Abstract
Exome sequencing (ES) has been utilized in diagnosing children with neurodevelopmental manifestations, this study aimed to investigate the utility of ES in children within a highly consanguineous population that presented with neurodevelopmental complaints. A retrospective chart review was performed for 405 children with neurodevelopmental complaints who have had ES and were evaluated in multiple centers in the United Arab Emirates over a four-year period. Within the cohort of 405 children, consanguinity was reported in 35% (144/405). The primary clinical presentations were developmental delay/cognitive impairment, distinctive facial features, hypotonia, seizures, and weakness. The diagnostic yield was 57% (231/405). Novel variants were identified in 54% (125/231) of positive cases. Within the positive cases, specific treatment was available in 6% (13/231) and copy number variants (CNV) were reported in 3% (8/231) of cases. In eight children, variants in genes that have not yet been linked to human disease that could potentially be the cause of the observed phenotype "candidate genes" were identified. ES was utilized effectively within this cohort with a high diagnostic yield and through the identification of novel gene variants, CNVs, candidate genes and secondary findings as well as the alteration of the treatment plan in cases where treatment was available.
Collapse
Affiliation(s)
- Tamam Khalaf
- Genetic Counseling Division, Igenomix, Dubai, UAE
| | - Mode Al Ojaimi
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
- Department of Pediatrics, University Hospital Sharjah, Sharjah, UAE
| | - Dina Amin Saleh
- Pediatric Neurology Division, American Center for Psychiatry and Neurology, Abu Dhabi, UAE
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Alena Sulaiman
- Pediatric Division, KidsHeart Medical Center, Abu Dhabi, UAE
| | - Aman P Sohal
- Pediatric Neurology Division, Neuropedia Children's Neuroscience Center, Dubai, UAE
- Pediatric Neurology Division, Al Qassimi Women and Children's Hospital, Sharjah, UAE
| | - Arif Khan
- Pediatric Neurology Division, Neuropedia Children's Neuroscience Center, Dubai, UAE
- Pediatric Division, Kings College Hospital London, Dubai, UAE
- Pediatric Neurology Division, Kids Neuro Clinic and Rehab Center, Dubai, UAE
| | - Ayman W El-Hattab
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, UAE
- Department of Pediatrics, University Hospital Sharjah, Sharjah, UAE
| |
Collapse
|
4
|
Landgren V, Svensson L, Törnhage CJ, Theodosious M, Gillberg C, Johnson M, Knez R, Landgren M. Neurodevelopmental problems, general health and academic achievements in a school-based cohort of 11-year-old Swedish children. Acta Paediatr 2024; 113:506-516. [PMID: 37823347 DOI: 10.1111/apa.16989] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/10/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
AIM Assessing rates of neurodevelopmental problems (NDPs) in 11-year-old children and possible association with other health complaints and school performance. METHODS In-school study of 11-year-old children as an add-on assessment to the 4th grade regular health check-up, comprising a structured physical neurodevelopmental examination, neuropsychological assessment, behavioural ratings, maternal interview, review of medical records and academic achievements. RESULTS Out of 348 children recruited from eight schools, 223 (64%) participated. Any physical condition was found in 102/222 (46%), most commonly atopy (18%). One in five had a BMI z-score >2 standard deviations over the reference mean. One or more NDP was found in 86/221 (40%) children. The number of failed national tests correlated positively with NDP severity rated with the clinical global impression severity instrument (Spearman's r = 0.41, p < 0.001). The majority of participants with failed national tests, also had co-occurring health complaints (≥2 of: stomach or extremity ache, headache, difficulties sleeping, internalising symptoms or obesity) and NDPs. CONCLUSION Health complaints, physical conditions and NDPs are very common in 11-year-old children and warrant adequately staffed, thoroughly equipped school healthcare services.
Collapse
Affiliation(s)
- Valdemar Landgren
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Skaraborg Hospital, Skövde, Sweden
| | - Leif Svensson
- Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
| | - Carl-Johan Törnhage
- Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michail Theodosious
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School Health Services, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mats Johnson
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Rajna Knez
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
| | - Magnus Landgren
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
5
|
Kurokawa S, Nomura K, Hosogane N, Nagasawa T, Kawade Y, Matsumoto Y, Morinaga S, Kaise Y, Higuchi A, Goto A, Inada N, Kodaira M, Kishimoto T. Reliability of Telepsychiatry Assessments Using the Attention-Deficit/Hyperactivity Disorder Rating Scale-IV for Children With Neurodevelopmental Disorders and Their Caregivers: Randomized Feasibility Study. J Med Internet Res 2024; 26:e51749. [PMID: 38373022 PMCID: PMC10912982 DOI: 10.2196/51749] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Given the global shortage of child psychiatrists and barriers to specialized care, remote assessment is a promising alternative for diagnosing and managing attention-deficit/hyperactivity disorder (ADHD). However, only a few studies have validated the accuracy and acceptability of these remote methods. OBJECTIVE This study aimed to test the agreement between remote and face-to-face assessments. METHODS Patients aged between 6 and 17 years with confirmed Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnoses of ADHD or autism spectrum disorder (ASD) were recruited from multiple institutions. In a randomized order, participants underwent 2 evaluations, face-to-face and remotely, with distinct evaluators administering the ADHD Rating Scale-IV (ADHD-RS-IV). Intraclass correlation coefficient (ICC) was used to assess the reliability of face-to-face and remote assessments. RESULTS The participants included 74 Japanese children aged between 6 and 16 years who were primarily diagnosed with ADHD (43/74, 58%) or ASD (31/74, 42%). A total of 22 (30%) children were diagnosed with both conditions. The ADHD-RS-IV ICCs between face-to-face and remote assessments showed "substantial" agreement in the total ADHD-RS-IV score (ICC=0.769, 95% CI 0.654-0.849; P<.001) according to the Landis and Koch criteria. The ICC in patients with ADHD showed "almost perfect" agreement (ICC=0.816, 95% CI 0.683-0.897; P<.001), whereas in patients with ASD, it showed "substantial" agreement (ICC=0.674, 95% CI 0.420-0.831; P<.001), indicating the high reliability of both methods across both conditions. CONCLUSIONS Our study validated the feasibility and reliability of remote ADHD testing, which has potential benefits such as reduced hospital visits and time-saving effects. Our results highlight the potential of telemedicine in resource-limited areas, clinical trials, and treatment evaluations, necessitating further studies to explore its broader application. TRIAL REGISTRATION UMIN Clinical Trials Registry UMIN000039860; http://tinyurl.com/yp34x6kh.
Collapse
Affiliation(s)
- Shunya Kurokawa
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Kensuke Nomura
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
- Department of Child Psychiatry, Shimada Ryoiku Medical Center for Challenged Children, Tokyo, Japan
| | - Nana Hosogane
- Department of Child and Adolescent Mental Health, Aiiku Clinic, Tokyo, Japan
| | - Takashi Nagasawa
- Department of Child and Adolescent Psychiatry, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Yuko Kawade
- Department of Child Psychiatry, Shimada Ryoiku Medical Center for Challenged Children, Tokyo, Japan
- Tsurugaoka Garden Hospital, Tokyo, Japan
| | - Yu Matsumoto
- Department of Child Psychiatry, Shimada Ryoiku Medical Center for Challenged Children, Tokyo, Japan
| | - Shuichi Morinaga
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
- Hiratsuka City Hospital, Kanagawa, Japan
| | - Yuriko Kaise
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Ayana Higuchi
- Department of Neuropsychiatry, School of Medicine, Keio University, Tokyo, Japan
| | - Akiko Goto
- Tsurugaoka Garden Hospital, Tokyo, Japan
| | - Naoko Inada
- Department of Clinical Psychology, Taisho University, Tokyo, Japan
| | - Masaki Kodaira
- Department of Child and Adolescent Mental Health, Aiiku Clinic, Tokyo, Japan
| | - Taishiro Kishimoto
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
6
|
Rama Rao R, Reddy ABS, P D, Koul A. Schizencephaly Associated With Bipolar Affective Disorder. Cureus 2024; 16:e54534. [PMID: 38516433 PMCID: PMC10956483 DOI: 10.7759/cureus.54534] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 03/23/2024] Open
Abstract
Schizencephaly is a rare congenital anomaly characterized by the formation of abnormal clefts in the brain. Despite the association of psychotic symptoms with various brain abnormalities or insults, their occurrence in individuals with schizencephaly is relatively infrequent. The association of bipolar disorder, with or without psychosis, with schizencephaly is rarer. A systematic search on PubMed using "Schizencephaly AND Bipolar Disorder" yielded only four case studies specifically addressing the connection between these two conditions. Here, we present a case of a 22-year-old male patient with a history of childhood seizures who developed first episode psychosis along with manic symptoms and was found to have closed-lip schizencephaly.
Collapse
Affiliation(s)
- Rahul Rama Rao
- Psychiatry, Mysore Medical College and Research Institute, Mysuru, IND
| | | | - Dhanushia P
- Psychiatry, Mysore Medical College and Research Institute, Mysuru, IND
| | - Abhay Koul
- Psychiatry, Mysore Medical College and Research Institute, Mysuru, IND
| |
Collapse
|
7
|
Abela L, Gianfrancesco L, Tagliatti E, Rossignoli G, Barwick K, Zourray C, Reid KM, Budinger D, Ng J, Counsell J, Simpson A, Pearson TS, Edvardson S, Elpeleg O, Brodsky FM, Lignani G, Barral S, Kurian MA. Neurodevelopmental and synaptic defects in DNAJC6 parkinsonism, amenable to gene therapy. Brain 2024:awae020. [PMID: 38242634 DOI: 10.1093/brain/awae020] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/10/2023] [Accepted: 12/16/2023] [Indexed: 01/21/2024] Open
Abstract
DNAJC6 encodes auxilin, a co-chaperone protein involved in clathrin-mediated endocytosis (CME) at the presynaptic terminal. Biallelic mutations in DNAJC6 cause a complex, early-onset neurodegenerative disorder characterized by rapidly progressive parkinsonism-dystonia in childhood. The disease is commonly associated with additional neurodevelopmental, neurological and neuropsychiatric features. Currently, there are no disease-modifying treatments for this condition, resulting in significant morbidity and risk of premature mortality. To investigate the underlying disease mechanisms in childhood-onset DNAJC6 parkinsonism, we generated induced pluripotent stem cells (iPSC) from three patients harboring pathogenic loss-of-function DNAJC6 mutations and subsequently developed a midbrain dopaminergic (mDA) neuronal model of disease. When compared to age-matched and CRISPR-corrected isogenic controls, the neuronal cell model revealed disease-specific auxilin deficiency as well as disturbance of synaptic vesicle (SV) recycling and homeostasis. We also observed neurodevelopmental dysregulation affecting ventral midbrain patterning and neuronal maturation. In order to explore the feasibility of a viral vector-mediated gene therapy approach, iPSC-derived neuronal cultures were treated with lentiviral DNAJC6 gene transfer, which restored auxilin expression and rescued CME. Our patient-derived neuronal model provides deeper insights into the molecular mechanisms of auxilin deficiency as well as a robust platform for the development of targeted precision therapy approaches.
Collapse
Affiliation(s)
- Lucia Abela
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Lorita Gianfrancesco
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Erica Tagliatti
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
- Laboratory of Pharmacology and Brain Pathology, Humanitas Clinical and Research Center, Via Manzoni 56, 20089 Milano, Italy
| | - Giada Rossignoli
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Katy Barwick
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Clara Zourray
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Kimberley M Reid
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Dimitri Budinger
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Joanne Ng
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
- Gene Transfer Technology Group, UCL-Institute for Women's Health, London, WC1E 6 AU, UK
| | - John Counsell
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Arlo Simpson
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Toni S Pearson
- Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032-3784, USA
- Department of Pediatrics, Nationwide Children's Hospital, Ohio State University, Columbus, OH 43210, USA
- Department of Neurology, Nationwide Children's Hospital, Ohio State University, Columbus, OH 43210, USA
| | - Simon Edvardson
- Department of Genetics, Hadassah, Hebrew University Medical Center, 9574869 Jerusalem, Israel
| | - Orly Elpeleg
- Department of Genetics, Hadassah, Hebrew University Medical Center, 9574869 Jerusalem, Israel
| | - Frances M Brodsky
- Research Department of Structural and Molecular Biology, Division of Biosciences, University College London, London, WC1E 6BT, UK
| | - Gabriele Lignani
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Serena Barral
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
| | - Manju A Kurian
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, WC1N 1DZ, UK
- Department of Neurology, Great Ormond Street Hospital, London, WC1N 3JH, UK
| |
Collapse
|
8
|
Nordby ES, Guribye F, Schønning V, Andersen SL, Kuntsi J, Lundervold AJ. A Blended Intervention Targeting Emotion Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder: Development and Feasibility Study. JMIR Form Res 2024; 8:e53931. [PMID: 38231536 PMCID: PMC10831671 DOI: 10.2196/53931] [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: 10/25/2023] [Revised: 12/17/2023] [Accepted: 12/17/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Many adults with attention-deficit/hyperactivity disorder (ADHD) experience difficulties related to emotion regulation. Such difficulties are known to substantially impact quality of life and overall functioning. Yet, there is a lack of treatment interventions specifically designed to address these challenges. OBJECTIVE This study aimed to describe the development and assess the feasibility, along with the initial clinical outcomes, of a novel blended intervention for adults with ADHD. The blended intervention combines both face-to-face and digital components and is specifically designed to address emotion dysregulation in ADHD. METHODS This intervention was an 8-week blended intervention combining weekly face-to-face group sessions with a supplementary digital companion app. The intervention is based on elements from dialectic behavioral therapy skills training and positive psychology. To evaluate its feasibility, we performed a 10-week feasibility study with an uncontrolled pre-post study design, including 16 adults with ADHD and co-occurring emotion dysregulation. The feasibility measures encompassed adherence, satisfaction, and perceived credibility of the intervention. Clinical outcomes were evaluated by self-reported symptoms of emotion dysregulation, inattention, hyperactivity-impulsivity, executive function, depression, anxiety, and a measure of quality of life. Paired sample 2-tailed t tests were used to analyze clinical outcomes with a Bonferroni-corrected significance level. RESULTS Both treatment credibility and treatment satisfaction were rated favorably by the majority of the participants. In particular, the participants emphasized meeting others with ADHD as beneficial. In terms of adherence, 3 participants withdrew before initiating the intervention, while another 4 participants did not complete the intervention. On average, the participants who enrolled in the intervention attended 6.2 of the 8 group sessions and completed 6.7 of the 8 skills training modules in the companion app. In terms of clinical outcomes, there was a reduction in symptoms of emotion dysregulation from before to after the intervention (d=2.0). Significant improvements were also observed in measures of inattention (d=1.1) and hyperactivity-impulsivity (d=0.9). However, no significant improvements were found in the domains of depression, anxiety, quality of life, and executive functioning. CONCLUSIONS The results are encouraging, both in terms of feasibility and the preliminary clinical results on emotion dysregulation. The blended format, combining digital and face-to-face elements, may also seem to offer some advantages: the group-based format was valued as it facilitated peer interaction, while a rather high completion of modules in the companion app highlights its potential to enhance skills training between the group sessions. Future randomized controlled trials are called for to further evaluate the clinical effectiveness of the intervention. TRIAL REGISTRATION ClinicalTrials.gov NCT05644028; https://clinicaltrials.gov/study/NCT05644028.
