Wechsler Intelligence Scale For Children-Revised Research Articles

Serum Biomarker Analysis in Pediatric ADHD: Implications of Homocysteine, Vitamin B12, Vitamin D, Ferritin, and Iron Levels.

The current diagnosis of attention deficit hyperactivity disorder (ADHD) is based on history, clinical observation, and behavioral tests. There is a high demand to find biomarkers for the diagnosis of ADHD. The aim of this study is to analyze the serum profiles of several biomarkers, including homocysteine (Hcy), vitamin B12, vitamin D, ferritin, and iron, in a cohort of 133 male subjects (6.5-12.5 years), including 67 individuals with an ADHD diagnosis based on DSM-V criteria and 66 age-matched healthy boys (healthy controls, HC). Assessments for ADHD included the Iowa Conners' Teacher Rating Scale (CPRS) and the ADHDT test, as well as cognitive assessments using the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the TROG-2 language comprehension test. Hcy and iron were quantified using spectrophotometry, while vitamin B12 and total 25-hydroxy vitamin D levels were determined using an electrochemiluminescence immunoassay (ECLIA) and ferritin was measured using a particle-enhanced immunoturbidimetric assay. The results showed significantly increased Hcy levels and decreased vitamin B12 levels in ADHD patients compared to HCs. Multiple logistic regression analysis indicated that Hcy is a potential prognostic indicator for ADHD. These results suggest that elevated homocysteine and decreased vitamin B12 may serve as markers for the diagnosis and prognosis of ADHD.

Cognitive function in Indonesian children with type 1 diabetes mellitus

Background Children with type 1 diabetes mellitus (T1DM) are at risk of cognitive impairment. While the pathophysiology is still unclear, cognitive impairment in children with T1DM can result in significant negative effects on quality of life. 
 Objective to evaluate the cognitive function of Indonesian children with T1DM and its association with glycemic control and to identify factors affecting cognitive function in children with T1DM.
 Methods The cognitive function of children aged 6 years or older with T1DM was measured using the Wechsler Intelligence Scale for Children-Revised (WISC-R). We analyzed for potential associations between cognitive function and glycemic control based on mean HbA1c levels and other factors, such as the age of onset, duration of illness, and maternal educational attainment. We also identified failure to achieve age-appropriate results on any of the WISC-R subtests (cognitive impairment) and associated factors. 
 Results A total of 46 subjects were included in this study, with a mean age of 12.8 (SD 3.4) years. There were 27 (58.7%) girls and 19 (41.3%) boys. Subjects’ mean full-scale IQ (FSIQ) was 91.35 (SD 11.43). A moderate negative correlation was found between FSIQ and mean HbA1c levels (r=-0.43; P<0.01). Children with mothers who had university degrees had significantly higher IQs (mean difference 7.39; 95%CI 3.10 to 13.66; P=0.02) than those with mothers without degrees. Failure of any WISC-R subtest was noted in 34 subjects, consisting of 17 verbal, 1 performance, and 34 verbal and performance subtests. A higher proportion of those with cognitive impairment had mean HbA1c >10%. However, compared to those with mean HbA1c ?10, the difference did not reach a statistical significance (OR 5.0; 95%CI 0.95 to 26.31; P=0.50)
 Conclusion Glycemic control and maternal educational attainment are associated with cognitive function in Indonesian children with T1DM. Poor glycemic control is also associated with a higher risk of cognitive impairment. 

60 Family Functioning Effects on Cognitive Abilities in Children with Sickle Cell Disease

Objective:Psychosocial factors show a significant relationship between child behavior problems, family functioning, and cognitive performance in children with Sickle Cell Disease, marking those as important targets for intervention among this population. The purpose of this research is to address the effects of psychosocial factors impact on specific cognitive domains.Participants and Methods:Archival data from the National Institutes of Health’s Cooperative Study of Sickle Cell Disease was used. Data was restricted to individuals aged 14 or younger (N= 2,408), with 47.8% (n = 1,152) identified as female and 52.2% (n = 1,256) as male. Black or African American (96.9%, n = 2,334) children made up the majority of the sample, with the remainder coded as “other” (2.8%, n = 68). The measures utilized included the Wechsler Intelligence Scale for Children-Revised (WISC-R), Wechsler Intelligence Scale for Children-Third Edition (WISC-III), Peabody Picture Vocabulary Test (PPVT), Achenbach Child Behavior Checklist, and Family Environment Scale (FES).Results:Bivariate correlations were completed with significant correlations found between FES and performance on the WISC-R/III and PPVT. Supportiveness subscale on the FES demonstrated several statistically significant correlations with WAIS FSIQ (r = .21, p = .000) as well as the Information (r = .22, p = .000), Similarities (r = .17, p = .001), Arithmetic (r = .13, p = .021), Block Design (r = .11, p = .036), Vocabulary (r = .22, p = .000), Object Assembly (r = .12, p = .033), Comprehension (r = .19, p = .000), and Digit Span (r = .13, p = .014) subscales. A statistically significant correlation was observed between the PPVT and the Supportiveness subscale (r = .34, p = .000).Conclusions:Various areas of cognitive functioning are affected by family dynamics. Improvement in family functioning would benefit the cognitive functioning of children with SCD. To increase aspects of family functioning including supportiveness, early identification of children with SCD, targeted interventions, and family and/or individual therapy for caregivers are suggested.

