Significant Differences In IQ Research Articles

Social-environmental factors as mediators of IQ and achievement differences across race groups in adolescents with high risk congenital heart disease

ABSTRACT An increasing number of neuropsychologists are evaluating children with congenital heart disease (CHD). When conceptualizing results, the provider must consider medical risks such as abnormal neuroimaging and comorbidities, along with social risks such as socioeconomic status. The aim of the current study was to examine the influence of parent income and education on IQ and achievement across race groups in adolescents with CHD, while also accounting for medical risk (e.g., gestational age, number of ventricles, neuroimaging). This is a single-center cross-sectional study, including 92 children ages 12–19 years (median 14.9 years; 59% male; 71% White; 29% Black) with high risk CHD (i.e., cardiac surgery <12 months) who were referred for a neuropsychological evaluation. Retrospective data were retrieved from a larger clinical registry. Patients completed an intellectual assessment (WISC-V; WAIS-IV; WASI-II), Word Reading and Math Calculation tests. Parents completed questionnaires assessing the family environment [income, parent education]. Results revealed significant differences in IQ when comparing children who were Black versus White (11.4 point IQ difference); however, around 70% of this variance was explained by parent income and education. Medical variables accounted for 12% of the variance in IQ. For academics, parent income and education accounted for 91.5% and 78.8% of the variance in race group differences for reading and math, respectively. Medical risk and sex explained 11.7% and 14.7% of the variance in reading and math, respectively. Findings suggest that sociodemographic factors should be weighed heavily during the neuropsychological evaluation, including prioritizing risk, making recommendations, and facilitating referrals.

RELATIONSHIP BETWEEN ANTHROPOMETRIC PARAMETERS AND INTELLIGENCE IN PRESCHOOL CHILDREN FROM RURAL KONKAN

Aim: To study association between anthropometric parameters and intelligence in preschool children from Rural KONKAN.Method: Children between 3 to7 years of age were examined for anthropometry, dietary recall and Intelligence (Intelligent Quotient-IQ) assessment from rural anganwadis. IQ test was performed by clinical psychologist using Binet-Kamat test of intelligence (version 4). Nutritional information was collected from 24- hour dietary recall and food diversity. Results: Results were interpreted using Prorated IQ We studied 159 (82 boys, 78 girls) out of which 15 (9.6%) had higher IQ. 25 (15.8%) were born LBW. Anthropometry classification showed that 61 (38.4%) were stunted and 25(15.7%) were wasted. According to IOTF, 72 (46%) were thin, 83(52%) were normal and 3 (2%) were overweight. we found that there is no significant difference in IQ with respect to anthropometric parameters, birth weight and nutritional status. Conclusion: We could not find any association of anthropometric parameters with IQ inspite of high prevalence of malnutrition. Brain is vital organ which can be protected by redistribution of blood flow at the cost of other organs like liver and abdominal viscera, which are the markers for future risk of diabetes. There is need to improve nutritional status. New update of IQ test is much needed as the current test is more than 50 years old and does not take into account the social, cultural transition over last 2 decades.&#x0D;

