Cognitive outcome of 458 children over 25 years of neonatal screening for congenital hypothyroidism

Abstract Objectives: To describe the neurocognitive profile of 458 children with congenital hypothyroidism detected by neonatal screening, followed under the same treatment protocol over 25 years. To correlate estimated full-scale IQ (FSIQ) scores with age at the start of treatment, disease severity, and maternal education. Methods: Observational, analytical, retrospective, and longitudinal cohort study, that evaluated children detected between 1991 and 2014, who underwent at least one psychometric assessment (WPPSI- R and/or WISC-III). Estimated FSIQ scores are described and correlated with prognosis determinants. Results: Median T4 at diagnosis was 2.8 µg/dL (0.0-16.5), the median age at the start of treatment was 18.5 days (3-309). Maternal education (n = 445): 2.7% of illiteracy, 59.8% with basic education. Estimated FSIQ scores were 88.0 (±11.8) in WPPSI-R (age 5.6 ± 0.5 years) and 84.1 (±13.0) in WISC-III (age 9.1 ± 1.4 years). The intellectual deficit was identified in 11.6%. Correlation between age at the start of treatment and estimated FSIQ was found only in the WPPSI-R test (p = 0.02). Initial T4 and maternal education significantly correlated with estimated FSIQ scores in both tests, with the latter being the most important determining factor. Conclusions: In this large cohort of mainly low socioeconomic status children, most children achieved normal cognitive levels; however, a significant percentage presented with below-average estimated FSIQ scores and intellectual deficits. Maternal education was the main determining factor in cognitive level followed by hypothyroidism severity.

Nascer de cesariana e associação com quociente de inteligência em adolescentes: contribuição do Consórcio de Coortes RPS (Ribeirão Preto, Pelotas e São Luís), Brasil / Cesarean section and association with intelligence quotient in adolescents: contribution from the RPS Cohort Consortium (Ribeirão Preto, Pelotas and São Luís), Brazil / Parto por cesárea y asociación con cociente de inteligencia en adolescentes: contribución del Consorcio de Cohorte RPS (Ribeirão Preto, Pelotas y São Luís), Brasil

O objetivo do estudo foi avaliar a associação entre a cesariana e o quociente de inteligência (QI) em adolescentes do Município de São Luís, Maranhão, Brasil. Trata-se de um estudo longitudinal utilizando dados da coorte de nascimento em São Luís, iniciado no ano de 1997. A abordagem ocorreu na terceira fase da coorte, em 2016, com adolescente aos 18 e 19 anos de idade. A variável de exposição foi a via de nascimento e a variável de desfecho foi o QI, mensurada a partir da aplicação da terceira versão da Escala de Inteligência Wechsler para Adultos (WAIS-III). Na análise dos dados verificou-se a média do QI segundo as covariáveis e utilizou-se a regressão linear multivariada. Para controlar os fatores de confundimento foi elaborado um modelo teórico utilizando o gráfico acíclico dirigido. As variáveis confundidoras foram as socioeconômicas no momento do nascimento e as variáveis perinatais. A média do QI dos adolescentes foi 101,4. Na análise bruta, o QI dos adolescentes nascidos de cesariana foi 5,8 pontos maior em relação aos nascidos de parto vaginal (IC95%: 3,8; 7,7, p ≤ 0,001), com significância estatística. Na análise multivariada, o valor reduziu para 1,9 (IC95%: -0,5; 3,6, p = 0,141), sem significância estatística. O resultado do estudo mostrou que a cesariana não está associada ao QI dos adolescentes nessa amostra e reflete que as diferenças encontradas podem ser explicadas por outros fatores, como aspectos socioeconômicos e perinatais.

This study aimed to evaluate the association between cesarean section and intelligence quotient (IQ) in adolescents from the Municipality of São Luís, Maranhão State, Brazil. This is a longitudinal study using data from the São Luís birth cohort, started in 1997. The approach occurred in the third phase of the cohort, in 2016, with adolescents aged 18 and 19 years. The exposure variable was mode of delivery and the outcome variable was IQ, measured by applying the third version of the Wechsler Adult Intelligence Scale (WAIS-III). In the data analysis, the average IQ was verified according to the covariates and multivariate linear regression was used. To control confounding factors, a theoretical model was elaborated using the directed acyclic graph. The confounding variables were socioeconomic variables at birth and perinatal variables. Their average IQ was 101.4. In the crude analysis, the IQ of adolescents born by cesarean section was 5.8 points higher than those born by vaginal delivery (95%CI: 3.8; 7.7, p ≤ 0.001), with statistical significance. In the multivariate analysis, the value decreased to 1.9 (95%CI: -0.5; 3.6, p = 0.141), without statistical significance. The result of the study showed that cesarean section is not associated with the IQ of adolescents in this sample and reflects that the differences can be explained by other factors, such as socioeconomic and perinatal aspects.