Collapse
Affiliation(s)
- Emilie S Nordby
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Frode Guribye
- Department of Information Science and Media Studies, Faculty of Social Sciences, University of Bergen, Bergen, Norway
| | - Viktor Schønning
- Department of Child and Adolescent Psychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | | | - Jonna Kuntsi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| |
Collapse
|
9
|
Doda V, Kennedy C, Kaur M. Policies for Individuals With Autism: Gaps, Research, and Recommendations. Cureus 2024; 16:e51875. [PMID: 38327931 PMCID: PMC10849157 DOI: 10.7759/cureus.51875] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 02/09/2024] Open
Abstract
Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by social, behavioral, and learning challenges. Individuals with autism and their families often struggle to get an appropriate diagnosis and continuation of specialty services, including general healthcare, mental health and transition services, special education, employment, and social and emotional support. This paper presents information about the current policies and support mechanisms that exist to help these individuals and their families. This paper identifies the gaps and recommends areas of improvement based on evidence-based research and current data. ASD is a lifelong disability without a cure, but by constructing robust policies and providing enhanced support, the quality of lives of those with ASD and their families can be improved.
Collapse
Affiliation(s)
- Vandana Doda
- Psychiatry and Behavioral Sciences, Cone Health, Greensboro, USA
| | - Cheryl Kennedy
- Psychiatry and Behavioral Sciences, Rutgers University New Jersey Medical School, Newark, USA
| | - Mandeep Kaur
- Psychiatry and Behavioral Sciences, Cape Fear Valley Health, Fayetteville, USA
| |
Collapse
|
10
|
Ward SK, Wadley A, Tsai CHA, Benke PJ, Emrick L, Fisher K, Houck KM, Dai H, Guillen Sacoto MJ, Craigen W, Glaser K, Murdock DR, Rohena L, Diderich KEM, Bruggenwirth HT, Lee B, Bacino C, Burrage LC, Rosenfeld JA. De novo missense variants in ZBTB47 are associated with developmental delays, hypotonia, seizures, gait abnormalities, and variable movement abnormalities. Am J Med Genet A 2024; 194:17-30. [PMID: 37743782 DOI: 10.1002/ajmg.a.63399] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 09/26/2023]
Abstract
The collection of known genetic etiologies of neurodevelopmental disorders continues to increase, including several syndromes associated with defects in zinc finger protein transcription factors (ZNFs) that vary in clinical severity from mild learning disabilities and developmental delay to refractory seizures and severe autism spectrum disorder. Here we describe a new neurodevelopmental disorder associated with variants in ZBTB47 (also known as ZNF651), which encodes zinc finger and BTB domain-containing protein 47. Exome sequencing (ES) was performed for five unrelated patients with neurodevelopmental disorders. All five patients are heterozygous for a de novo missense variant in ZBTB47, with p.(Glu680Gly) (c.2039A>G) detected in one patient and p.(Glu477Lys) (c.1429G>A) identified in the other four patients. Both variants impact conserved amino acid residues. Bioinformatic analysis of each variant is consistent with pathogenicity. We present five unrelated patients with de novo missense variants in ZBTB47 and a phenotype characterized by developmental delay with intellectual disability, seizures, hypotonia, gait abnormalities, and variable movement abnormalities. We propose that these variants in ZBTB47 are the basis of a new neurodevelopmental disorder.
Collapse
Affiliation(s)
- Scott K Ward
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
- Department of Pediatrics, Division of Medical Genetics and Genomic Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alexandrea Wadley
- Department of Pediatrics, Section of Genetics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Chun-Hui Anne Tsai
- Department of Pediatrics, Section of Genetics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Paul J Benke
- Joe DiMaggio Children's Hospital, Hollywood, Florida, USA
| | - Lisa Emrick
- Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Baylor College of Medicine (BCM), Houston, Texas, USA
| | - Kristen Fisher
- Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Baylor College of Medicine (BCM), Houston, Texas, USA
| | - Kimberly M Houck
- Department of Pediatrics, Section of Neurology and Developmental Neuroscience, Baylor College of Medicine (BCM), Houston, Texas, USA
| | - Hongzheng Dai
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
| | | | - William Craigen
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
| | - Kimberly Glaser
- Joe DiMaggio Children's Hospital, Hollywood, Florida, USA
- Invitae, San Francisco, California, USA
| | - David R Murdock
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
- The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Luis Rohena
- Department of Pediatrics, Division of Medical Genetics, San Antonio Military Medical Center, San Antonio, Texas, USA
- Department of Pediatrics, Long School of Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Karin E M Diderich
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Hennie T Bruggenwirth
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
| | - Carlos Bacino
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
| | - Lindsay C Burrage
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
- Texas Children's Hospital, Houston, Texas, USA
| | - Jill A Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine (BCM), Houston, Texas, USA
| |
Collapse
|
11
|
Maciver D, Rutherford M, Johnston L, Roy AS. Prevalence of neurodevelopmental differences and autism in Scottish primary schools 2018-2022. Autism Res 2023; 16:2403-2414. [PMID: 38009513 DOI: 10.1002/aur.3063] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/30/2023] [Indexed: 11/29/2023]
Abstract
This study investigated the prevalence of neurodevelopmental needs among children in primary schools in Scotland. Two groups were identified: autistic learners and a larger group of learners who had neurodevelopmental differences. These differences encompassed any need for additional support in various domains, including communication, interaction, emotional regulation, coordination, movement, and cognition. A two-phase process was employed, drawing on data from a cross-sectional study followed by a secondary analysis of a population census. In the first phase, a random sample of 688 children with additional support needs from 22 schools participated. Demographics, support characteristics, and neurodevelopmental needs were identified. Results revealed that 76.89% of children with additional support needs exhibited a need type consistent with a neurodevelopmental difference. In the second phase, data from the Scottish Government Annual Pupil Census, covering all state-provided primary school children between 2018 and 2022, were analyzed. Modeling was conducted using data from the first phase to estimate prevalence of neurodevelopmental differences. Data on autism were directly extracted from the census. Analysis revealed an increase in the prevalence of neurodevelopmental differences and autism. The prevalence of autism rose by 31.98%, with 2.60% of primary school children identified as autistic in 2022. Similarly, the prevalence of neurodevelopmental differences increased by 10.57%, with 16.22% of primary school children exhibiting such differences in 2022. Across 32 localities, regional variations in prevalence were observed. These findings show the substantial number of neurodivergent children within Scottish primary schools and emphasize the need for a neurodevelopmentally informed approach to inclusive education.
Collapse
Affiliation(s)
- Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Marion Rutherford
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| | - Anusua Singh Roy
- School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
| |
Collapse
|
12
|
de Rijk MM, Drake MJ, von Gontard A, Solomon E, Dmochowski R, Schurch B, van Koeveringe GA. Functional neuroimaging related to lower urinary tract sensations: Future directions for study designs and selection of patient groups: ICI-RS 2023. Neurourol Urodyn 2023. [PMID: 37960970 DOI: 10.1002/nau.25333] [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: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES Neuroimaging studies have advanced our understanding of the intricate central nervous system control network governing lower urinary tract (LUT) function, shedding light on mechanisms for urine storage and voiding. However, a lack of consensus in methodological approaches hinders the comparability of results among research groups and limits the translation of this knowledge to clinical applications, emphasizing the need for standardized methodologies and clinical utilization guidelines. METHODS This paper reports the discussions of a workshop at the 2023 meeting of the International Consultation on Incontinence Research Society, which reviewed uncertainties and research priorities to progress the field of neuroimaging in LUT control and dysfunction. RESULTS Neuroimaging holds great potential for improving our understanding of LUT control and pathophysiological conditions. To date, functional neuroimaging techniques have not yet achieved sufficient strength to make a direct clinical impact. Potential approaches that can improve the clinical utilization of neuroimaging were discussed and research questions proposed. CONCLUSIONS Neuroimaging offers a valuable tool for investigating LUT control, but it's essential to acknowledge the potential for oversimplification when interpreting brain activity due to the complex neural processing and filtering of sensory information. Moreover, technical limitations pose challenges in assessing key brain stem and spinal cord centers, particularly in cases of neurological dysfunction, highlighting the need for more reliable imaging of these centers to advance our understanding of LUT function and dysfunction.
Collapse
Affiliation(s)
- Mathijs M de Rijk
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Marcus J Drake
- Department of Surgery and Cancer, Imperial College, Hammersmith Hospital, London, UK
| | - Alexander von Gontard
- Parent-Child and Adolescent Department, Hochgebirgsklinik, Davos, Switzerland
- Governor Kremers Centre, Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Eskinder Solomon
- Urology Centre, Guy's and St Thomas' NHS Trust, London, UK
- Paediatric Nephro-Urology, Evelina Children's Hospital, London, UK
| | - Roger Dmochowski
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Brigitte Schurch
- Neuourology Unit, Clinique des Grangettes, Genève, Switzerland
- Department of Neuroscience, University Hospital Lausanne, Lausanne, Switzerland
| | - Gommert A van Koeveringe
- Department of Urology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Urology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| |
Collapse
|
13
|
Wong KP, Qin J. Effectiveness of Social Virtual Reality Training in Enhancing Social Interaction Skills in Children With Attention-Deficit/Hyperactivity Disorder: Protocol for a Three-Arm Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48208. [PMID: 37721790 PMCID: PMC10546265 DOI: 10.2196/48208] [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: 04/15/2023] [Revised: 08/23/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Children with ADHD have challenges in understanding social cues and behavioral problems when entering a social setting. Virtual reality (VR) has been applied to improve cognitive behaviors in children with ADHD. Previous studies have not adopted VR to improve social interaction competence and appropriateness in children with ADHD. VR offers a more effective alternative to therapeutic strategies for children with ADHD. OBJECTIVE This study aims to examine the feasibility and effectiveness of social VR training in enhancing social interaction skills compared to traditional social skills training in children with ADHD. We hypothesize that participants in the social VR training group are likely to perform better on social interaction skills than those in the traditional social skills training group. METHODS In this nonblinded, 3-arm randomized controlled trial (RCT), 90 participants with ADHD recruited from the community will be randomized 1:1:1 to the social VR intervention group, traditional social skills training group, or waitlist control group. The child psychiatrist will conduct assessments for each participant at baseline and after the intervention. The Social Skills Rating Scale-Parent will be used to assess the social interaction skills of the participants before and after the intervention. Participants in the social VR intervention group and traditional social skills training group will receive twelve 20-minute training sessions for 3 weeks. The participants in the waitlist control group will receive no training. The primary outcome measure is training acceptability and compliance. The secondary outcome measures are the child psychiatrist's assessment and the Social Skills Rating Scale-Parent before and after the intervention. Another outcome measure is the Behavior Rating Inventory of Executive Function and Attention. Differences in the scale scores will be examined using a t test and an F test. RESULTS This study is set to commence in the fourth quarter of 2023. It is anticipated that participants in the social VR intervention group will exhibit superior social interaction skills than those in the traditional social skills training group. CONCLUSIONS To our knowledge, this RCT is the first study examining the feasibility and effectiveness of a social VR-based intervention for enhancing the social interaction skills of children with ADHD in Hong Kong. The VR-based social skills training is expected to provide a safer and more effective environment for children with ADHD to learn than the traditional approach. This study can lead to a full-scale RCT. TRIAL REGISTRATION ClinicalTrials.gov NCT05778526; https://clinicaltrials.gov/study/NCT05778526. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/48208.