M48 - DECONSTRUCTING THE NEUREXIN1 DELETION PHENOTYPE: A NEUROPSYCHOLOGICAL, NEUROCOGNITIVE AND NEUROIMAGING PERSPECTIVE

Background The Neurexin1 (NRXN1; 2p16.3) gene has been identified as a rare but significant genetic risk factor for neurodevelopmental disorders including Autism Spectrum Disorder (ASD) schizophrenia, Intellectual Disability (ID) and bipolar disorder. NRXN1 encodes Neurexins, neuronal adhesion molecules on axon terminals, which bind postsynaptic Neuroligins (encoded by NLGN). The primary function of NRXN1 is to stabilise synapse formation and facilitate neuronal transmission. Common clinical features are associated with NRXN1 deletions but these have not been deconstructed using in-depth neuropsychological, neurocognitive and neuroimaging techniques. This project aims to deep phenotype individuals and characterise the clinicopathological features of NRXN1 deletions. Methods 21 participants with NRXN1 deletions and 21 age and gender matched controls were recruited. Semi-structured neuropsychological assessments (CAPA, PAS-ADD) were performed and questionnaires to probe for existing and/or sub-threshold psychiatric disorders or symptoms were collated. The Wechsler Abbreviated Scale of Intelligence-second edition (WASI-II) and a comprehensive cognition battery (CANTAB; http://www.cambridgecognition.com/) was administered to all participants to assess neurocognitive functioning. High Angular Resolution Diffusion Imaging (HARDI) data (61 directions, b-value=1500 s/mm2) were acquired (n=17 per group) to evaluate neuroanatomical differences. Preprocessing was completed using ExploreDTI software (http://www.ExploreDTI.com). Data quality checks were performed and subject motion and eddy current induced geometric distortions were corrected for in one interpolation step to minimise blurring effects. Fractional anisotropy (FA) values were extracted and voxelwise statistical analysis of the FA data was carried out using Tract-Based Spatial Statistics (TBSS) in FSL ( https://fsl.fmrib.ox.ac.uk/fsl ). Results The groups did not differ in age (t(40)=-0.015, p=0.988) but there was a significant difference in IQ (t(40)=-6.3, p=0.00) thus IQ was included as a covariate in all statistical analyses. Neuropsychological assessments indicated that 6 individuals have met criteria for ASD, 3 for mild ID, 2 for ADHD, 1 for a psychotic disorder and 1 for a conduct disorder. Neurocognitive assessments indicate a trend towards executive dysfunction and aberrant social cognition in individuals with NRXN1 deletions characterised by greater number of errors on spatial working memory, spatial organisation and emotion recognition tasks, p Discussion Interesting clinical characteristics of NRXN1 deletions are emerging. This study indicates that NRXN1 deletions may contribute to neurocognitive deficits related to executive functioning and social cognition, two domains that are consistently described as aberrant in neurodevelopmental disorders. Furthermore, individuals with NRXN1 deletions demonstrate a pattern of disrupted structural connectivity, which has also been described in neurodevelopmental disorders such as ASD and schizophrenia. Further clinical and neurobiological phenotyping in addition to mapping of the NRXN1 genotype may elucidate the underlying neurobiological processes contributing to neurodevelopmental disorders.

Intellectual Functioning in In-Patients with Substance Use Disorders: Preliminary Results from a Clinical Mediation Study of Factors Contributing to IQ Variance

Aims: To investigate the direct effect of different childhood difficulties on adult intelligence coefficient (IQ) and their possible indirect effect through the mediating pathways of education and severity substance use. Participants: Ninety in-patients aged 19–64. The participants had abstained from substance use for at least 6 weeks and had different substance use profiles. Measurements: Substance use disorder (SUD) and psychiatric illnesses were diagnosed according to the International Classification of Diseases 10th edition criteria. IQ was measured with the Wechsler Adult Intelligence Scale, 4th edition. Childhood difficulties, severity of substance use and level of education were assessed through a self-report questionnaire. Findings: Mean full scale IQ for the studied population was 87.3. Learning and attention deficit/hyperactivity difficulties in childhood were directly related to adult IQ. Education had a mediating effect between childhood learning difficulties/conduct problems and the verbal comprehension index. There was no significant difference in IQ due to the specific substance used or severity of substance use. Conclusion: IQ variance in in-treatment individuals with SUD was related to childhood functioning alone or through the mediator of education. Substance-related factors did not contribute to IQ variance. The results fit a normal theory of IQ development with commonly known risk factors and no disturbing effect of substance use.

Evaluating the relationship between cannabis use and IQ in youth and young adults at clinical high risk of psychosis

Among people with psychosis, those with a history of cannabis use show better cognitive performance than those who are cannabis naïve. It is unknown whether this pattern is present in youth at clinical high risk (CHR) of psychosis. We evaluated relationships between IQ and cannabis use while controlling for use of other substances known to impact cognition in 678 CHR and 263 healthy control (HC) participants. IQ was estimated using the Vocabulary and Block Design subtests of the Wechsler Abbreviated Scale of Intelligence. Drug and alcohol use severity and frequency were assessed with the Alcohol and Drug Use Scale, and we inquired participants' age at first use. CHR were further separated into early and late age at onset of cannabis use sub-groups, and low-, moderate- and high-frequency sub-groups. No significant differences in IQ emerged between CHR or HC cannabis users vs. non-users, or between use frequency groups. CHR late-onset users showed significantly higher IQ than CHR early-onset users. Age at onset of cannabis use was significantly and positively correlated with IQ in CHR only. Results suggest that age at onset of cannabis may be a more important factor for IQ than use current use or use frequency in CHR.