El objetivo del estudio fue evaluar la asociación entre la cesárea y el cociente de inteligencia (CI) en adolescentes del Municipio de São Luís, Maranhão, Brasil. Este es un estudio longitudinal que utiliza datos de la cohorte de nacimiento en São Luís, que comenzó en 1997. El abordaje ocurrió en la tercera fase de la cohorte, en 2016, con adolescente a los 18 y 19 años de edad. La variable de exposición fue la vía de nacimiento y la variable de resultado fue el CI, medido a partir de la aplicación de la tercera versión de la Escala de Inteligencia para Adultos (WAIS-III). En el análisis de datos se verificó el CI medio según las covariables y se utilizó la regresión lineal multivariada. Para controlar los factores de confusión se elaboró un modelo teórico utilizando el gráfico acíclico dirigido. Las variables de confusión fueron las socioeconómicas en el momento del nacimiento y las variables perinatales. El coeficiente intelectual promedio de los adolescentes fue de 101,4. En el análisis bruto, el CI de los adolescentes nacidos de cesárea fue 5,8 puntos mayor en relación a los nacidos de parto vaginal (IC95%: 3,8; 7,7, p ≤ 0,001), con significancia estadística. En el análisis multivariado, el valor se redujo a 1,9 (IC95%: -0,5; 3,6, p = 0,141), sin significación estadística. El resultado del estudio mostró que la cesárea no está asociada con el coeficiente intelectual de los adolescentes en esta muestra y refleja que las diferencias encontradas pueden explicarse por otros factores, como los aspectos socioeconómicos y perinatales.

General, verbal, and non-verbal cognitive functioning of children and adolescents with 22q11-2 deletion syndrome / Funcionamento cognitivo geral, verbal e não verbal de crianças e adolescentes com síndrome de deleção 22q11-2

BACKGROUND: Cognitive dysfunctions are frequently found in the 22q11.2 Deletion Syndrome, being an aggravating factor in the impairment of social relationships and communication, strongly impacting the functionality of the individual. Increasing the knowledge regarding cognitive skills may provide contributions to the diagnostic process and the intervention planning. OBJECTIVES: To estimate the general, verbal, and non-verbal cognitive functioning of children and adolescents with 22q11.2 Deletion Syndrome. METHODS: This is a cross-sectional, descriptive, and case series study regarding 15 individuals between 7-18 years-old diagnosed with 22q11.2 Deletion Syndrome. An assessment of the cognitive functions was performed using the Wechsler Abbreviated Scale of Intelligence (WASI). For data analysis we used a descriptive statistics analysis, having absolute frequencies for variables, and mean, median, standard deviation, minimum and maximum values for numerical variables. RESULTS: In the group analysis, we observed an important cognitive impairment degree. Most of the sampling (n=8; 53.33%) presented a considerably low total intelligence quotient score. Cases showing lower performances also presented greater difficulties regarding Visual Motor and Visuospatial coordination. Regarding the intelligence quotient representative punctuation in the WASI scale, the sample showed a large variability in the results (between 40 and 92 points), with the median total of 83. CONCLUSIONS: We observed important dysfunctions, cognitive difficulties, and intellectual, verbal, and non-verbal disabilities in the population studied. These findings indicate the need for an early intervention to assist not only the cognitive aspect, but also the socio-emotional development of children with the 22q11.2 Deletion Syndrome, aiming at their participation in society.