Collapse
Affiliation(s)
- Ka Po Wong
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Jing Qin
- Centre for Smart Health, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| |
Collapse
|
14
|
Scholze DA, Gosdin MM, Perez SL, Schweitzer JB. Identifying the Information Needs and Format Preferences for Web-Based Content Among Adults With or Parents of Children With Attention-Deficit/Hyperactivity Disorder: Three-Stage Qualitative Analysis. JMIR Form Res 2023; 7:e47409. [PMID: 37695648 PMCID: PMC10520768 DOI: 10.2196/47409] [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: 03/18/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent childhood and adult behavioral disorder. Internet searches for ADHD information are rising, particularly for diagnosis and treatment. Despite effective ADHD treatments, research suggests that there are delays in seeking help for ADHD. Identifying ways to shorten delays is important for minimizing morbidity associated with ADHD. One way to shorten these delays is to improve internet health information resources. Research shows that parents of children with ADHD feel that much of the information available is technical and not tailored for their child's needs and verbal instructions given by health care providers were too pharmacologically focused with limited information about how to manage and support ADHD symptoms in daily living. A majority of parents search the internet for general and pharmacological information for ADHD and prefer web-based resources for learning about ADHD, but web-based resources may be inaccurate and of low quality. Ensuring accurate information through the internet is an important step in assisting parents and adults in making informed decisions about the diagnosis and treatment of ADHD. OBJECTIVE Although a great deal of information regarding ADHD is available on the internet, some information is not based on scientific evidence or is difficult for stakeholders to understand. Determining gaps in access to accurate ADHD information and stakeholder interest in the type of information desired is important in improving patient engagement with the health care system, but minimal research addresses these needs. This study aims to determine the information needs and formatting needs of web-based content for adults with ADHD and parents of children with ADHD in order to improve user experience and engagement. METHODS This was a 3-phase study consisting of in-depth phone interviews about experiences with ADHD and barriers searching for ADHD-related information, focus groups where participants were instructed to consider the pathways by which they made decisions using web-based resources, and observing participants interacting with a newly developed website tailored for adults with potential ADHD and caregivers of children who had or might have ADHD. Phase 1 individual interviews and phase 2 focus groups identified the needs of the ADHD stakeholders related to website content and format. Interview and focus group findings were used to develop a website. Phase 3 used think-aloud interviews to evaluate website usability to inform the tailoring of the website based on user feedback. RESULTS Interviews and focus group findings revealed preferences for ADHD website information and content, website layout, and information sources. Themes included a preference for destigmatizing information about ADHD, information specific to patient demographics, and evidence-based information tailored to lay audiences. CONCLUSIONS ADHD stakeholders are specifically seeking positive information about ADHD presented in a user-friendly format.
Collapse
Affiliation(s)
- Danielle A Scholze
- MIND Institute, University of California, Davis, Sacramento, CA, United States
- Department of Pediatrics, University of California, Davis, Sacramento, CA, United States
| | - Melissa M Gosdin
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA, United States
| | - Susan L Perez
- Department of Kinesiology and Health Science, California State University, Sacramento, CA, United States
| | - Julie B Schweitzer
- MIND Institute, University of California, Davis, Sacramento, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| |
Collapse
|
15
|
Alhajaj G, Lacroix C, Trakadis Y, Garfinkle J, Srour M. An in-frame deletion affecting the critical acid loop of PPP2R5D is associated with a neonatal lethal form of PPP2R5D-related neurodevelopmental disorder. Am J Med Genet A 2023; 191:2416-2421. [PMID: 37248744 DOI: 10.1002/ajmg.a.63307] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/31/2023] [Accepted: 05/06/2023] [Indexed: 05/31/2023]
Abstract
Heterozygous pathogenic variants in PPP2R5D gene are associated with PPP2R5D-related neurodevelopmental disorder, a rare autosomal dominant condition, characterized by neurodevelopmental impairment in childhood, macrocephaly/megalencephaly, hypotonia, epilepsy, and dysmorphic features. Up-to-date, only approximately 100 cases have been published in the literature and the full phenotypic and genotypic spectrum have not yet been fully described. PPP2R5D gene encodes the B56δ subunit of the PP2A enzyme complex. We describe a neonatal form of PPP2R5D-related disorder with early infantile death, caused by a novel in-frame deletion causing loss of 8 amino acids and insertion of serine at position 201 (p.Phe194_Pro201delinsSer) of the B56δ subunit. This deletion is predicted to disrupt a critical acidic loop of amino acids important for binding other subunits of the PP2A enzyme complex, and harbors many of the residues previously reported to cause a mild-moderate form of this condition. This report describes a neonatal lethal presentation of the PPP2R5D-related neurodevelopmental disorder and provides additional evidence that disruption of the acidic loop is an important pathomechanism underlying PPP2R5D-related disorder.
Collapse
Affiliation(s)
- Ghadd Alhajaj
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Saudi Arabia
- Department of Pediatrics, Division of Pediatric Neurology, McGill University Health Center, Montreal, Quebec, Canada
| | - Caroline Lacroix
- Department of Diagnostic Radiology, McGill University Health Center, Montreal, Quebec, Canada
| | - Yannis Trakadis
- Department of Specialized Medicine, Division of Medical Genetics, McGill University Health Center, Montreal, Quebec, Canada
| | - Jarred Garfinkle
- Department of Pediatrics, Division of Neonatology, McGill University Health Center, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Myriam Srour
- Department of Pediatrics, Division of Pediatric Neurology, McGill University Health Center, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| |
Collapse
|
16
|
Papadopoulou MT, Welniarz Q, Roubertie A, Gras D, Milh M, Panagiotakaki E, Roze E. Effect of Oxygen Administration on Paroxysmal Motor Events in Alternating Hemiplegia of Childhood. Mov Disord 2023; 38:1759-1761. [PMID: 37466145 DOI: 10.1002/mds.29561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023] Open
Affiliation(s)
- Maria T Papadopoulou
- Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, University Hospitals of Lyon (HCL), Member of the ERN EpiCARE, Lyon, France
| | - Quentin Welniarz
- APHP, Salpêtrière Hospital, DMU Neurosciences, Paris, France
- Sorbonne University, Inserm, CNRS, Paris Brain Institute, Paris, France
| | - Agathe Roubertie
- CHU Montpellier, Département de Neuropédiatrie, INM, Université de Montpellier, Inserm U 1298, Montpellier, France
| | - Domitille Gras
- Sorbonne University, Inserm, CNRS, Paris Brain Institute, Paris, France
| | - Mathieu Milh
- Department of Pediatric Neurology, AP-HM, La Timone Children's Hospital, Marseille, France
- Faculté de Médecine Timone, Aix Marseille Université, Inserm, MMG, U1251, ERN Epicare, Marseille, France
| | - Eleni Panagiotakaki
- Department of Clinical Epileptology, Sleep Disorders and Functional Neurology in Children, University Hospitals of Lyon (HCL), Member of the ERN EpiCARE, Lyon, France
| | - Emmanuel Roze
- APHP, Salpêtrière Hospital, DMU Neurosciences, Paris, France
- Sorbonne University, Inserm, CNRS, Paris Brain Institute, Paris, France
| |
Collapse
|
17
|
Ruf A, Neubauer AB, Koch ED, Ebner-Priemer U, Reif A, Matura S. Microtemporal Dynamics of Dietary Intake, Physical Activity, and Impulsivity in Adult Attention-Deficit/Hyperactivity Disorder: Ecological Momentary Assessment Study Within Nutritional Psychiatry. JMIR Ment Health 2023; 10:e46550. [PMID: 37590053 PMCID: PMC10472180 DOI: 10.2196/46550] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/24/2023] [Accepted: 06/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Increasing attention is being paid to lifestyle factors, such as nutrition and physical activity (PA), as potential complementary treatment options in attention-deficit/hyperactivity disorder (ADHD). Previous research indicates that sugar and saturated fat intake may be linked to increased impulsivity, a core symptom of ADHD, whereas protein intake and PA may be related to reduced impulsivity. However, most studies rely on cross-sectional data that lack microtemporal resolution and ecological validity, wherefore questions of microtemporal dynamics (eg, is the consumption of foods high in sugar associated with increased impulsivity within minutes or hours?) remain largely unanswered. Ecological momentary assessment (EMA) has the potential to bridge this gap. OBJECTIVE This study is the first to apply EMA to assess microtemporal associations among macronutrient intake, PA, and state impulsivity in the daily life of adults with and without ADHD. METHODS Over a 3-day period, participants reported state impulsivity 8 times per day (signal-contingent), recorded food and drink intake (event-contingent), and wore an accelerometer. Multilevel 2-part models were used to study the association among macronutrient intake, PA, and the probability to be impulsive as well as the intensity of impulsivity (ADHD: n=36; control: n=137). RESULTS No association between macronutrient intake and state impulsivity was found. PA was not related to the intensity of impulsivity but to a higher probability to be impulsive (ADHD: β=-.09, 95% CI -0.14 to -0.04; control: β=-.03, 95% CI -0.05 to -0.01). No evidence was found that the combined intake of saturated fat and sugar amplified the increase in state impulsivity and that PA alleviated the positive association between sugar or fat intake and state impulsivity. CONCLUSIONS Important methodological considerations are discussed that can contribute to the optimization of future EMA protocols. EMA research in the emerging field of nutritional psychiatry is still in its infancy; however, EMA is a highly promising and innovative approach as it offers insights into the microtemporal dynamics of psychiatric symptomology, dietary intake, and PA in daily life.
Collapse
Affiliation(s)
- Alea Ruf
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Andreas B Neubauer
- DIPF | Leibniz Institute for Research and Information in Education, Frankfurt, Germany
- Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
| | - Elena D Koch
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Ulrich Ebner-Priemer
- Mental mHealth Lab, Institute of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Germany
| |
Collapse
|
18
|
Deotto A, Fabiano GF, Chung BYT, Wade SL, Anagnostou E, Crosbie J, Kelley E, Nicolson R, Andrade BF, Miller SP, Williams TS. Stepping up to COVID-19: A Clinical Trial of a Telepsychology Positive Parenting Program Targeting Behavior Problems in Children With Neurological Risk. J Pediatr Psychol 2023:jsad032. [PMID: 37316980 DOI: 10.1093/jpepsy/jsad032] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 05/19/2023] [Accepted: 05/19/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To evaluate the feasibility, acceptability, and preliminary efficacy of a stepped-care parenting program implemented during COVID-19 among families of behaviorally at-risk children with neurological or neurodevelopmental disorders aged 3-9 years. METHODS Stepped-care I-InTERACT-North increased psychological support across 3 steps, matched to family needs: (1) guided self-help (podcast), (2) brief support, and (3) longer-term parent support. The intervention was provided by clinicians at The Hospital for Sick Children. Recruitment occurred via hospital and research cohort referral. A single-arm trial using a pragmatic prospective pre-post mixed-method design was utilized to assess accrual, engagement, acceptability, and preliminary efficacy. RESULTS Over 15 months, 68 families enrolled (83% consent rate) and 56 families completed stepped-care (Step 1 = 56; Step 2 = 39; Step 3 = 28), with high adherence across Steps (100%, 98%, and 93%, respectively). Parents reported high acceptability, reflected in themes surrounding accessibility, comprehension, effectiveness, and targeted care. Positive parenting skill increases were documented, and robust improvement in child behavior problems was apparent upon Step 3 completion (p =.001, d = .390). Stepped-care was as effective as traditional delivery, while improving consent and completion rates within a pandemic context. CONCLUSIONS This stepped-care telepsychology parenting program provides a compelling intervention model to address significant gaps in accessible mental health intervention while simultaneously balancing the need for efficient service. Findings inform program scalability beyond COVID-19 and emphasize the value of stepped-care intervention in delivering and monitoring mental health treatment.
Collapse
Affiliation(s)
- Angela Deotto
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
| | - Giulia F Fabiano
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Beryl Y T Chung
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Shari L Wade
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Evdokia Anagnostou
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queens University, Kingston, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, Western University, London, ON, Canada
- Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada
| | - Brendan F Andrade
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Steven P Miller
- Faculty of Medicine, BC Children's Hospital, Vancouver, BC, Canada
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tricia S Williams
- Division of Neurology, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| |
Collapse
|
19
|
Wallin L, Gillberg C, Fernell E, Gillberg C, Billstedt E. Neurodevelopmental and other psychiatric disorders in 22q11.2 deletion syndrome from childhood to adult age: Prospective longitudinal study of 100 individuals. Am J Med Genet C Semin Med Genet 2023. [PMID: 37248687 DOI: 10.1002/ajmg.c.32052] [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] [Grants] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023]
Abstract
The 22q11.2 deletion syndrome (22q11.2DS), affects physical as well as cognitive and emotional functioning with increased risk for psychiatric and behavioral problems. This longitudinal study of 79 individuals (18-50 years) with 22q11.2DS investigated neurodevelopmental (NDD) and psychiatric disorders in adulthood, evaluated the stability of childhood diagnoses over time, and examined associations between clinical characteristics in childhood/adolescence and diagnostic outcome in adult age. Examination using validated instruments for cognitive, psychiatric, and global functional problems in the context of an in-depth clinical evaluation found adult age stability of NDD diagnoses made in childhood, however, rates increased at follow-up. Rates of anxiety, mood, and psychotic disorders were high, with a majority meeting diagnostic criteria for one or more psychiatric disorder. The rate of psychotic disorders was much lower compared to many other studies. Variability in functioning at follow-up was primarily associated with intellectual ability at T1. The findings obtained highlight the increased risk of NDD and psychiatric problems and of cognitive impairment and reduced levels of global functioning over time. Results emphasize the importance of clinical follow-up to enable appropriate support for the promotion of optimal health along with a need for future research on effective interventions and treatment strategies.