The second wave of the Controlled Antenatal Thyroid Screening (CATS II) study: the cognitive assessment protocol.

BackgroundChildren whose mothers had low thyroid hormone levels during pregnancy have been reported to have decreased cognitive function. The reported research is part of the follow-on study of the Controlled Antenatal Thyroid Screening Study (CATS I), a randomised controlled trial which investigated the impact of treated vs. untreated low thyroid hormone level in women during pregnancy with the primary outcome being the child’s IQ at age 3. No significant differences in IQ were found between the treated and untreated groups. These children are now aged between 7 and 10 years and aspects of their cognitive functioning including their IQ are being reassessed as part of CATS II.Methods/DesignCognitive assessments generate an IQ score and further tests administered will investigate long term memory function and motor coordination. The aim is to complete the assessments with 40% of the children born to mothers either in the treated or untreated low thyroid hormone groups (n = 120 per group). Also children born to mothers who had normal thyroid functioning during CATS I are being assessed for the first time (n = 240) to provide a comparison. Assessments are conducted either in the research facility or the participant’s home.DiscussionThe study is designed to assess the cognitive functioning of children born to mothers with low thyroid hormone levels and normal thyroid functioning during pregnancy. This is the largest study of its type and also is distinguishable in its longitudinal design. The research has the potential to have a significant impact on public health policy in the UK; universal screening of thyroid hormone levels in pregnancy may be the recommendation.

Topological methods reveal high and low functioning neuro‐phenotypes within fragile X syndrome

Fragile X syndrome (FXS), due to mutations of the FMR1 gene, is the most common known inherited cause of developmental disability as well as the most common single-gene risk factor for autism. Our goal was to examine variation in brain structure in FXS with topological data analysis (TDA), and to assess how such variation is associated with measures of IQ and autism-related behaviors. To this end, we analyzed imaging and behavioral data from young boys (n = 52; aged 1.57-4.15 years) diagnosed with FXS. Application of topological methods to structural MRI data revealed two large subgroups within the study population. Comparison of these subgroups showed significant between-subgroup neuroanatomical differences similar to those previously reported to distinguish children with FXS from typically developing controls (e.g., enlarged caudate). In addition to neuroanatomy, the groups showed significant differences in IQ and autism severity scores. These results suggest that despite arising from a single gene mutation, FXS may encompass two biologically, and clinically separable phenotypes. In addition, these findings underscore the potential of TDA as a powerful tool in the search for biological phenotypes of neuropsychiatric disorders.

Cognition, academic achievement, and epilepsy in school-age children: A case–control study in a developing country

We conducted a case–control study of 33 Jamaican children 7 to 12years old with uncomplicated epilepsy and 33 of their classroom peers matched for age and gender to determine whether epilepsy resulted in differences in cognitive ability and school achievement and if socioeconomic status or the environment had a moderating effect on any differences. Intelligence, language, memory, attention, executive function, and mathematics ability were assessed using selected tests from NEPSY, WISCR, TeaCh, WRAT3 — expanded, and Raven's Coloured Progressive Matrices. The child's environment at home was measured using the Middle Childhood HOME inventory. Socioeconomic status was determined from a combination of household, crowding, possessions, and sanitation. We compared the characteristics of the cases and controls and used random effects regression models (using the matched pair as the cluster) to examine the relationship between cognition and epilepsy. We found that there was no significant difference in IQ, but children with epilepsy had lower scores on tests of memory (p<0.05), language (p<0.05), and attention (p<0.01) compared with their controls. In random effects models, epilepsy status had a significant effect on memory (coefficient=−0.14, CI: −0.23, −0.05), language (coefficient=−0.13, CI: −0.23, −0.04), and mathematics ability (coefficient=−0.01, CI: −0.02, −0.00). Adjustment for the home environment and socioeconomic status and inclusion of interaction terms for these variables did not alter these effects. In conclusion, we found that epilepsy status in Jamaican children has a significant effect on performance on tests of memory, language, and mathematics and that this effect is not modified or explained by socioeconomic status or the child's home environment.