FUNDAMENTO: Disfunções cognitivas são frequentemente encontradas na Síndrome de Deleção 22q11.2, sendo um agravante no comprometimento das relações sociais e da comunicação, impactando fortemente na funcionalidade do indivíduo. O aumento do conhecimento sobre as habilidades cognitivas pode trazer contribuições no processo diagnóstico e no planejamento da intervenção. OBJETIVO: Estimar o funcionamento cognitivo geral, verbal e não verbal de crianças e adolescentes com Síndrome de Deleção 22q11.2. MÉTODOS: Estudo transversal, descritivo, tipo série de casos, com 15 indivíduos entre 7-18 anos com diagnóstico da Síndrome de Deleção 22q11.2. A avaliação das habilidades cognitivas foi realizada com a Escala Wechsler Abreviada de Inteligência (WASI). Para análise dos dados, foi utilizada análise estatística descritiva, com frequências absolutas para variáveis, e média, mediana, desvio padrão, mínima e máximo para variáveis numéricas. RESULTADOS: Na análise do grupo, observou-se um importante grau de comprometimento cognitivo. A maior parte da amostra (n=8; 53,33%) mostrou quociente de inteligência total extremamente baixo. Os casos com desempenhos mais baixos apresentaram maiores dificuldades em relação às habilidades de coordenação visuomotora e visuoespacial. Em relação à pontuação representativa do quociente de inteligência na escala WASI, a amostra apresentou uma grande variabilidade de resultados (entre 40 a 92 pontos), com mediana total de 83 pontos. CONCLUSÕES: As dificuldades cognitivas encontradas indicam a necessidade de uma intervenção precoce para auxiliar não só no desenvolvimento cognitivo, mas socioemocional de crianças com a Síndrome de Deleção 22q11.2 visando sua participação na sociedade.

Intellectual performance profi le of a sample of children and adolescents from Brazil with 22q11. 2 Deletion Syndrome (22q11. 2DS) based on the Wechsler Scale / Perfil de desempenho intelectual de uma amostra brasileira de crianças e adolescentes com Síndrome da Deleção 22q11. 2 (22q11. 2DS)com base na Escala Wechsler

The 22q11.2 Deletion Syndrome (22q11.2DS), the most common human chromosome microdeletion syndrome, is associated with a very heterogeneous neurocognitive phenotype. One of the main characteristics of the syndrome spectrum is the intellectual variability, which encompasses average performance and intellectual disability and discrepancies between Verbal Intelligence Quotient and Performance Verbal Intelligence Quotient, with greater impairment in nonverbal tasks. The present study aimed at investigating the intellectual performance aspects of a 21children and adolescents sample from Brazil who had been diagnosed with 22q11.2DS, based on the Wechsler Intelligence Scale for Children - 4th edition. The samples were reviewed considering the differences between indices. The results revealed an Full Scale Intelligence Quotient predominant in the borderline range (42 to 104) and a significant discrepancy between the indices of Verbal Comprehension and Perceptual Reasoning in 42% of the sample. With regard to the performance in the subtests alone, a better performance was found in Similarities, whereas block design, matrix reasoning, digit span and letter-number sequencing subtests were the most challenging. These findings indicate that a comprehensive assessment of intellectual performance aspects covering the different measures of the Wechsler Intelligence Scale may contribute to a broader understanding of the neurocognitive phenotype associated with 22q11.2DS.

A Síndrome da Deleção 22q11.2 (SD22q11.2), microdeleção cromossômica mais frequente em humanos, é associada a um fenótipo neurocognitivo muito heterogêneo. Uma das principais características do espectro da síndrome é a variabilidade intelectual, que abrange de desempenho médio a deficiência intelectual, bem como discrepâncias entre Quociente de Inteligência Verbal e de Quociente de Inteligência de Execução, com maior prejuízo nas tarefas não verbais. O presente estudo teve por objetivo investigar aspectos do desempenho intelectual de uma amostra brasileira de 21 crianças e adolescentes diagnosticados com SD22q11.2, com base nos indicadores da Wechsler Intelligence Scale for Children - 4th edition. As amostras foram analisadas considerando diferenças entre os índices. Os resultados revelaram predomínio de Quociente de Inteligência Total na faixa limítrofe, entre 42 e 104, assim como discrepância significativa entre os índices de compreensão verbal e organização perceptual em 42% da amostra. No que concerne ao desempenho nos subtestes de forma isolada, um melhor resultado foi verificado em semelhanças, ao passo que cubos, raciocínio matricial, dígitos e sequência de números e letras foram os mais desafiadores. Esses achados indicam que uma avaliação abrangente de aspectos do desempenho intelectual contemplando as diversas medidas da Escala Wechsler de Inteligência pode contribuir para uma compreensão mais ampla do fenótipo neurocognitivo associado à SD22q11.2.