Neurocognitive Profile in Children with Attention Deficit/Hyperactivity Disorder and Dyslexia

Objective: The current study aimed to examine the neurocognitive deficits of children with ADHD and/or Developmental Dyslexia (DD) using neurocognitive tests. Material and Methods: The participants of the study consisted of children diagnosed with Dyslexia (N=33), ADHD (N=32), and DD+ADHD (N=37) who applied to the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ankara University. The control group consists of 30 primary school children aged 7-11 with similar sociodemographic data. K-SADS-PL is used for the DSM-5 diagnoses of the patients and the control group. Stroop Test, Trail Making Test, Verbal Cancellation Test, and Wechsler Intelligence Scale for Children-Revised (WISC-R) were used to evaluate the cognitive functions of the groups in detail. Results: Children with ADHD and/or Dyslexia were evaluated to have significant deficits in all neurocognitive measures such as reaction inhibition, selective attention, sustained attention, shifting attention, and visuospatial short-term memory compared to the healthy control group (p<0.001). Children with ADHD-only revealed the most significant weaknesses in reaction inhibition, and visuospatial short-term memory measures (p<0.001). The comorbid group exhibited significant weakness on almost all neurocognitive measures compared with the control group, but did not perform significantly lower than the ADHD-only and Dislexia-only groups. Conclusion: It has been shown that children with ADHD and/or Dyslexia have multiple neurocognitive deficits, and our study supports the multiple cognitive deficit hypothesis.

Cognitive performance of medulloblastoma tumour survivors related to the area of cerebellum damage.

The aim of the study was to determine the relationship between a damaged cerebellum area and the cognitive performance of medulloblastoma tumour survivors. Also, age-based differences in cognitive performance were tested. Magnetic resonance imaging (MRI) technique was used to obtain brain images of survivors. The cognitive performance was tested using Wechsler Intelligence Scale for Children Revised (WISC-R) and Wechsler Adult Intelligence Scale (WAIS). Statistical analysis was performed with highly robust permutation tests. There were two anatomical features strongly influencing the cognitive performance of survivors. The extension of the foramen of Luschka had a negative impact on the overall verbal IQ score and some non-verbal scales while the excision of the middle part of the vermis influenced scores in such scales as arithmetic and picture completing. Children with postoperative damages in the area of the middle part of the vermis are more likely to suffer from cognitive dysfunctions after the end of the treatment.

A-209 Cognitive Effects of Sickle Cell Disease in Children

Abstract Objective: Multiple contributors to neurocognitive impairment in individuals with sickle cell disease (SCD) have been identified. Research indicates that a history of cerebrovascular accidents are associated with greater cognitive decline among children with sickle cell disease, specifically among visual-spatial tasks. Studies have also indicated the presence of age effects within this population. The purpose of this research is to examine the specific cognitive domains impacted by disease severity and age. Method: Archival data from the National Institutes of Health’s Cooperative Study of Sickle Cell Disease was used. Data was restricted to individuals aged 14 or younger (N= 2,408), with 47.8% (n = 1,152) female and 52.2% (n = 1,256) male. Black or African American (96.9%, n = 2,334) children made up the majority of the sample, with the remainder coded as “other” (2.8%, n = 68). The measures utilized included the Wechsler Intelligence Scale for Children-Revised (WISC-R), Wechsler Intelligence Scale for Children-Third Edition (WISC-III), Woodcock Johnson-Revised (WJ-R), and Peabody Picture Vocabulary Test (PPVT). Results: Disease severity was negatively correlated with some aspects of cognitive functioning, specifically in the visual-spatial domain [F(2, 1) = 4.42, p = .013, η² = .02]. Age was inversely correlated with measures of perceptual organization (r = -.36, p = .02) and visual motor abilities (r = -.49, p = .001). Conclusions: Results revealed that disease severity was negatively correlated with several aspects of cognitive functioning. Cognitive decline also increased with age among this population. Introducing remediation interventions at earlier stages may help to reduce significant cognitive deficits.

Psychosocial problems and cognitive functions in children with spina bifida.

Objectives This study aims to assess psychosocial functioning in relation to lesion level and ambulatory status in children with spina bifida (SB) and compare them to their peers. Patients and methods Between March 2013 and May 2013, a total of 31 patients with SB (11 males, 20 females; mean age: 9.4 years; range, 6 to 14.7 years) and 36 typically developing peers (16 males, 20 females; mean age: 9.8 years; range, 6.5 to 14.8 years) were included in the study. All participants were assessed using a semi-structured psychiatric diagnostic interview via the Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (K-SADS-PL), Wechsler Intelligence Scale for Children-Revised (WISC-R), Behavioral Rating Inventory of Executive Functions (BRIEF) parent form, Social Responsiveness Scale (SRS), and Aberrant Behavior Checklist (ABC). Results In the SB group, the rate of psychiatric disorders was significantly higher (p=0.001) and the SRS scores and the planning and organizational components of the executive function were higher than their peers (p=0.02 and p=0.007, respectively). The psychiatric diagnosis rate, BRIEF, and SRS total scores did not significantly differ according to lesion level and ambulatory status. The BRIEF initiate and organization of materials subtest scores and ABC scores were significantly lower at high lesion levels (p=0.02, p=0.02, and p=0.02, respectively) and non-community walkers (p=0.002, p=0.03, and p=0.003, respectively). Conclusion Psychiatric disorders, impairment in social responsiveness, and planning and organization components of the executive function are prevalent in children with SB with no intellectual disabilities, compared to their peers. Therefore, psychosocial counseling and multidisciplinary follow-up for SB patients seem to be beneficial.