PP.30 The Effect of Maternal Sublinical Hypothyroidism on the IQ of Children

In our practise, pregnant women are not routinely screened or treated for subclinical hypothyroidism (SCH) Our objective was to compare the IQ of children whose mothers had been diagnosed with...

Effects of Iron Supplementation of LBW Infants on Cognition and Behavior at 3 Years

Low birth weight (LBW) infants are at increased risk of cognitive and behavioral problems and at risk for iron deficiency, which is associated with impaired neurodevelopment. We hypothesized that iron supplementation of LBW infants would improve cognitive scores and reduce behavioral problems. In a randomized controlled trial, 285 marginally LBW (2000-2500 g) infants received 0, 1, or 2 mg/kg/day of iron supplements from 6 weeks to 6 months of age. At 3.5 years of age, these infants and 95 normal birth weight controls were assessed with a psychometric test (Wechsler Preschool and Primary Scale of Intelligence) and a questionnaire of behavioral problems (Child Behavior Checklist; CBCL). There were no significant differences in IQ between the LBW groups or LBW infants versus controls. Mean (SD) full-scale IQ was 105.2 (14.5), 104.2 (14.7), and 104.5 (12.7) in the placebo, 1 mg, and 2 mg groups, respectively (P = .924). However, for behavioral problems, there was a significant effect of intervention. The prevalence of children with CBCL scores above the US subclinical cutoff was 12.7%, 2.9%, and 2.7% in the placebo, 1-mg, and 2-mg groups, respectively (P = .027), compared with 3.2% in controls. Relative risk (95% confidence interval) for CBCL score above cutoff in placebo-treated children versus supplemented was 4.5 (1.4-14.2). Early iron supplementation of marginally LBW infants does not affect cognitive functions at 3.5 years of age but significantly reduces the prevalence of behavioral problems. The study suggests a causal relation between infant iron deficiency and later behavioral problems.

175: The effect of subclinical hypothyroidism on IQ in seven to eight year old children