Study on the correlation between sleep snoring and intelligence level in 4-6 years old children / 中国耳鼻咽喉头颈外科

OBJECTIVE Aim to evaluate the mental level in 4-6 years old children with obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS Children who were diagnosed as OSAHS with a whole night PSG monitor in the sleep center between January 2015 and August 2016, and 30 healthy children were included in the study. Intelligent levels were evaluated at the enrollment day. The following intelligent levels evaluation questionnaires were used: Wechsler Intelligence Scale for children and infants. Intelligent levels were compared between the patient and healthy control groups. RESULTS The 60 children, including 30 children with OSAHS(patient group) and 30 healthy children(control group) were enrolled. Comparison of the patient versus the control groups revealed that total intelligence quotient(FIQ) was 96.59±12.60 vs 102.53±8.44; language capability(VIQ) was 94.00±13.24 vs 101.03±9.41; comprehension test was 5.96±2.5 vs 7.57±2.14; visual analysis was 8.85±2.32 vs 10.3±1.93. All the 4 values in the patient group were significantly lower than those in the control group(all P ＜0.05). The accumulated time of SO2＜90％ correlated with PIQ negatively and significantly. CONCLUSION The intelligent level of children with OSAHS was in the normal range, but lower than that of healthy group. Snoring affects the IQ level of 4-6 years old children, and the influence on PIQ is closely related to the accumulated time of SO2＜90％ in total sleep time.

Eye Movement Characteristics of Cooperation Degree during Image Completion Test in Psychiatric Impairment Assessment / 法医学杂志

OBJECTIVES@#To explore the difference of eye movement characteristics between uncooperative and cooperative subjects with mental disorder after cerebral trauma.@*METHODS@#Thirty-nine subjects which needed psychiatric impairment assessment were selected. According to the binomial forced-choice digit memory test （BFDMT）, all subjects were divided into cooperative and uncooperative groups. The subjects were asked to take the image completion test from Wechsler adult intelligence scale. Meanwhile, the data of eye movement track, fixation, saccade, pupil and blink were recorded by the track system of eye movement.@*RESULTS@#There were significantly differences （P<0.05） in the data of saccade between cooperative （10 cases） and uncooperative groups （29 cases）. The frequency, time, amplitude, acceleration of saccadic in uncooperative group were significantly higher than cooperation group. The saccade latencies of cooperation group increased more than uncooperative group. There was a significant difference （P<0.05） in total discrete distance, average distance and total time of fixation between two groups, while the average duration time, number and frequency of fixation had no significantly difference （P>0.05） between two groups. And the blink frequency of cooperation group was higher than uncooperative group.@*CONCLUSIONS@#Eye movement can be an objective index for the primary judgment of cooperation level.

Evidencia de validez de constructo para el WISC-IV con muestra brasileña / Construct Validity of the WISC-IV among a Brazilian Sample

El objetivo fue analizar la estructura interna de la versión brasileña del WISC-IV, comparando el modelo de puntuaciones compuestas con otros dos modelos, el de un factor general de la inteligencia y un modelo con base en la teoría CHC de Cattell-Horn-Carroll. Participaron 795 niños y adolescentes de diferentes regiones de Brasil, con edades entre 6 y 16 años. Los resultados mostraron que el modelo que mejor se ajustó fue el propuesto por el manual del WISC-IV. El modelo con base en la teoría CHC también presentó buen ajuste, pero con valores un poco inferiores a la propuesta original. El modelo de un factor general fue rechazado, pues los índices de bondad de ajuste no fueron satisfactorios. Se sugieren futuras investigaciones que estudien la estructura del WISC-IV en otros países.

This study analyzed the internal structure of the Brazilian version of the WISC-IV by comparing the composed scoring model with two other models: one based on a general factor of intelligence and another based on the CHC theory. The participants included 795 children and adolescents between the ages of 6 and 16 hailing from different regions of Brazil. The results indicated that the most suitable model was the one proposed in the manual. The model of the CHC theory also presented a good fit, but with values that was inferior to those of the original proposal. Moreover, the model of the general factor was rejected because the goodness-of-fit indices were not satisfactory.

Children’s intelligence quotient following general anesthesia for dental care:a clini-cal observation by Chinese Wechsler young children scale of intelligence / 北京大学学报(医学版)