Collapse
Affiliation(s)
- Lena Wallin
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry, Cognition and Old Age Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Carina Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
20
|
Jafri A, Edwards O, Gupta P, Abdul-Aziz R. Scurvy in a Pediatric Patient Unable to Bear Weight: A Case Report. Cureus 2023; 15:e38687. [PMID: 37292550 PMCID: PMC10244491 DOI: 10.7759/cureus.38687] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2023] [Indexed: 06/10/2023] Open
Abstract
Pediatric scurvy is uncommon in the twenty-first century but cases have been reported in children with neurodevelopmental issues and restricted diets. We are reporting a two-year and nine-month-old boy who had a coronavirus disease (COVID) infection and then presented with a refusal to walk. By careful history-taking, he was found to have a restricted diet, speech delay, and gum bleeding suggestive of scurvy, which was confirmed by extremely low levels of ascorbic acid. In this case, the diagnosis of scurvy was established before establishing the diagnosis of neurodevelopmental delay. Treatment with ascorbic acid resulted in a remarkable improvement in his symptoms. This case highlights the importance of collecting a thorough history, connecting exam findings to the history, and including scurvy in differential diagnoses for the presentation of inability to bear weight.
Collapse
Affiliation(s)
- Aleena Jafri
- Pediatrics, State University of New York (SUNY) at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
| | - Olayinka Edwards
- Family Medicine, Jericho Road Community Health Center, Buffalo, USA
| | - Puneet Gupta
- Radiology, John R. Oishei Children's Hospital of Buffalo, Buffalo, USA
| | - Rabheh Abdul-Aziz
- Pediatric Rheumatology, State University of New York (SUNY) at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
| |
Collapse
|
21
|
Bjørklund G, Tippairote T, Hangan T, Chirumbolo S, Peana M. Early-Life Lead Exposure: Risks and Neurotoxic Consequences. Curr Med Chem 2023:CMC-EPUB-130800. [PMID: 37031386 DOI: 10.2174/0929867330666230409135310] [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: 08/14/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 04/10/2023]
Abstract
Lead (Pb) does not have any biological function in a human, and there is likely no safe level of Pb in the human body. The Pb exposure impacts are a global concern for their potential neurotoxic consequences. Despite decreasing both the environmental Pb levels and the average blood Pb levels in the survey populations, the lifetime redistribution from the tissues-stored Pb still poses neurotoxic risks from the low-level exposure in later life. The growing fetus and children hold their innate high-susceptible to these Pb-induced neurodevelopmental and neurobehavioral effects. This article aims to evaluate the cumulative studies and insights on the topic of Pb neurotoxicology while assessing the emerging trends in the field. The Pb-induced neurochemical and neuro-immunological mechanisms are likely responsible for the high-level Pb exposure with the neurodevelopmental and neurobehavioral impacts at the initial stages. Early-life Pb exposure can still produce neurodegenerative consequences in later life due to the altered epigenetic imprints and the ongoing endogenous Pb exposure. Several mechanisms contribute to the Pb-induced neurotoxic impacts, including the direct neurochemical effects, the induction of oxidative stress and inflammation through immunologic activations, and epigenetic alterations. Furthermore, the individual nutritional status, such as macro-, micro-, or antioxidant nutrients, can significantly influence the neurotoxic impacts even at low-level exposure to Pb. The prevention of early-life Pb exposure is, therefore, the critical determinant for alleviating various Pb-induced neurotoxic impacts across the different age groups.
Collapse
Affiliation(s)
- Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610 Mo i Rana, Norway
| | - Torsak Tippairote
- Department of Nutritional and Environmental Medicine, HP Medical Center, Bangkok 10540, Thailand
| | - Tony Hangan
- Faculty of Medicine, Ovidius University of Constanta, 900470-Constanta, Romania
| | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134-Verona, Italy
- CONEM Scientific Secretary, Strada Le Grazie 9, 37134-Verona, Italy
| | - Massimiliano Peana
- Department of Chemical, Physical, Mathematical and Natural Sciences, University of Sassari, via Vienna 2, 07100 Sassari, Italy
| |
Collapse
|
22
|
Lobato D, Montesinos F, Polín E, Cáliz S. Third-Generation Behavioural Therapies in the Context of Neurodevelopmental Problems and Intellectual Disabilities: A Randomised Clinical Trial with Parents. Int J Environ Res Public Health 2023; 20:4406. [PMID: 36901415 PMCID: PMC10002330 DOI: 10.3390/ijerph20054406] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to examine how 14 parents of children with autism and intellectual impairments responded to an Acceptance and Commitment Therapy (ACT)-based psychological flexibility intervention programme. A randomised clinical trial was conducted. Parents were randomly assigned to the training programme group (n = 8) or waiting list group (n = 6). The treatment effect was measured using the 6-PAQ, PSS-14, GHQ-12, and WBSI questionnaires. Changes in interactions were assessed through self-recording, including a baseline to observe the previous functioning. Measures were taken before and after the application of the intervention programme and three months later. After that, the control group was switched to the psychological flexibility programme condition. After the programme's implementation, we could see a reduction in stress and the tendency to suppress unwanted private events. The impacts also appeared to apply to family interactions, resulting in a rise in positive interactions and a decrease in unfavourable ones. The results led us to think about the importance of psychological flexibility for the parents of children with chronic conditions, facilitating a reduction in the emotional impact derived from parenting and the emission of behaviours that promote the harmonious development of the diagnosed child.
Collapse
Affiliation(s)
- David Lobato
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Francisco Montesinos
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
- Instituto ACT, 28036 Madrid, Spain
| | - Eduardo Polín
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Saray Cáliz
- Department of Psychology, Universidad Europea de Madrid, 28670 Madrid, Spain
| |
Collapse
|
23
|
Mohammadi T, Mohammadi B. Neuropsychological features in children and adults with congenital heart disease: an exploratory data analysis. PSYCHOL HEALTH MED 2023; 28:693-706. [PMID: 36377086 DOI: 10.1080/13548506.2022.2147558] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to recognize clinically meaningful patterns among patients with congenital heart disease to support clinical decision-making and better classification in practice. This research was a secondary analysis of data from the Congenital Heart Disease Genetic Network Study conducted from December 2010 to November 2014 in the United States. The analytic dataset included 6002 patients ≥1 year of age with non-syndromic congenital heart disease. For each patient, features included demographic, clinical, maternal and paternal characteristics. We clustered patients to identify subgroups that shared similarities in their clinical features. The performance of the clustering algorithm was evaluated with a random forest. Next, we used the apriori algorithm to generate clinical rules from patients' characteristics. The clustering algorithm identified two discernible groups of patients. The two classes of patients were different in maternal diabetes and in neuropsychological indicators [Accuracy (95% CI) = 97.1% (96.2, 97.8), area under the ROC curve = 96.8%]. Our rule extraction suggested the presence of clinical pictures with high lift values among patients with maternal diabetes or with seizure, depression, attention-deficit hyperactivity disorder, anxiety, developmental delay, learning disability and speech problem. Beyond the age of 1 year, maternal diabetes and neuropsychological characteristics identify two clusters of patients with congenital heart disease. These characteristics have the potential of being incorporated into the current systems for the classification of congenital heart disease.
Collapse
Affiliation(s)
- Tanya Mohammadi
- College of Science, School of Mathematics, Statistics, and Computer Science, The University of Tehran, Tehran, Iran
| | - Babak Mohammadi
- Independent Researcher, Aja University of Medical Sciences Tehran, Iran
| |
Collapse
|
24
|
Branford D, Sun JJ, Shankar R. Antiseizure medications prescribing for behavioural and psychiatric concerns in adults with an intellectual disability living in England. Br J Psychiatry 2023; 222:191-195. [PMID: 36786124 DOI: 10.1192/bjp.2022.182] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Antiseizure medications (ASMs) are the second most widely prescribed psychotropic for people with intellectual disabilities in England. Multiple psychotropic prescribing is prevalent in almost half of people with intellectual disabilities on ASMs. This analysis identifies limited evidence of ASM benefit in challenging behaviour management and suggests improvements needed to inform clinical practice.
Collapse
Affiliation(s)
- David Branford
- Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK
| | - James J Sun
- Royal Free London NHS Foundation Trust, London, UK
| | - Rohit Shankar
- Cornwall Intellectual Disability Equitable Research (CIDER), University of Plymouth Peninsula School of Medicine, UK; and Cornwall Intellectual Disability Equitable Research (CIDER), Cornwall Partnership NHS Foundation Trust, Bodmin, UK
| |
Collapse
|
25
|
Basile NL, Brown Kirschman KJ, Dempster NR. Psychosocial, neurodevelopmental, and transition of care practices provided to children with CHD across North American cardiac clinics. Cardiol Young 2023; 33:235-41. [PMID: 35184773 DOI: 10.1017/S1047951122000488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Children with CHD are at risk for psychosocial and neurodevelopmental difficulties, as well as lapses in care during their transition from paediatric to adult CHD providers. The American Heart Association and American Academy of Pediatrics released guidelines for best practices in the neurodevelopmental and transitional care for children with CHD in 2012 and 2011, respectively. CHD providers from 48 (42.1% response rate) geographically diverse cardiac clinics completed a 31-item electronic survey designed to assess the cardiac teams' consistency with neurodevelopmental evaluation and management recommendations, consultation/liaison patterns for psychosocial services, and procedures regarding transitional services for emerging adults. Responses suggest most cardiac teams refer patients to psychosocial services as needed, and 39.6% of teams screen for psychosocial distress. CHD providers at 66.7% of cardiac clinics reported a formal neurodevelopmental programme/clinic. Nearly half of cardiac teams conduct routine neurodevelopmental evaluations, most frequently occurring at 9 months of age. Less than 10% of cardiac clinics have resources to meet the American Heart Association and American Academy of Pediatrics 2012 neurodevelopmental evaluation and management guidelines. Formal paediatric to adult CHD transition programmes were reported at 70.8% of cardiac clinics and were associated with younger ages of transition to adult CHD care. Care practices varied across the 48 represented cardiac clinics, indicating inconsistent practices for patients with CHD. Barriers and facilitators to the provision of care for children in these areas were reported and are presented. More support is needed for cardiac clinics to continue improvements in psychosocial, neurodevelopmental, and transitional care services.
Collapse
|
26
|
D'Arcy E, Evans K, Afsharnejad B, Milbourn B, Bölte S, Girdler S. Assessing functioning for individuals with neurodevelopmental conditions: Current clinical practice in Australia. Aust Occup Ther J 2023; 70:43-60. [PMID: 35934786 PMCID: PMC10087051 DOI: 10.1111/1440-1630.12834] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND In the disability sector globally, and specifically in Australia, assessments of functioning have become key to diagnostic processes, and accessing therapy and funding. Over half of all individuals accessing support through Australia's National Disability Insurance Scheme have a neurodevelopmental condition diagnosis. Little is known about assessments of functioning for this population. METHODS A mixed methods online survey was designed to understand the current assessment of functioning practices (including clinical contexts, concepts being assessed, and assessment methods) and barriers and facilitators to clinicians using best practice. Results were analysed descriptively, and differences between professions calculated where possible. Content analysis was used to explore qualitative comments. RESULTS Clinicians from various medical and allied health backgrounds completed the survey (n = 93), with varying ranges of age, experience, and education. Clinicians reported that they assessed functioning across age, setting, sector, funding body, and individuals with a wide variety of diagnoses. Missing from current practice is a clear transdisciplinary conceptualisation of functioning. The largest barriers to best practice were limited time, large caseloads, availability of appropriate tools, and lack of clarity from funding bodies. CONCLUSIONS Missing from current practice is a clear transdisciplinary conceptualisation of functioning.These results will help inform steps forward to improve assessment of functioning practices to ensure that all individuals receive appropriate and sufficient support.