IQ in seven to eight year old children Niamh Murphy, Mairead Diviney, Jennifer Donnelly, Sharon Cooley, Colin Kirkham, Adrienne Foran, Fionnuala Breathnach, Fergal Malone, Michael Geary Rotunda Hospital, Department of Obstetrics and Gynaecology, Dublin, Ireland, Rotunda Hospital, Department of Neonatology and Paediatrics, Dublin, Ireland, Rotunda Hospital, Department of Statistics, Dublin, Ireland, National University of Ireland, Maynooth, Department of Psychology, Co. Kildare, Ireland OBJECTIVE: In our practice, pregnant women are not routinely screened or treated for subclinical hypothyroidism (SCH), although overt hypothyroidism is treated. Our objective was to compare the IQ of children whose mothers had been diagnosed with SCH antenatally (in a prior observational trial) with closely matched controls. STUDY DESIGN: In a previous study from our group, 1000 healthy nulliparous patients were screened anonymously for SCH. Those with overt hypothyroidism were informed and treated, whereas those with SCH were contacted postnatally for paediatric follow-up. SCH (defined as reduced free T4 with normal TSH, or normal free T4 with raised TSH) was found in 4.6% (n 46) of the study population. These cases were matched for gestational age, gender and mode of delivery with 47 controls. All children underwent a formal neurodevelopmental assessment at age 7 to 8 years by a single psychologist blinded to the original maternal thyroid status. WISC-IV assessment scores were used to compare the groups. RESULTS: From the cohort of cases, 23 mothers agreed to assessment of their children as well as 47 controls. The children in the control group had higher mean scores than those in the case group across the categories of Verbal Comprehension Intelligence, Perceptual Reasoning Intelligence, Working Memory Intelligence, Processing Speed Intelligence and Full Scale IQ. Mann Whitney U testing confirmed a statistically significant difference in IQ between the cases (composite score 103.87) and the controls (composite score 109.11) This had a 95% confidence interval (.144, 10.330). CONCLUSION: Our results highlight significant differences in IQ of children of mothers who had unrecognised SCH during pregnancy. While our study size and design prevents us from making statements on causation, our data suggests significant potential public health implications in terms of routine thyroid function screening in pregnancy. The results of prospective intervention trials to address a causative association will be vital to address this issue. 176 Perinatal risk factors for severe hypoxic-ischemic encephalopathy in neonates treated with whole body hypothermia Christopher Wayock, Benjamin Greenberg, Jacky Jennings, Frances Northington, Ernest Graham Johns Hopkins University School of Medicine, Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Baltimore, MD, Johns Hopkins University School of Medicine, Division of Neonatology, Department of Pediatrics, Baltimore, MD, Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD OBJECTIVE: Whole body hypothermia has been shown to reduce the risk of death or neurologic injury in neonates with hypoxic-ischemic encephalopathy (HIE). However, newer regimens and other therapies may also benefit the most severely injured neonates. Our objective is to identify perinatal risk factors that identify the most severely injured neonates. STUDY DESIGN: A case-control study was conducted from 1/2007 to 5/2012 among 104 neonates 35 weeks with suspected HIE treated with whole body hypothermia of which 99 underwent an MRI at 7-10 days of life. Of the 5 neonates that did not have an MRI 3 died. 39% were born within our system, and 61% were transferred. Cases were defined as those neonates who died or had an abnormal brain MRI at 7-10 days. Controls were surviving neonates with a normal MRI. Logistic regression models were used to determine the predictive value of factors hypothesized to impact neurologic injury. RESULTS: Cases and controls did not differ on gestational age, birthweight, mode of delivery, sentinel events, initial neonatal blood gas, positive neonatal blood cultures, histologic chorioamnionitis, funisitis or diagnosis of nonreassuring fetal heart rate prior to delivery. Cases were significantly more likely to have an abruption, a cord blood gas showing metabolic acidosis, elevated initial neonatal WBC count and seizures. In multivariable logistic regression, decreased cord pH (p 0.001) and increased initial neonatal WBC count (p 0.026) predicted an increased risk of neurologic injury. Cord pH and initial neonatal WBC count can predict an abnormal brain MRI with a sensitivity of 59.4%, specificity of 77.6%, positive predictive value of 66.7% and negative predictive value of 71.7%. CONCLUSION: Worsening metabolic acidosis in cord blood at birth and elevated initial neonatal WBC correlate with neurologic injury among neonates with HIE treated with whole body hypothermia. These cases may be candidates for new hypothermia regimens as well as other therapies.

988 Effects Of Iron Supplementation Of Low Birth Weight Infants On Cognition And Behavior At 3 Years

ObjectiveLow birth weight infants (LBW) are at increased risk of cognitive and behavioral problems and at risk of iron deficiency (ID) which is associated with impaired neurodevelopment. We hypothesized that...

Timing deficits are implicated in motor dysfunction in Asperger's Syndrome

This study addressed what role movement timing irregularities have in producing the motor deficits documented in Asperger's Syndrome (AS). Participants included males with AS (n=14) and without (n=16), matched by age (7–23 years) and with no significant IQ differences. They completed measures of timing perception (comparisons of tempo of tones) and production (rhythmic finger tapping), and general motor skills (Dean–Woodcock Neuropsychological Battery motor tests). No central timing difficulties were noted, but the AS group showed more irregularity in motor implementation (with a large effect size), and this irregularity correlated with general motor skills.

What can ADHD without comorbidity teach us about comorbidity?

Neuropsychiatric comorbidity in ADHD is frequent, impairing and poorly understood. In this report, characteristics of comorbid and comorbid-free ADHD subjects are investigated in an attempt to identify differences that could potentially advance our understanding of risk factors. In a clinically-referred ADHD cohort of 449 youths (ages 6-18), age, gender, IQ, SES and ADHD symptoms were compared among ADHD comorbid free subjects and ADHD with internalizing and externalizing disorders. Logistic regression analyses were also carried out to investigate the relationship between comorbidity and parental psychiatric status. Age range was younger in the ADHD without comorbidity and older in ADHD+internalizing disorders. No significant difference in IQ or SES was found among ADHD comorbid and comorbid-free groups. ADHD with internalizing disorder has a significantly greater association with paternal psychiatric conditions. After matching by age, gender, IQ and SES, ADHD with externalizing disorders had significantly higher total ADHD, hyperactivity/impulsivity score and single item score of difficulty awaiting turn than ADHD without comorbidity and ADHD with internalizing disorders. Older age ranges, ADHD symptom severity and parental psychopathology may be risk factors for comorbidity.