Objective:It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models.However,for the limitation that the animal models can-not fully mimic the dose and duration in clinical settings especially for dental general anesthesia,the cli-nical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore,we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia comparing to that before surgery.We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ)after the administration of dental general anesthesia compared with that before surgery.Methods:Thirty two patients,ASA Ⅰ, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology,aged 4 to 6.5 years,were enrolled in this prospective study.Patients with severe learning difficulties or communication disorders were excluded.Written and informed consent was obtained from each patients’family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version)before and 2 weeks after dental anesthesia.They were treated by experienced pediatric dentists and the sevoflurane,propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extrac-tion.The examiners and scorers for IQ had technical training in the test administration.All the patients were tested by the same examiner and with standardized guide language.Each subtest was scored accor-ding to the tool review.Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS 18.0.All the scores of subtests and 3 types of IQ were ex-pressed as x-±s.Paired two-tailed t test was applied and P cant.Results:The results of intelligent assessment from 28 subjects were collected.The anesthetic time was (163.4 ±32.6)min and the number of treated teeth was 12.1 ±2.3,mean age (4.60 ±0.41 ) years;age range=4.04 to 5.44 years.Among the patients,there were 13 girls and 15 boys.There was no significant difference in gender distribution.The postoperative full IQ (128.46 ±10.85 )was higher than that before surgery (124.64 ±11.46,P=0.017).We found that the elevation of performance IQ, to a large extent,contributed to this change in full IQ (P=0.007).Correspondingly,there was no sta-tistical difference in the verbal IQ,which was 119.68 ±11.74 to 120.21 ±15.61 (P=0.854).Con-clusion:Dental general anesthesia has no negative effect on the intelligence of preschool children,who were treated under general anesthesia by sevoflurane,propofol and nitrous oxide for 2 to 4 hours.The full IQ and performance IQ were slightly enhanced after treatment which can be explained by the memory effect.

Influence of early operation treatment for snoring children on intelligence development / 中国基层医药

Objective To explore the early surgical treatment for sleep apnea in children with the influence of mental development,provide important basis for children with sleep apnea early surgery.Methods 40 children with sleep apnea underwent bilateral amygdala and/or adenoidectomy (observation group).The Chinese wechsler intelligence scale for children (C-WYCSI) was used for preoperative and postoperative 6 months of intelligence tests,including language IQ and operation IQ test two parts,a total of 11 points.Operation IQ but also contain visual analysis test(VA) and two categories,including geometry test (GD).According to the 1 ∶ 1 matching selection of the same gender,and age(± 3 months),family condition was quite healthy check-up preschool children comparing 40 cases as control group.Results Observation group preoperative total intelligence quotient (IQ),verbal IQ,IQ operation was 82,81,83,respectively,which were lower than those of the control group 101,101,101 (t =4.131,3.952,3.842,all P ＜ 0.05).Postoperative total intelligence quotient(IQ),verbal IQ and operation IQ 98,98,99,respectively,were in normal range,with no statistically significant difference were observed in the control group (all P ＞ 0.05).Conclusion Children with sleep apnea early surgical treatment can improve children mental development.Children with sleep apnea early,breathing and surgical indications should be early surgical treatment.

Estrutura fatorial do WISC-III em crianças com dificuldades de aprendizagem / WISC-III factor structure for children with learning disabilities / Estructura factorial del WISC-III en niños con problemas de aprendizaje

O presente trabalho busca verificar qual o modelo fatorial mais adequado para o WISC-III no grupo clínico das crianças com dificuldades de aprendizagem. Foram analisados 263 protocolos de testes aplicados em alunos de escolas públicas, encaminhados por seus professores para avaliação psicológica. Foram utilizadas as técnicas estatísticas da análise fatorial exploratória e confirmatória. O presente estudo, além de corroborar a estrutura fatorial definida na padronização brasileira, vai ao encontro dos resultados da pesquisa internacional quanto à definição do modelo de quatro fatores como o de melhor ajuste para esse grupo clínico. Apesar de também ter identificado dois modelos trifatoriais como vantajosos quanto ao ajuste, parcimônia e interpretabilidade teórica, a estrutura quadrifatorial é a mais indicada para interpretar clinicamente as pontuações que expressam as habilidades cognitivas do grupo estudado, uma vez que permite aproveitar as normas existentes do WISC-III para a população geral.

This work contributes to the investigation of a factorial model that is more appropriate for Brazilian children with learning disabilities (LD). 263 WISC-III test protocols of public school students with academic difficulties referred by their teachers for psychological evaluation were analyzed. Statistical techniques of exploratory factor analysis and confirmatory factor analysis were performed. This study, besides corroborating the factor structure defined in the Brazilian standardization, meets the results of the international research for the definition of four-factor model as the best adjusting for the LD population. Although we have also identified two three-factor models as advantageous as to the fit, parsimony and theoretical interpretability, the four-factor structure is the most suitable for clinical interpretation of the scores that express the LD group cognitive abilities, since it allows us to leverage existing standards of WISC-III for the general population.