Collapse
Affiliation(s)
- Emily D'Arcy
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Kiah Evans
- Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Bahareh Afsharnejad
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Benjamin Milbourn
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia
| | - Sven Bölte
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden.,Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sonya Girdler
- School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Telethon Kids Institute, Nedlands, Western Australia, Australia.,Cooperative Research Centre for Living with Autism, Indooroopilly, Queensland, Australia.,Curtin Autism Research Group, Curtin University, Perth, Western Australia, Australia.,School of Allied Health, University of Western Australia, Perth, Western Australia, Australia.,Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
| |
Collapse
|
27
|
Maciver D, Rutherford M, Johnston L, Curnow E, Boilson M, Murray M. An interdisciplinary nationwide complex intervention for lifespan neurodevelopmental service development: Underpinning principles and realist programme theory. Front Rehabil Sci 2023; 3:1060596. [PMID: 36794269 PMCID: PMC9922833 DOI: 10.3389/fresc.2022.1060596] [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] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/28/2022] [Indexed: 01/31/2023]
Abstract
Background People seeking support for neurodevelopmental differences often report waiting too long for assessment and diagnosis, as well as receiving inadequate support in educational and health settings. The National Autism Implementation Team (NAIT) developed a new national improvement programme in Scotland, focusing on assessment, diagnosis, educational inclusion, and professional learning. The NAIT programme was conducted within health and education services across the lifespan for a range of neurodevelopmental differences, including autism, developmental coordination disorder, developmental language disorder, and attention deficit hyperactivity disorder. NAIT included a multidisciplinary team, with the involvement of an expert stakeholder group, clinicians, teachers, and people with lived experience. This study explores how the NAIT programme was planned, delivered, and received over three years. Design We performed a retrospective evaluation. We collected data from review of programme documents, consultation with programme leads and consultation with professional stakeholders. A theory-based analysis was completed, drawing on the Medical Research Council Framework for developing and evaluating complex interventions, and realist analysis methods. We developed a programme theory of the contexts (C), mechanisms (M), and outcomes (O) influencing the NAIT programme, based on comparison and synthesis of evidence. A key focus was on identifying the factors that contributed to the successful implementation of NAIT activities across different domains, including practitioner, institutional and macro levels. Results On synthesis of the data, we identified the key principles underlying the NAIT programme, the activities and resources utilised by the NAIT team, 16 aspects of context, 13 mechanisms, and 17 outcome areas. Mechanisms and outcomes were grouped at practitioner level, service level and macro level. The programme theory is pertinent to observed practice changes across all stages of referral, diagnosis and support processes within health and education services for neurodivergent children and adults. Conclusions This theory-informed evaluation has resulted in a clearer and more replicable programme theory that can be used by others with similar aims. This paper illustrates the value of NAIT, as well as realist and complex interventions methodologies as tools for policymakers, practitioners, and researchers.
Collapse
Affiliation(s)
- Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom,Correspondence: Donald Maciver
| | - Marion Rutherford
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom,Additional Support for Learning Service, Communities and Families, City of Edinburgh Council, Edinburgh, UK
| | - Eleanor Curnow
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Marie Boilson
- Fife Health and Social Care Partnership, Whytemans Brae Hospital, Kirkcaldy, United Kingdom
| | - Mairéad Murray
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| |
Collapse
|
28
|
Bakır ÇN, Abbas SO, Sever E, Özcan Morey A, Aslan Genç H, Mutluer T. Use of augmented reality in mental health-related conditions: A systematic review. Digit Health 2023; 9:20552076231203649. [PMID: 37791140 PMCID: PMC10542245 DOI: 10.1177/20552076231203649] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 09/08/2023] [Indexed: 10/05/2023] Open
Abstract
Objective Augmented reality (AR) is a relatively new technology that merges virtual and physical environments, augmenting one's perception of reality. AR creates a computer-generated environment that evokes a unique perception of reality, where real and virtual objects are registered with one another, which operates interactively and in real time. Recently, the medical application of AR technology has dramatically increased with other assisted technologies, from training to clinical practice. The ability to manipulate the real environment extensively has given AR interventions an advantage over traditional approaches. In this study, we aim to conduct a systematic review of the use of AR to have a better understanding of how the use of AR may affect patients with mental health-related conditions when combined with gamification. Method This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by searching Pubmed and Web of Science databases. Results and Conclusion We identified 48 relevant studies that fulfill the criteria. The studies were grouped into four categories: Neurodevelopmental disorders, anxiety and phobia, psychoeducation & well-being, and procedural & pain management. Our results revealed the effectiveness of AR in mental health-related conditions. However, the heterogeneity and small sample sizes demonstrate the need for further research with larger sample sizes and high-quality study designs.
Collapse
Affiliation(s)
| | | | - Egemen Sever
- School of Medicine, Koç University, Istanbul, Turkey
| | | | - Herdem Aslan Genç
- Department of Psychiatry, Koç University School of Medicine, Istanbul, Turkey
| | - Tuba Mutluer
- Department of Psychiatry, Koç University School of Medicine, Istanbul, Turkey
| |
Collapse
|
29
|
Dante SA, Carroll MK, Ng DK, Patel A, Spinella PC, Steiner ME, Loftis LL, Bembea MM. Extracorporeal Membrane Oxygenation Outcomes in Children With Preexisting Neurologic Disorders or Neurofunctional Disability. Pediatr Crit Care Med 2022; 23:881-892. [PMID: 36000833 PMCID: PMC9633375 DOI: 10.1097/pcc.0000000000003064] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Patient selection for pediatric extracorporeal membrane oxygenation (ECMO) support has broadened over the years to include children with pre-existing neurologic morbidities. We aimed to determine the prevalence and nature of pre-ECMO neurologic disorders or disability and investigate the association between pre-ECMO neurologic disorders or disability and mortality and unfavorable neurologic outcome. DESIGN Multicenter retrospective observational cohort study. SETTING Eight hospitals reporting to the Pediatric ECMO Outcomes Registry between October 2011 and June 2019. PATIENTS Children younger than 18 years supported with venoarterial or venovenous ECMO. INTERVENTIONS The primary exposure was presence of pre-ECMO neurologic disorders or moderate-to-severe disability, defined as Pediatric Cerebral Performance Category (PCPC) or Pediatric Overall Performance Category (POPC) 3-5. The primary outcome was unfavorable outcome at hospital discharge, defined as in-hospital mortality or survival with moderate-to-severe disability (discharge PCPC 3-5 with deterioration from baseline). MEASUREMENTS AND MAIN RESULTS Of 598 children included in the final cohort, 68 of 598 (11%) had a pre-ECMO neurologic disorder, 70 of 595 (12%) had a baseline PCPC 3-5, and 189 of 592 (32%) had a baseline POPC 3-5. The primary outcome of in-hospital mortality ( n = 267) or survival with PCPC 3-5 with deterioration from baseline ( n = 39) was observed in 306 of 598 (51%). Overall, one or more pre-ECMO neurologic disorders or disability were present in 226 of 598 children (38%) but, after adjustment for age, sex, diagnostic category, pre-ECMO cardiac arrest, and ECMO mode, were not independently associated with increased odds of unfavorable outcome (unadjusted odds ratio [OR], 1.34; 95% CI, 1.07-1.69; multivariable adjusted OR, 1.30; 95% CI, 0.92-1.82). CONCLUSIONS In this exploratory study using a multicenter pediatric ECMO registry, more than one third of children requiring ECMO support had pre-ECMO neurologic disorders or disability. However, pre-existing morbidities were not independently associated with mortality or unfavorable neurologic outcomes at hospital discharge after adjustment for diagnostic category and other covariates.
Collapse
Affiliation(s)
- Siddhartha A. Dante
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland
| | - Megan K. Carroll
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Derek K. Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ankur Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Philip C. Spinella
- Department of Surgery, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Marie E. Steiner
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Laura L. Loftis
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Melania M. Bembea
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | |
Collapse
|
30
|
Naser AY, Dahmash EZ, Alqahtani JS, Alsairafi ZK, Alsaleh FM, Alwafi H. Trends in Hospital Admissions for Mental, Behavioural and Neurodevelopmental Disorders in England and Wales between 1999 and 2019: An Ecological Study. Healthcare (Basel) 2022; 10:healthcare10112191. [PMID: 36360532 PMCID: PMC9690103 DOI: 10.3390/healthcare10112191] [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: 08/24/2022] [Revised: 10/21/2022] [Accepted: 10/28/2022] [Indexed: 11/04/2022] Open
Abstract
Objectives: To investigate the trends in hospital admissions for mental, behavioural and neurodevelopmental disorders (MBNDs) in England and Wales. Methods: This is an ecological study using the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admission data was collected for the period between April 1999 and March 2019. Results: The most common type of hospital admission was for mental and behavioural disorders due to psychoactive substance use, which accounted for 26.6%. The admission rate among males increased by 8.1% [from 479.59 (95% CI 476.90−482.27) in 1999 to 518.30 (95% CI 515.71−520.90) in 2019 per 1000 persons; p < 0.001]. The admission rate among females increased by 0.3% [from 451.45 (95% CI 448.91−453.99) in 1999 to 452.77 (95% CI 450.37−455.17) in 2019 per 1000 persons; p = 0.547]. The 15−59 years’ age group accounted for 65.1% of the entire number of such hospital admissions, followed by the 75 years and above age group, with 19.0%. Conclusion: We observed an obvious variation in MBNDs influenced by age and gender. Observational studies are needed to identify other factors associated with increased hospital admission rates related to MBNDs, specifically among the young population (aged 15−59 years) and males.
Collapse
Affiliation(s)
- Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Eman Zmaily Dahmash
- School of Life Science, Pharmacy, and Chemistry, Faculty of Health, Science, Social Care & Education, Kingston University, Surrey KT1 2EE, UK
| | - Jaber S. Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam 34313, Saudi Arabia
| | - Zahra K. Alsairafi
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli 13060, Kuwait
| | - Fatemah M. Alsaleh
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Hawalli 13060, Kuwait
- Correspondence:
| | - Hassan Alwafi
- Faculty of Medicine, Umm Al-Qura University, Mecca 21955, Saudi Arabia
| |
Collapse
|
31
|
Zhou B, Yan X, Yang L, Zheng X, Chen Y, Liu Y, Ren Y, Peng J, Zhang Y, Huang J, Tang L, Wen M. Effects of arginine vasopressin on the transcriptome of prefrontal cortex in autistic rat model. J Cell Mol Med 2022; 26:5493-5505. [PMID: 36239083 PMCID: PMC9639040 DOI: 10.1111/jcmm.17578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 07/06/2022] [Revised: 09/04/2022] [Accepted: 09/25/2022] [Indexed: 11/25/2022] Open
Abstract
Our previous studies have also demonstrated that AVP can significantly improve social interaction disorders and stereotypical behaviours in rats with VPA‐induced autism model. To further explore the mechanisms of action of AVP, we compared the PFC transcriptome changes before and after AVP treatment in VPA‐induced autism rat model. The autism model was induced by intraperitoneally injected with VPA at embryonic day 12.5 and randomly assigned to two groups: the VPA‐induced autism model group and the AVP treatment group. The AVP treatment group were treated with intranasal AVP at postnatal day 21 and for 3 weeks. The gene expression levels and function changes on the prefrontal cortex were measured by RNA‐seq and bioinformatics analysis at PND42 and the mRNA expression levels of synaptic and myelin development related genes were validated by qPCR. Our results confirmed that AVP could significantly improve synaptic and axon dysplasia and promote oligodendrocyte development in the prefrontal cortex in VPA‐induced autism models by regulating multiple signalling pathways.
Collapse
Affiliation(s)
- Bo Zhou
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Xuehui Yan
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Liu Yang
- Department of Neurology, Wuhan Third Hospital (Tongren Hospital of Wuhan University), Wuhan, China
| | - Xiaoli Zheng
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Yunhua Chen
- College of Basic Medical, Guizhou Medical University, Guizhou, China
| | - Yibu Liu
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Yibing Ren
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Jingang Peng
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Yi Zhang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Jiayu Huang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Lei Tang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| | - Min Wen
- State Key Laboratory of Functions and Applications of Medicinal Plants, Guizhou Medical University, Guizhou, China.,Guizhou Provincial Engineering Technology Research Center for Chemical Drug R&D, Guizhou Medical University, Guizhou, China.,College of Pharmacy, Guizhou Medical University, Guizhou, China
| |
Collapse
|
32
|
Rapp T, Kalinousky AJ, Johnson J, Bjornsson H, Harris J. Sleep disturbance is a common feature of Kabuki syndrome. Am J Med Genet A 2022; 188:3041-3048. [PMID: 35930004 PMCID: PMC9474613 DOI: 10.1002/ajmg.a.62921] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 01/31/2023]
Abstract
Kabuki syndrome (KS) is a rare epigenetic disorder caused by heterozygous loss of function variants in either KMT2D (90%) or KDM6A (10%), both involved in regulation of histone methylation. While sleep disturbance in other Mendelian disorders of the epigenetic machinery has been reported, no study has been conducted on sleep in KS. This study assessed sleep in 59 participants with KS using a validated sleep questionnaire. Participants ranged in age from 4 to 43 years old with 86% of participants having a pathogenic variant in KMT2D. In addition, data on adaptive function, behavior, anxiety, and quality of life were collected using their respective questionnaires. Some form of sleep issue was present in 71% of participants, with night-waking, daytime sleepiness, and sleep onset delay being the most prevalent. Sleep dysfunction was positively correlated with maladaptive behaviors, anxiety levels, and decreasing quality of life. Sleep issues were not correlated with adaptive function. This study establishes sleep disturbance as a common feature of KS. Quantitative sleep measures may be a useful outcome measure for clinical trials in KS. Further, clinicians caring for those with KS should consider sleep dysfunction as an important feature that impacts overall health and well being in these patients.