Language performance in siblings of nonverbal children with autism

The study focuses on language and cognitive abilities of siblings of the linguistically most affected children with autism (i.e. siblings of nonverbal children - SIBS-ANV). Twenty-eight SIBS-ANV (17 boys), ages 4-9 years, took part in the study. All children attended regular schools, and none had received a diagnosis of autism. Controls were 27 typically developing children (SIBS-TD; 16 boys) matched to the SIBS-ANV on age, family background, socioeconomic status and type of school they attended. Significant IQ differences, as well as language differences as measured on the Clinical Evaluation of Language Fundamentals (CELF), emerged between SIBS-ANV and SIBS-TD. However, differences in the language scores mostly disappeared when PIQ and FSIQ were controlled for. Furthermore, grammatical analysis of spontaneous speech samples produced in the course of testing did not reveal any significant differences between the groups. These results add to recent work suggesting that language deficits may not be part of the Broad Autism Phenotype (BAP). It further suggests that the cognitive deficit characteristic of nonverbal people with autism may be familial.

Neurocognitive functioning and suicidality in schizophrenia spectrum disorders

Objective The aim of this study was to investigate whether suicide attempters had higher IQ, better executive functioning, or were more impulsive as measured by neuropsychological tests than non-attempters in a group of patients with schizophrenia spectrum disorders. Method One hundred seventy-four patients with schizophrenia spectrum disorders were assessed with a clinical interview for diagnosis, suicidality, symptoms and function, and underwent an extensive neurocognitive test battery. Results There were no statistically significant differences in any neurocognitive domains between lifetime suicide attempters and non-attempters, or between patients with different rates of suicide attempts. Currently suicidal patients were significantly more impulsive (had poorer inhibitory control) than currently non-suicidal patients, but this difference was mediated by positive psychotic symptoms. Conclusion The findings indicate that among patients with schizophrenia spectrum disorders, there are no significant differences in IQ or neurocognitive functioning between suicide attempters and non-attempters.

Abstract 690: Variability and Predictors of Patient Radiation Dose with Dual Source Cardiac CT: Implications for Future Algorithms to Reduce Patient Radiation Dose

Intro : DSCT provides improved temporal resolution due to the simultaneous use of two x-ray sources &amp; detectors. Although use of two sources may increase radiation, the DSCT offers key mechanisms to reduce dose (i.e. pitch adaptation, tube current modulation (TCM) &amp; prospective triggering). Thus, our aim was to assess the patient radiation exposure associated with DSCT and identify variations based on the use of different scan related parameters. Methods : Prospective study of a single tertiary medical center where radiation and image quality related data was collected on 304 consecutive patients (pts) presenting for clinical CCT examination. Effective radiation dose was calculated by multiplying the dose-length product × (k=.017 mSv/mGy/cm). Image quality was rated on a subjective IQ score [1=poor to 4=excellent], as well as contrast (CNR) and signal-to-noise (SNR) ratios. Adjusted means of increased radiation dose were calculated based on linear regression models. Results: Among 304 consecutive studies (mean age 56.4, BMI 29.4 kg/m 2 , 37% Female), 60% were performed for coronary evaluation, 8% for CABG, 18% for pulmonary veins and 11% for aortic disease. The average radiation dose was 13.5±9.2mSv [range 0.5–55.5 mSv]. TABLE provides unadjusted and adjusted mean radiation dose for parameters which had a significant univariate association with radiation dose. Independent predictors of lower radiation included low kV, use of TCM, higher pitch, smaller scan length, and regular heart rhythm. Selected use of various TCM algorithms &amp; low KV resulted in no significant difference in IQ, CNR, or SNR. Conclusions : DSCT is associated with a wide range of patient radiation exposure. The variability in dose is due to both controllable parameters (i.e. use of TCM, low kV, scan length) as well as parameters that cannot be altered (i.e. irregular rhythm). These results suggest that individualizing scan protocols may result in lower radiation dose without compromising image quality. Table: Cardiac DSCT Parameters Affecting Patient Radiation Dose