El presente trabajo busca verificar cual el modelo factorial más adecuado para el WISC-III en el grupo clínico de niños con dificultades de aprendizaje. Se analizaron 263 testes aplicados en alumnos de escuelas públicas, encaminados por sus maestros para evaluación psicológica. Se utilizaron las técnicas estadísticas del análisis factorial exploratorio y confirmatorio. Este estudio, además de corroborar la estructura factorial definida en la estandarización brasileña, coincide con los resultados de la investigación internacional en cuanto a la definición del modelo de cuatro factores como de mejor ajuste para ese grupo clínico. Además de haber también identificado dos modelos trifactoriales como ventajosos en cuanto al ajuste, a la economía factorial y a la interpretabilidad teórica, la estructura de cuatro factores es la más indicada para interpretar clinicamente los puntajes que expresan las habilidades cognitivas del grupo estudiado, pues permite aprovechar las normas ya existentes del WISC-III para la población general.

Executive Dysfunction and It's Relation to K-WAIS Scores in Mild Traumatic Brain Injury Patients with Normal Intelligence Quotient / 정신신체의학

OBJECTIVES: This study examined the selective deficits of executive function in patients with mild traumatic brain injury that in normal range of general intelligence level and aimed to analysis of the correlation between K-WAIS result and executive function. METHODS: 59 subjects were included in this study, who were diagnosed as mild traumatic brain injury(MTBI) and they have visited in neuropsychiatric department of Wonkwang University Hospital during from March, 2005 to September, 2010. For measurement of general intelligence quotient, the Korean-Wechsler Adults Intelligence Scale(K-WAIS) was administered and for measurement of executive intelligence quotient(EIQ), Executive Intelligence Test(EXIT) was administered. RESULTS: Of patients, 50.8% included at abnormal EIQ group. The patients of abnormal EIQ showed poorer full scale IQ(FIQ), performance IQ(PIQ) and in subscale that picture arrangement, digit symbol, digit span, block design, object assembly and comprehension were significantly different. In terms of relationships between K-WAIS and EIQ, FIQ and PIQ have positive correlation with EIQ. And in subscale, picture arrangement, digit symbol, digit span, block design, object assembly and comprehension show positive correlation with EIQ. CONCLUSION: This study suggest that MTBI patients with have normal range of general intelligence level may have deficit of executive function is common. The decline of FIQ, PIQ and some subscales of K-WAIS may suggest executive dysfunction in MTBI patients.

Study of level and structure of intelligence in children with benign epilepsy of childhood with centrotemporal spikes / 中华神经科杂志

Objective To study the level and structure of intelligence in children with benign epilepsy of childhood with centrotemporal spikes(BECT)and investigate factors affecting their intelligence.Methods Congitive skills such as intelligence quotient(IQ),phonological test and morphological test,were evaluated in 47 children with BECT,and the results were compared to a control group of 30 children matched for gender,age,level of education and family background.The effects of age of onset,disease course,seizure frequency,seizure type,location of spike,and spike and wave index(SWI)on the level and structure of intelligence were also analyzed.Results The total IQ score was slightly lower in children with BECT(104.20±12.34)when compared to the control group of normal children(109.45±15.01),but the difference was not significant.There was no difference in performance IQ scores between BECT and normal children.BECT children had a lower verbal IQ score(90.67±18.40)when compared to the control group(98.17±13.18,t=3.431.P<0.05).Analyses of verbal subtests revealed significant differences between BECT and normal children in vocabulary and similarities(5.97±2.95 vs 8.51±3.67 and 4.85±3.02 vs 6.95±3.07,respectively,t value were 2.365 and 2.096,both P<0.05).The differences between BECT and normal children were also significant in phonological test and morphological test (12.56±2.3 vs 16.78±3.72 and 22.35±3.25 vs 24.15±5.28,respectively,t=2.478 and 2.770,both P<0.05).SWI was negatively correlated with verbal IQ,vocabulary,similarities,phonological test and morphological test(r=-0.305--0.838,P<0.05).Age of onset,disease course and seizure frequency were not correlated with verbal IQ,phonological test and morphological test.The level of intelligence was not different among children with left hemispheric foci,fight hemispheric foci or bilateral foci.The level of intelligence Was similar between children with partial seizures or secondarily generalized seizures.Conclusions Children with BECT have normal level of intelligence,but the structure of intelligence is abnormal with retardation of their language ability.SWI affects the language ability in children with BECT,but age of onset,seizure type and location of spike do not influence their language ability.