Collapse
Affiliation(s)
- Tyler Rapp
- University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Allison J Kalinousky
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | | | - Hans Bjornsson
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Landspitali University Hospital, Reykjavik, Iceland
| | - Jacqueline Harris
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Kennedy Krieger Institute, Baltimore, MD 21205, USA
| |
Collapse
|
33
|
Salik D, Hadj-Rabia S, Hohl D, Vahidnezhad H, Youssefian L, Rakosi A, Dangoisse C, Marangoni M, Vilain C, Smits G. Evaluation of neurodevelopmental symptoms in 10 cases of neonatal ichthyosis and sclerosing cholangitis syndrome. Pediatr Dermatol 2022; 39:590-593. [PMID: 35304779 DOI: 10.1111/pde.14976] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 02/12/2022] [Accepted: 02/27/2022] [Indexed: 11/28/2022]
Abstract
Neonatal ichthyosis and sclerosing cholangitis (NISCH) syndrome is an extremely rare entity with only 19 patients described in the literature. We report an extended family with the disorder and investigate the association of neurodevelopmental symptoms. Patients with CLDN1 mutations, and specifically « the Moroccan» c.200_201delTT deletion, may be an increased risk for neurodevelopmental symptoms such as learning disabilities, mental retardation, and language delay.
Collapse
Affiliation(s)
- Deborah Salik
- Department of Dermatology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Smail Hadj-Rabia
- Department of Dermatology, Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Paris, France.,Institut Imagine, Université Descartes, Sorbonne Paris Cité, Hôpital Necker-Enfants Malades, Paris, France
| | - Daniel Hohl
- Department of Dermatology, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Hassan Vahidnezhad
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leila Youssefian
- Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College, and Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Adèle Rakosi
- Department of Dermatology, University Hospital Center of Lausanne, Lausanne, Switzerland
| | - Chantal Dangoisse
- Department of Dermatology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Martina Marangoni
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Catheline Vilain
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, ULB Center of Human Genetics, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Brussels, Belgium
| | - Guillaume Smits
- Department of Genetics, Hôpital Erasme, ULB Center of Human Genetics, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Department of Genetics, Hôpital Universitaire des Enfants Reine Fabiola, ULB Center of Human Genetics, Université Libre de Bruxelles (ULB), Brussels, Belgium.,Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
34
|
Cooley Coleman JA, Sarasua SM, Moore HW, Boccuto L, Cowan CW, Skinner SA, DeLuca JM. Clinical findings from the landmark MEF2C-related disorders natural history study. Mol Genet Genomic Med 2022; 10:e1919. [PMID: 35416405 PMCID: PMC9184670 DOI: 10.1002/mgg3.1919] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/27/2022] [Accepted: 02/25/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction MEF2C‐related disorders are characterized by developmental and cognitive delay, limited language and walking, hypotonia, and seizures. A recent systematic review identified 117 patients with MEF2C‐related disorders across 43 studies. Despite these reports, the disorder is not easily recognized and assessments are hampered by small sample sizes. Our objective was to gather developmental and clinical information on a large number of patients. Methods We developed a survey based on validated instruments and subject area experts to gather information from parents of children with this condition. No personal identifiers were collected. Surveys and data were collected via REDCap and analyzed using Excel and SAS v9.4. Results Seventy‐three parents completed the survey, with 39.7% reporting a MEF2C variant and 54.8% reporting a deletion involving MEF2C. Limited speech (82.1%), seizures (86.3%), bruxism (87.7%), repetitive movements (94.5%), and high pain tolerance (79.5%) were some of the prominent features. Patients with MEF2C variants were similarly affected as those with deletions. Female subjects showed higher verbal abilities. Conclusion This is the largest natural history study to date and establishes a comprehensive review of developmental and clinical features for MEF2C‐related disorders. This data can help providers diagnose patients and form the basis for longitudinal or genotype–phenotype studies.
Collapse
Affiliation(s)
- Jessica A Cooley Coleman
- School of Nursing, Clemson University, Clemson, South Carolina, USA.,Greenwood Genetic Center, Greenwood, South Carolina, USA
| | - Sara M Sarasua
- School of Nursing, Clemson University, Clemson, South Carolina, USA
| | | | - Luigi Boccuto
- School of Nursing, Clemson University, Clemson, South Carolina, USA
| | - Christopher W Cowan
- Department of Neuroscience, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | - Jane M DeLuca
- School of Nursing, Clemson University, Clemson, South Carolina, USA.,Greenwood Genetic Center, Greenwood, South Carolina, USA
| |
Collapse
|
35
|
Clasby B, Mirfin‐Veitch B, Blackett R, Kedge S, Whitehead E. Responding to neurodiversity in the courtroom: A brief evaluation of environmental accommodations to increase procedural fairness. Crim Behav Ment Health 2022; 32:197-211. [PMID: 35932097 PMCID: PMC9540328 DOI: 10.1002/cbm.2239] [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] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/20/2022] [Indexed: 06/15/2023]
Abstract
Recent research has highlighted that a high prevalence of young adults who have various forms of neurodivergence come into contact with the criminal justice system. Currently, many courts are not designed to respond to neurological differences often seen in young people who engage with them. The aim of this study was to identify ways to make locality courts more accessible, engaging, and ultimately more responsive to neurodivergence. A panel of neurodivergence specialists reviewed the general district courtroom environment of a new specialised young adult list court in Aotearoa New Zealand to identify potential barriers to accessibility and to highlight areas for improvement. The methodology involved naturalistic observation of a typical morning in the courtroom. We identified a series of recommendations with the potential to improve the court experience and increase access to justice for neurodivergent young adults. This study identified specific need for neurodiversity education and screening within the court environment.
Collapse
Affiliation(s)
- Betony Clasby
- Department of Sociological StudiesThe University of SheffieldSheffieldUK
- Murdoch Children’s Research InstituteMelbourneAustralia
- Donald Beasley InstituteDunedinNew Zealand
| | - Brigit Mirfin‐Veitch
- Donald Beasley InstituteDunedinNew Zealand
- Centre for Postgraduate Nursing StudiesUniversity of OtagoDunedinNew Zealand
| | - Rose Blackett
- Registered Psychologist, Dyslexia Foundation of New ZealandChristchurchNew Zealand
| | - Sally Kedge
- The University of AucklandAucklandNew Zealand
| | - Esther Whitehead
- PGDipLitEdMassey UniversityPalmerston NorthNew Zealand
- Advocate and AdvisoryNeurodiversity Community of PracticeAko AotearoaThrivableNew Zealand
| |
Collapse
|
36
|
Fisher HL. Editorial: The near ubiquity of comorbidity - what are the implications for children's mental health research and practice? J Child Psychol Psychiatry 2022; 63:505-506. [PMID: 35442517 DOI: 10.1111/jcpp.13612] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
The experience of two or more mental health disorders or symptom-clusters, either simultaneously or sequentially, is common among adults. Increasing evidence suggests that such comorbidity may also be prevalent among children though it often extends beyond mental health disorders. This is highlighted by several of the papers featured in the current issue of the Journal, which are summarised in this editorial. These studies underscore the importance of providing integrated care for children to ensure all their needs are effectively addressed. It also raises questions about the distinctions we draw between disorders and supports calls for dimensional approaches to conceptualising psychopathology and its inter-relatedness with other aspects of health and functioning.
Collapse
Affiliation(s)
- Helen L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,ESRC Centre for Society and Mental Health, King's College London, London, UK
| |
Collapse
|
37
|
Gale-Grant O, Fenn-Moltu S, França LGS, Dimitrova R, Christiaens D, Cordero-Grande L, Chew A, Falconer S, Harper N, Price AN, Hutter J, Hughes E, O'Muircheartaigh J, Rutherford M, Counsell SJ, Rueckert D, Nosarti C, Hajnal JV, McAlonan G, Arichi T, Edwards AD, Batalle D. Effects of gestational age at birth on perinatal structural brain development in healthy term-born babies. Hum Brain Mapp 2022; 43:1577-1589. [PMID: 34897872 PMCID: PMC8886657 DOI: 10.1002/hbm.25743] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/19/2021] [Accepted: 11/30/2021] [Indexed: 11/12/2022] Open
Abstract
Infants born in early term (37-38 weeks gestation) experience slower neurodevelopment than those born at full term (40-41 weeks gestation). While this could be due to higher perinatal morbidity, gestational age at birth may also have a direct effect on the brain. Here we characterise brain volume and white matter correlates of gestational age at birth in healthy term-born neonates and their relationship to later neurodevelopmental outcome using T2 and diffusion weighted MRI acquired in the neonatal period from a cohort (n = 454) of healthy babies born at term age (>37 weeks gestation) and scanned between 1 and 41 days after birth. Images were analysed using tensor-based morphometry and tract-based spatial statistics. Neurodevelopment was assessed at age 18 months using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Infants born earlier had higher relative ventricular volume and lower relative brain volume in the deep grey matter, cerebellum and brainstem. Earlier birth was also associated with lower fractional anisotropy, higher mean, axial, and radial diffusivity in major white matter tracts. Gestational age at birth was positively associated with all Bayley-III subscales at age 18 months. Regression models predicting outcome from gestational age at birth were significantly improved after adding neuroimaging features associated with gestational age at birth. This work adds to the body of evidence of the impact of early term birth and highlights the importance of considering the effect of gestational age at birth in future neuroimaging studies including term-born babies.
Collapse
Affiliation(s)
- Oliver Gale-Grant
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Sunniva Fenn-Moltu
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Lucas G S França
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Ralica Dimitrova
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Daan Christiaens
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Department of Electrical Engineering, ESAT/PSI, KU Leuven, Leuven, Belgium
| | - Lucilio Cordero-Grande
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Biomedical Image Technologies, ETSI Telecomunicación, Universidad Politécnica de Madrid and CIBER-BBN, Madrid, Spain
| | - Andrew Chew
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Shona Falconer
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Nicholas Harper
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Anthony N Price
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Jana Hutter
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Emer Hughes
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Jonathan O'Muircheartaigh
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Mary Rutherford
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Serena J Counsell
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Daniel Rueckert
- Department of Computing, Imperial College London, London, UK.,Department of Medicine and Informatics, Technical University of Munich, Munich, Germany
| | - Chiara Nosarti
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph V Hajnal
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Grainne McAlonan
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Tomoki Arichi
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,Paediatric Neurosciences, Evelina London Children's Hospital Guy's and St Thomas' NHS Foundation Trust, London, UK.,Department of Bioengineering, Imperial College London, London, UK
| | - A David Edwards
- Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK.,MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK
| | - Dafnis Batalle
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Centre for the Developing Brain, School of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| |
Collapse
|
38
|
Saldaña-García N, Espinosa-Fernández MG, Martínez-Pajares JD, Tapia-Moreno E, Moreno-Samos M, Cuenca-Marín C, Rius-Díaz F, Sánchez-Tamayo T. Antenatal Betamethasone Every 12 Hours in Imminent Preterm Labour. J Clin Med 2022; 11:jcm11051227. [PMID: 35268318 PMCID: PMC8911008 DOI: 10.3390/jcm11051227] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/04/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Benefits of antenatal corticosteroids have been established for preterm infants who have received the full course. In imminent preterm labours there is no time to administer the second dose 24 h later. Objective: To determine whether the administration of two doses of betamethasone in a 12 h interval is equivalent to the effects of a full maturation. Methods: We performed a retrospective cohort study including preterm infants ≤34 weeks gestational age at birth and ≤1500 g, admitted to an NICU IIIC level in a tertiary hospital from 2015 to 2020. The population was divided into two cohorts: complete maturation (CM) (two doses of betamethasone 24 h apart), or advanced maturation (AM) (two doses of betamethasone 12 h apart). The primary outcomes were mortality or survival with severe morbidities. The presence of respiratory distress syndrome and other morbidities of prematurity were determined. These variables were analysed in the neonates under 28 weeks gestational age cohort. Neurodevelopment at 2 years was evaluated with the validated Ages and Stages Questionnaires®, Third Edition (ASQ®-3). Multiple regression analyses were performed and adjusted for confounding factors. Results: A total of 275 preterm neonates were included. Serious outcomes did not show differences between cohorts, no increased incidence of morbidity was found in AM. A lower percentage of hypotension during the first week (p = 0.04), a tendency towards lower maximum FiO2 (p = 0.14) and to a shorter mechanical ventilation time (p = 0.14) were observed for the AM cohort. Similar results were found in the subgroup of neonates under 28 weeks gestational age. There were no differences in cerebral palsy or sensory deficits at 24 months of corrected age, although the AM cohort showed a trend towards better scores on the ASQ3 scale. Conclusions: Administration of betamethasone every 12 h showed similar results to the traditional pattern with respect to mortality and severe morbidities. No deleterious neurodevelopmental effects were found at 24 months of corrected age. Earlier administration of betamethasone at 12 h after the first dose would be an alternative in imminent preterm delivery. Further studies are needed to confirm these results.
Collapse
Affiliation(s)
- Natalia Saldaña-García
- Department of Neonatology, Regional University Hospital of Málaga, 29010 Malaga, Spain; (M.G.E.-F.); (J.D.M.-P.); (E.T.-M.); (M.M.-S.)