Frequency and latency of social interaction in an inclusive kindergarten setting

This study investigated the frequency and latency of naturally occurring social interaction with typically developing children and those with autism in inclusive kindergarten settings. The children with autism were also subdivided into two groups according to intellectual functioning in order to analyze frequency and latency of social interaction in relation to degree of disability. The results showed a significant difference in frequency of social interaction between the typical children and those with autism. There was no difference between the groups on latency to initiate interaction. However, shorter latency was associated with higher frequency in the typical group but not in the group of children with autism. Significant differences in IQ and adaptive functioning were found between the children with autism who showed interaction and those who did not. The results for the typical children may be used as benchmark values for the assessment of treatment outcome for children with autism.

Selective subtemporal amygdalohippocampectomy for refractory temporal lobe epilepsy: operative and neuropsychological outcomes

The authors evaluated operative, neuropathological, and neuropsychological results after selective subtemporal amygdalohippocampectomy for refractory temporal lobe epilepsy in patients who were observed for at least 2 years after surgery. Twenty-six consecutive patients underwent selective subtemporal amygdalohippocampectomy for nonlesional, medically refractory temporal lobe epilepsy. Neuropsychological evaluation using the Wechsler Adult Intelligence Scale was done before surgery in all patients, 2 months after surgery in 24 patients, and at 2-year follow up in 19 patients. A verbal paired associates learning test was administered before surgery and 2 months after surgery in 19 patients. The data were compared between the 13 patients in whom the language-dominant hemisphere was surgically treated and the six patients in whom the language-nondominant hemisphere was treated. After surgery, 84% of the patients attained either Engel Class I or II seizure outcome. There were no permanent subjective complications except postoperative memory impairment in one patient. Neuropathological examination confirmed hippocampal sclerosis in 19 patients. No significant differences in IQ and verbal memory test scores were observed between the patients in whom the language-dominant hemisphere was treated and those in whom the language-nondominant hemisphere was treated. Significant postoperative increases in verbal IQ, performance IQ, and full-scale IQ were observed over time. No significant differences were found between pre- and postoperative verbal memory test scores, and no subjective visual field loss was marked in any patient. Subtemporal selective amygdalohippocampectomy provides favorable surgical and neuropsychological outcomes and does not cause significant postoperative decline of verbal memory if performed on the language-dominant side.

Children Experience Cognitive Decline Despite Reversal of Brain Atrophy One Year After Resolution of Cushing Syndrome

Adults with Cushing syndrome frequently develop brain atrophy, memory impairment, and depression, with partial to complete resolution after cure. The effect of excess glucocorticoid exposure on the brain of children has not been systematically studied. Eleven children (six girls, five boys; ages, 8-16 yr) with endogenous Cushing syndrome seen at the National Institutes of Health Clinical Center from 1999-2000 and 10 healthy age- and sex-matched control subjects were studied. Cognitive and psychological evaluations and magnetic resonance imaging of the brain were done before and 1 yr after cure for patients with Cushing syndrome and once for controls. The estimated duration of Cushing syndrome was 4.4 +/- 1.2 yr. When compared with control subjects, children with Cushing syndrome had significantly smaller cerebral volumes (P < 0.001), larger ventricles (P = 0.02), and smaller amygdala (P = 0.004). At baseline, there were no significant differences in IQ between the two groups, and no psychopathology was identified. Despite reversal of cerebral atrophy 1 yr after surgical cure (total cerebral volume, 947 +/- 94 vs.1050 +/- 74 ml, P < 0.001; ventricular volume, 21.4 +/- 12.5 vs. 14.5 +/- 11.6 ml, P < 0.001), children with Cushing syndrome experienced a significant (P < 0.05) decline in Wechsler IQ scores (Full Scale, 112 +/- 19 vs. 98 +/- 14) and a decline in school performance, without any associated psychopathology. The effect of glucocorticoid excess on the brain of children appears to be different from adults. Despite rapid reversibility of cerebral atrophy, children experience a significant decline in cognitive function 1 yr after correction of hypercortisolism.