- School of Medicine, Malaga University, 29071 Malaga, Spain
- Correspondence: (N.S.-G.); (T.S.-T.)
| | - María Gracia Espinosa-Fernández
- Department of Neonatology, Regional University Hospital of Málaga, 29010 Malaga, Spain; (M.G.E.-F.); (J.D.M.-P.); (E.T.-M.); (M.M.-S.)
| | - Jose David Martínez-Pajares
- Department of Neonatology, Regional University Hospital of Málaga, 29010 Malaga, Spain; (M.G.E.-F.); (J.D.M.-P.); (E.T.-M.); (M.M.-S.)
| | - Elías Tapia-Moreno
- Department of Neonatology, Regional University Hospital of Málaga, 29010 Malaga, Spain; (M.G.E.-F.); (J.D.M.-P.); (E.T.-M.); (M.M.-S.)
| | - María Moreno-Samos
- Department of Neonatology, Regional University Hospital of Málaga, 29010 Malaga, Spain; (M.G.E.-F.); (J.D.M.-P.); (E.T.-M.); (M.M.-S.)
| | - Celia Cuenca-Marín
- Department of Obstetrics and Gineocology, Regional University Hospital of Málaga, 29010 Malaga, Spain;
| | - Francisca Rius-Díaz
- Department of Preventive Medicine and Public Health, Biostatistics, School of Medicine, Malaga University, 29071 Malaga, Spain;
| | - Tomás Sánchez-Tamayo
- Department of Neonatology, Regional University Hospital of Málaga, 29010 Malaga, Spain; (M.G.E.-F.); (J.D.M.-P.); (E.T.-M.); (M.M.-S.)
- Pharmacology and Pediatrics Department, Malaga University, 29071 Malaga, Spain
- Correspondence: (N.S.-G.); (T.S.-T.)
| |
Collapse
|
39
|
Farhat LC, Brentani H, de Toledo VHC, Shephard E, Mattos P, Baron-Cohen S, Thapar A, Casella E, Polanczyk GV. ADHD and autism symptoms in youth: a network analysis. J Child Psychol Psychiatry 2022; 63:143-151. [PMID: 33984874 DOI: 10.1111/jcpp.13436] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Previous research investigating the overlap between attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (henceforth, autism) symptoms in population samples have relied on latent variable modeling in which averaged scores representing dimensions were derived from observed symptoms. There are no studies evaluating how ADHD and autism symptoms interact at the level of individual symptom items. METHODS We aimed to address this gap by performing a network analysis on data from a school survey of children aged 6-17 years old (N = 7,405). ADHD and autism symptoms were measured via parent-report on the Swanson, Nolan, Pelham-IV questionnaire and the Childhood Autism Spectrum test, respectively. RESULTS A relatively low interconnectivity between ADHD and autism symptoms was found with only 10.06% of possible connections (edges) between one ADHD and one autism symptoms different than zero. Associations between ADHD and autism symptoms were significantly weaker than those between two symptoms pertaining to the same construct. Select ADHD symptoms, particularly those presenting in social contexts (e.g. 'talks excessively', 'does not wait turn'), showed moderate-to-strong associations with autism symptoms, but some were considered redundant to autism symptoms. CONCLUSIONS The present findings indicate that individual ADHD and autism symptoms are largely segregated in accordance with diagnostic boundaries corresponding to these conditions in children and adolescents from the community. These findings could improve our clinical conceptualization of ADHD and autism and guide advancements in diagnosis and treatment.
Collapse
Affiliation(s)
- Luis C Farhat
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Helena Brentani
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | - Elizabeth Shephard
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Paulo Mattos
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Simon Baron-Cohen
- Department of Psychiatry, Autism Research Center, University of Cambridge, Cambridge, UK
| | - Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Center for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK
| | - Erasmo Casella
- Instituto da Criança, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Guilherme V Polanczyk
- Departamento de Psiquiatria da Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
40
|
Sams EI, Ng JK, Tate V, Claire Hou YC, Cao Y, Antonacci-Fulton L, Belhassan K, Neidich J, Mitra RD, Cole FS, Dickson P, Milbrandt J, Turner TN. From karyotypes to precision genomics in 9p deletion and duplication syndromes. HGG Adv 2022; 3:100081. [PMID: 35047865 PMCID: PMC8756500 DOI: 10.1016/j.xhgg.2021.100081] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 12/21/2021] [Indexed: 11/27/2022] Open
Abstract
While 9p deletion and duplication syndromes have been studied for several years, small sample sizes and minimal high-resolution data have limited a comprehensive delineation of genotypic and phenotypic characteristics. In this study, we examined genetic data from 719 individuals in the worldwide 9p Network Cohort: a cohort seven to nine times larger than any previous study of 9p. Most breakpoints occur in bands 9p22 and 9p24, accounting for 35% and 38% of all breakpoints, respectively. Bands 9p11 and 9p12 have the fewest breakpoints, with each accounting for 0.6% of all breakpoints. The most common phenotype in 9p deletion and duplication syndromes is developmental delay, and we identified eight known neurodevelopmental disorder genes in 9p22 and 9p24. Since it has been previously reported that some individuals have a secondary structural variant related to the 9p variant, we examined our cohort for these variants and found 97 events. The top secondary variant involved 9q in 14 individuals (1.9%), including ring chromosomes and inversions. We identified a gender bias with significant enrichment for females (p = 0.0006) that may arise from a sex reversal in some individuals with 9p deletions. Genes on 9p were characterized regarding function, constraint metrics, and protein-protein interactions, resulting in a prioritized set of genes for further study. Finally, we achieved precision genomics in one child with a complex 9p structural variation using modern genomic technologies, demonstrating that long-read sequencing will be integral for some cases. Our study is the largest ever on 9p-related syndromes and provides key insights into genetic factors involved in these syndromes.
Collapse
Affiliation(s)
- Eleanor I. Sams
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jeffrey K. Ng
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Victoria Tate
- Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Ying-Chen Claire Hou
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Yang Cao
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | | | - Khadija Belhassan
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Julie Neidich
- Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Robi D. Mitra
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - F. Sessions Cole
- Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Patricia Dickson
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA
- Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jeffrey Milbrandt
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA
- McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO 63110, USA
- Needleman Center for Neurometabolism and Axonal Therapeutics, St. Louis, MO, USA
| | - Tychele N. Turner
- Department of Genetics, Washington University School of Medicine, St. Louis, MO 63110, USA
| |
Collapse
|
41
|
Zhang W, Li D, Pang N, Jiang L, Li B, Ye F, He F, Chen S, Liu F, Peng J, Yin J, Yin F. The second-tier status of fragile X syndrome testing for unexplained intellectual disability/global developmental delay in the era of next-generation sequencing. Front Pediatr 2022; 10:911805. [PMID: 35935362 PMCID: PMC9353215 DOI: 10.3389/fped.2022.911805] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Although many unexplained intellectual disability/global developmental delay (ID/GDD) individuals have benefited from the excellent detection yield of copy number variations and next-generation sequencing testing, many individuals still who suffer from ID/GDD of unexplained etiology. In this study, we investigated the applicability of fragile X syndrome (FXS) testing in unexplained ID/GDD individuals with negative or absent genetic testing. METHODS In this study, we used the triplet repeat primed polymerase chain reaction to evaluate the value and application of fragile X testing in unexplained ID/GDD individuals with negative or absent genetic testing (n = 681) from three hospitals. RESULTS Of the 681 ID/GDD individuals with negative or absent genetic testing results detected by FXS testing, 12 men and one woman were positive. This corresponded to a diagnostic yield of 1.9% for FXS testing in our cohort. All FXS individuals had either a family history of ID/GDD or suggestive clinical features. The detection yield of FXS testing in ID/GDD individuals who completed genetic testing (2.70%, 12/438) was significantly higher than in individuals without any genetic testing (0.40%, 1/243). CONCLUSIONS This is the first report of FXS testing in ID/GDD individuals who lacked previous genetic testing, which promotes standardization of the FXS diagnostic process. These results highlight the utility of FXS testing of unexplained ID/GDD individuals with negative results from standard genetic testing. In the era of next-generation sequencing, FXS testing is more suitable as a second-tier choice and provides clinicians and geneticists with auxiliary references for tracing the etiology of ID/GDD.
Collapse
Affiliation(s)
- Wen Zhang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Dong Li
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Nan Pang
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Li Jiang
- Department of Neurology, Children's Hospital Affiliated to Chongqing Medical University, Chongqing, China
| | - Baomin Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Fanghua Ye
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China
| | - Fang He
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Shimeng Chen
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Fangyun Liu
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Jing Peng
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| | - Jinghua Yin
- Department of Pathophysiology, Xiangya Hospital, Central South University, Changsha, China
| | - Fei Yin
- Department of Pediatrics, Xiangya Hospital, Central South University, Changsha, China.,Hunan Intellectual and Developmental Disabilities Research Center, Pediatrics, Changsha, China.,Clinical Research Center for Children Neurodevelopmental Disabilities of Hunan Province, Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
42
|
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by variable impairment of social communication and repetitive behaviors, highly restricted interests, and/or sensory behaviors beginning early in life. Many individuals with ASD have dysfunction of microglia, which may be closely related to neuroinflammation, making microglia play an important role in the pathogenesis of ASD. Mounting evidence indicates that microglia, the resident immune cells of the brain, are required for proper brain function, especially in the maintenance of neuronal circuitry and control of behavior. Dysfunction of microglia will ultimately affect the neural function in a variety of ways, including the formation of synapses and alteration of excitatory-inhibitory balance. In this review, we provide an overview of how microglia actively interact with neurons in physiological conditions and modulate the fate and functions of synapses. We put a spotlight on the multi-dimensional neurodevelopmental roles of microglia, especially in the essential influence of synapses, and discuss how microglia are currently thought to influence ASD progression.
Collapse
Affiliation(s)
- Cong Hu
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Heli Li
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinhui Li
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Hao
- Division of Child Healthcare, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
43
|
Abstract
Executive functioning (EF) processes are essential for adaptive and flexible responding to the demands and complexities of everyday life. Conversely, if impaired, these processes are a key transdiagnostic risk factor that cuts across autism and a range of other neurodevelopmental (NDD) and neuropsychiatric (NPD) conditions. However, there are currently no freely available informant-report measures that comprehensively characterize non-affective (e.g., working memory, response inhibition, and set shifting) and affective (e.g., emotion regulation) EF subdomains. This study describes the development, refinement, and initial psychometric evaluation of a new 52-item Executive Functioning Scale (EFS). Two independent data collections yielded exploratory (n = 2004, 169 with autism, ages 2-17) and confirmatory (n = 954, 74 with autism, ages 2-17) samples. Exploratory Structural Equation Modeling (ESEM) model with six specific factors that closely matched hypothesized executive functioning subdomains of working memory and sequencing, response inhibition, set-shifting, processing speed, emotion regulation, and risk avoidance, and one general factor, showed the best fit to the data and invariance across age, sex, race, and ethnicity groups. Model reliability and internal consistency were excellent for the general factor (ω = 0.98; α = 0.97) and specific factors (ω ≥ 0.89-0.96; α ≥ 0.84-0.94). Conditional reliability estimates indicated excellent reliability (≥0.90) for the total EF scale and adequate or better reliability (≥0.70) for subscale scores. With further replication, the EFS has excellent potential for wide adoption across research and clinical contexts.
Collapse
Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Ru Ying Cai
- Aspect Research Centre for Autism Practice, Frenchs Forest, NSW, Australia
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Thomas W Frazier
- Department of Psychology, John Carroll University, University Heights, OH, United States
| |
Collapse
|
44
|
Ramdin TD, Saggers RT, Bandini RM, Magadla Y, Mphaphuli AV, Ballot DE. Neurodevelopmental Outcomes of Extremely Low Birth Weight Survivors in Johannesburg, South Africa. Front Pediatr 2022; 10:902263. [PMID: 35664886 PMCID: PMC9160720 DOI: 10.3389/fped.2022.902263] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Improved survival in extremely low birth weight infants (ELBWI) in Sub-Saharan Africa has raised the question whether these survivors have an increased chance of adverse neurodevelopmental outcomes. OBJECTIVES To describe neurodevelopmental outcomes of ELBWI in a neonatal unit in South Africa. METHODS This was a prospective follow-up study. All ELBWI who survived to discharge between 1 July 2013 and 31 December 2017 were invited to attend the clinic. Bayley Scales of Infant and Toddler Development (version III) were conducted at 9 to 12 months and 18 to 24 months. RESULTS There were 723 ELBWI admissions during the study period, 292 (40.4%) survived to hospital discharge and 85/292 (29.1%) attended the neonatal follow up clinic. The mean birth weight was 857.7 g (95% CI: 838.2-877.2) and the mean gestational age was 27.5 weeks (95% CI 27.1-27.9). None of the infants had any major complication of prematurity. A total of 76/85 (89.4%) of the infants had a Bayley-III assessment at a mean corrected age of 17.21 months (95% CI: 16.2-18.3). The mean composite scores for cognition were 98.4 (95% CI 95.1-101.7), language 89.9 (95% CI 87.3-92.5) and motor 97.6 (95% CI 94.5-100.6). All mean scores fell within the normal range, The study found 28 (36.8%) infants to be "at risk" for neurodevelopmental delay. CONCLUSION Our study demonstrates good neurodevelopmental outcome in a small group of surviving ELBWI, but these results must be interpreted in the context of the high mortality in this group of infants.
Collapse
Affiliation(s)
- Tanusha D Ramdin
- Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,PRINCE (Project to Improve Neonatal Care), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Robin T Saggers
- Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,PRINCE (Project to Improve Neonatal Care), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Rossella M Bandini
- PRINCE (Project to Improve Neonatal Care), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Yoliswa Magadla
- Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,PRINCE (Project to Improve Neonatal Care), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Aripfani V Mphaphuli
- Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,PRINCE (Project to Improve Neonatal Care), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Daynia E Ballot
- PRINCE (Project to Improve Neonatal Care), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
45
|
Abstract
AIM To find early predictors for poor neurodevelopmental outcome after neonatal group B streptococcal meningitis. METHODS We retrospectively analyzed clinical characteristics of 23 patients with neonatal group B streptococcal meningitis and their neurodevelopmental outcome at 18 months. Available group B Streptococcus strains were serotyped and their genomes characterized. RESULTS We found several differences between patients with early- (n = 5) and late-onset (n = 18) disease. Nine children had neurologic abnormalities at 18 months and 4 had epilepsy, all of them after late-onset disease. Most important risk factors for poor outcome were impaired consciousness at admission, hemodynamic instability, seizures, or abnormal electroencephalogram during the acute illness and abnormal neurologic and ophthalmologic examination at the end of treatment, whereas abnormalities in laboratory and imaging studies were not predictive. Hypervirulent serotype III, multilocus sequence type 17 group B Streptococcus was the predominant pathogen. CONCLUSIONS Neurodevelopmental impairment after neonatal group B streptococcal meningitis is likelier in those with clinical and neurophysiological features indicating worse disease severity.
Collapse
Affiliation(s)
- Petja Fister
- Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.,37664Faculty of Medicine, University of Ljubljana, Slovenia
| | - Jerneja Peček
- Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.,37664Faculty of Medicine, University of Ljubljana, Slovenia
| | - Samo Jeverica
- 68924National Laboratory for Health, Environment and Food, Maribor, Slovenia
| | - Zvonka Rener Primec
- 37664Faculty of Medicine, University of Ljubljana, Slovenia.,Department of Neurology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Darja Paro-Panjan
- Department of Neonatology, Division of Pediatrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.,37664Faculty of Medicine, University of Ljubljana, Slovenia
| |
Collapse
|
46
|
Uljarević M, Spackman EK, Cai RY, Paszek KJ, Hardan AY, Frazier TW. Daily living skills scale: Development and preliminary validation of a new, open-source assessment of daily living skills. Front Psychiatry 2022; 13:1108471. [PMID: 36756637 PMCID: PMC9900738 DOI: 10.3389/fpsyt.2022.1108471] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/30/2022] [Indexed: 01/25/2023] Open
Abstract
Autistic individuals and individuals with a range of other neurodevelopmental conditions (NDD) often present with lower levels of daily living skills (DLS) when compared to their neurotypical peers. Importantly, lower levels of DLS have been linked to a range of negative outcomes, including lower rates of post-secondary education, lower employment rates, and higher daily support needs across autism and NDD. However, there are currently no open-source informant-reported instruments for capturing key aspects of DLS. This study describes the development, refinement, and initial psychometric evaluation of a new, relatively brief (53-item). Daily Living Skills Scale (DLSS) in a sample of 1,361 children aged 2-17 years, Confirmatory Factor Analysis demonstrated an excellent fit of unidimensional model to the data (CFI = 0.953, TLI = 0.951, RMSEA = 0.073 [95% CI: 0.071-0.074]). The single-factor CFA model showed evidence of measurement invariance of factor loadings, thresholds, and residual variance (strict invariance) across sex, age, race, and ethnicity. Model reliability and internal consistency were excellent (ω = 0.98; α = 0.97). Conditional reliability estimates indicated very good reliability (= 0.80) for the total DLS scale from very low (θ = -4.2) to high (θ = +2.4) scores. Conceptually derived self-care, homecare, and community participation subscales also showed strong reliability and internal consistency. With further replication, the EFS has excellent potential for wide adoption across research and clinical contexts.
Collapse
Affiliation(s)
- Mirko Uljarević
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Emily K Spackman
- School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Ru Ying Cai
- Aspect Research Centre for Autism Practice, French's Forest, Sydney, NSW, Australia
| | - Katherine J Paszek
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Antonio Y Hardan
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
| | - Thomas W Frazier
- Department of Psychology, John Carroll University, University Heights, OH, United States
| |
Collapse
|
47
|
Sewell R, Buchanan CL, Davis S, Christakis DA, Dempsey A, Furniss A, Kazak AE, Kerlek AJ, Magnusen B, Pajor NM, Pyle L, Pyle LC, Razzaghi H, Schwartz BI, Vogiatzi MG, Nokoff NJ. Behavioral Health Diagnoses in Youth with Differences of Sex Development or Congenital Adrenal Hyperplasia Compared with Controls: A PEDSnet Study. J Pediatr 2021; 239:175-181.e2. [PMID: 34461062 PMCID: PMC8604751 DOI: 10.1016/j.jpeds.2021.08.066] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/10/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the odds of a behavioral health diagnosis among youth with differences of sex development (DSD) or congenital adrenal hyperplasia (CAH) compared with matched controls in the PEDSnet database. STUDY DESIGN All youth with a diagnosis of DSD (n = 1216) or CAH (n = 1647) and at least 1 outpatient encounter were extracted from the PEDSnet database and propensity-score matched on 8 variables (1:4) with controls (n = 4864 and 6588, respectively) using multivariable logistic regression. The likelihood of having behavioral health diagnoses was examined using generalized estimating equations. RESULTS Youth with DSD had higher odds of a behavioral health diagnosis (OR, 1.7; 95% CI, 1.4-2.1; P < .0001) and neurodevelopmental diagnosis (OR, 1.7; 95% CI, 1.4, 2.0; P < .0001) compared with matched controls. Youth with CAH did not have an increased odds of a behavioral health diagnosis (OR, 1.0; 95% CI, 0.9, 1.1; P = .9) compared with matched controls but did have higher odds of developmental delay (OR, 1.8; 95% CI, 1.4, 2.4; P < .0001). CONCLUSIONS Youth with DSD diagnosis have higher odds of a behavioral health or neurodevelopmental diagnosis compared with matched controls. Youth with CAH have higher odds of developmental delay, highlighting the need for screening in both groups.
Collapse
Affiliation(s)
- Rachel Sewell
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Cindy L Buchanan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Shanlee Davis
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Dimitri A Christakis
- Seattle Children's Research Institute, Center for Child Health, Behavior & Development, Seattle, WA
| | | | - Anna Furniss
- University of Colorado Anschutz Medical Campus, Adult & Child Consortium for Health Outcomes Research & Delivery, Aurora, CO
| | - Anne E Kazak
- Nemours Children's Health, Department of Pediatrics, Center for Healthcare Delivery Science and Thomas Jefferson University, Wilmington, DE
| | - Anna J Kerlek
- Department of Psychiatry and Behavioral Health, Nationwide Children's Hospital, Columbus, OH
| | - Brianna Magnusen
- Nationwide Children's Hospital, Institute for Informatics, Columbus, OH
| | - Nathan M Pajor
- Cincinnati Children's Hospital Medical Center, Division of Pulmonary Medicine and University of Cincinnati College of Medicine, Department of Pediatrics, Cincinnati, OH
| | - Laura Pyle
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Louise C Pyle
- Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Hanieh Razzaghi
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Beth I Schwartz
- Nemours Children's Health, Department of Pediatrics and Thomas Jefferson University, Department of Obstetrics and Gynecology, Wilmington, DE
| | - Maria G Vogiatzi
- Division of Endocrinology and Diabetes, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Natalie J Nokoff
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO.
| |
Collapse
|
48
|
Baeza-Velasco C. Neurodevelopmental atypisms in the context of joint hypermobility, hypermobility spectrum disorders, and Ehlers-Danlos syndromes. Am J Med Genet C Semin Med Genet 2021; 187:491-499. [PMID: 34741402 DOI: 10.1002/ajmg.c.31946] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/28/2021] [Accepted: 10/16/2021] [Indexed: 12/13/2022]
Abstract
Joint hypermobility (JHM), defined as an increased range of joint motion, is a frequent somatic trait in the general population but also the hallmark of many of the hereditary disorders of connective tissue. Ehlers-Danlos syndromes (EDS) belong to this group of diseases and are characterized by tissue fragility, skin abnormalities, and JHM. Between JHM and EDS, there are the so-called hypermobility spectrum disorders (HSD), which is an umbrella term referring to people with symptomatic JHM who do not fulfill criteria for a syndromic connective tissue disorder such as EDS. Among the variety of clinical correlates of JHM/HSD/EDS, neurodevelopmental atypisms are common although often not screened for and identified in the clinical setting. This article reviews the pertinent literature concerning neurodevelopmental conditions for which there is some evidence of an association with JHM/HSD/EDS. These include hyperactivity and attention deficit, learning, communication, and motor problems including tic disorders such as Tourette syndrome and autism spectrum disorders. Underlying mechanism hypotheses for such interconnections are also reviewed. The coexistence of connective tissue-altered conditions and neurodevelopmental atypisms increases disability in patients from an early age. Thus, increased awareness among clinicians and researchers is necessary to promote assessment, diagnosis, and develop management strategies to meet the specific needs of those affected.
Collapse
Affiliation(s)
- Carolina Baeza-Velasco
- Université de Paris, Laboratoire de Psychopathologie et Processus de Santé, Boulogne Billancourt, France.,Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France.,IGT, University of Montpellier, CNRS, INSERM, Montpellier, France
| |
Collapse
|
49
|
Rutherford M, Maciver D, Johnston L, Prior S, Forsyth K. Development of a Pathway for Multidisciplinary Neurodevelopmental Assessment and Diagnosis in Children and Young People. Children (Basel) 2021; 8:1033. [PMID: 34828746 PMCID: PMC8617836 DOI: 10.3390/children8111033] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/03/2021] [Accepted: 11/08/2021] [Indexed: 11/25/2022]
Abstract
There is a variable standard of access to quality neurodevelopmental assessment and diagnosis. People may have negative experiences, encountering lengthy waiting times, and inconsistent practices. Practitioners need guidance on standards and practices for assessment and diagnosis matched to new ways of working. In this paper, we present a new pathway and recommendations for multidisciplinary neurodevelopmental assessment and diagnosis for children and young people (<19 years), developed by the Scottish Government funded National Autism Implementation Team (NAIT). Our research used the Medical Research Council guidance for the development of complex interventions and included several iterative stages. Stage 1: n = 44 stakeholders attended an event on developing new practices for diagnosis and assessment. Stage 2: a literature synthesis was completed by the research team of clinical guidelines and diagnosis and assessment tools. Stage 3: an event with n = 127 stakeholders included discussion and debate of the data from stages 1 and 2. Recommendations and a draft pathway were written. Stage 4: successive drafts of recommendations and the pathway documentation were circulated among an advisory group, including multidisciplinary clinical experts and people with lived experience, until the final pathway was agreed upon. The finalised pathway includes guidance on terminology, assessment, diagnosis, triage, time standards and engagement of people with lived experience. The new pathway has been adopted by the Scottish Government. The pathway and associated documentation are freely available online for use by others.
Collapse
Affiliation(s)
- Marion Rutherford
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (M.R.); (L.J.); (S.P.); (K.F.)
| | - Donald Maciver
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (M.R.); (L.J.); (S.P.); (K.F.)
| | - Lorna Johnston
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (M.R.); (L.J.); (S.P.); (K.F.)
- Additional Support for Learning Service, Communities and Families, City of Edinburgh Council, Edinburgh EH8 8BG, UK
| | - Susan Prior
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (M.R.); (L.J.); (S.P.); (K.F.)
| | - Kirsty Forsyth
- School of Health Sciences, Queen Margaret University, Edinburgh EH21 6UU, UK; (M.R.); (L.J.); (S.P.); (K.F.)
| |
Collapse
|
50
|
Holmes J, Mareva S, Bennett MP, Black MJ, Guy J. Higher-order dimensions of psychopathology in a neurodevelopmental transdiagnostic sample. J Abnorm Psychol 2021; 130:909-922. [PMID: 34843293 PMCID: PMC8628482 DOI: 10.1037/abn0000710] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/13/2021] [Accepted: 07/03/2021] [Indexed: 11/21/2022]
Abstract
Hierarchical dimensional models of psychopathology derived for adult and child community populations offer more informative and efficient methods for assessing and treating symptoms of mental ill health than traditional diagnostic approaches. It is not yet clear how many dimensions should be included in models for youth with neurodevelopmental conditions. The aim of this study was to delineate the hierarchical dimensional structure of psychopathology in a transdiagnostic sample of children and adolescents with learning-related problems, and to test the concurrent predictive value of the model for clinically, socially, and educationally relevant outcomes. A sample of N = 403 participants from the Centre for Attention Learning and Memory (CALM) cohort were included. Hierarchical factor analysis delineated dimensions of psychopathology from ratings on the Conner's Parent Rating Short Form, the Revised Children's Anxiety and Depression Scale, and the Strengths and Difficulties Questionnaire. A hierarchical structure with a general p factor at the apex, broad internalizing and broad externalizing spectra below, and three more specific factors (specific internalizing, social maladjustment, and neurodevelopmental) emerged. The p factor predicted all concurrently measured social, clinical, and educational outcomes, but the other dimensions provided incremental predictive value. The neurodevelopmental dimension, which captured symptoms of inattention, hyperactivity, and executive function and emerged from the higher-order externalizing factor, was the strongest predictor of learning. This suggests that in struggling learners, cognitive and affective behaviors may interact to influence learning outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Joni Holmes
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Silvana Mareva
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Marc P Bennett
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Melissa J Black
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| | - Jacalyn Guy
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge
| |
Collapse
|