Residential green space and child intelligence and behavior across urban, suburban, and rural areas in Belgium: A longitudinal birth cohort study of twins.

Exposure to green space has beneficial effects on several cognitive and behavioral aspects. However, to our knowledge, no study addressed intelligence as outcome. We investigated whether the level of urbanicity can modify the association of residential green space with intelligence and behavior in children. This study includes 620 children and is part of the East Flanders Prospective Twin Survey (EFPTS), a registry of multiple births in the province of East Flanders, Belgium. Intelligence was assessed with the Wechsler Intelligence Scale for Children-Revised (WISC-R) in 620 children (310 twin pairs) between 7 and 15 years old. From a subset of 442 children, behavior was determined based on the Achenbach Child Behavior Checklist (CBCL). Prenatal and childhood residential addresses were geocoded and used to assign green space indicators. Mixed modeling was performed to investigate green space in association with intelligence and behavior while adjusting for potential confounding factors including sex, age, parental education, neighborhood household income, year of assessment, and zygosity and chorionicity. We found that residential green space in association with both intelligence and behavior in children was modified by the degree of urbanicity (p < 0.001). In children living in an urban environment, multivariable adjusted mixed modeling analysis revealed that an IQR increment of residential green space (3,000-m radius) was associated with a 2.6 points (95% CI 1.4-3.9; p < 0.001) higher total intelligence quotient (IQ) and 2.0 points (95% CI -3.5 to -0.4; p = 0.017) lower externalizing behavioral score. In children residing in a rural or suburban environment, no association was found. A limitation of this study is that no information was available on school location and the potential for unmeasured confounding (e.g., time spend outdoors). Our results indicate that residential green space may be beneficial for the intellectual and the behavioral development of children living in urban areas. These findings are relevant for policy makers and urban planners to create an optimal environment for children to develop their full potential.

Sleep quality in children and adolescents with obsessive-compulsive disorders

Background Although the effect of obsessive-compulsive disorder (OCD) on sleep is not well-known, recent studies suggest an association between OCD and sleep quality. Aims We aimed to assess sleep quality in children and adolescents with OCD and to seek its association with OCD symptoms and OCD severity. Methods All of the subjects were assessed using DSM 5 and affective disorders and schizophrenia for school-age children – present and lifetime version, which is based on DSM-IV. The Yale-Brown obsessive-compulsive scale and children’s Yale-Brown obsessive-compulsive scale were applied to the subjects with OCD. Pittsburgh sleep quality index (PSQI) was used to assess sleep quality, and the Wechsler intelligence scale for children-revised (WISC-R) was used to measure their intelligence levels. Results PSQI total score was significantly higher in patients with OCD (p < 0.001), suggesting that patients with OCD have a significantly worse sleep quality. The presence of somatic disorders was also associated with worse sleep quality (p = 0.040). Sleep quality was not significantly associated with OCD severity (p = 0.152). Among patients with extreme OCD, the ‘sleep duration’ component of the PSQI was higher than those with moderate or severe OCD (p = 0.019). The patients with ‘contamination/cleaning’ symptom group had a lower total PSQI score compared with ‘symmetry/hoarding’ symptom group (p = 0.014). Conclusions The findings of the present study indicate that the sleep quality of children and adolescents with OCD is influenced, and there may be an association between sleep quality and OCD symptoms and severity in these patients.

Evaluation of neuropsychological development of children diagnosed with primary monosymptomatic nocturnal enuresis: A pilot study.

Studies on primary monosymptomatic nocturnal enuresis have supported neuromotor development delay. This study aims to examine the neuropsychological development of children with primary monosymptomatic nocturnal enuresis. This study included 30 children diagnosed with primary monosymptomatic nocturnal enuresis and 30 healthy children. Both groups were analyzed by pediatric psychologists using the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Bender Gestalt Visual Motor Detection test. The WISC-R test is an intelligence test that includes six verbal subscales (information, similarities, arithmetic, vocabulary, judgment, and digit span) and six performance subscales (picture completion, picture arrangement, block design, object assembly, coding, and labyrinths). The Bender Gestalt test is a psychological assessment instrument used to evaluate visuomotor functioning, visuospatial functions, spatial memory, visuomotor integration skills, and visual perception skills. There were no differences in age (7.66±0.9 versus 8±1.07 years, p>0.05) or sex (20 females versus 20 males, p>0.05) between the groups. Picture completion (p=0.024), picture arrangement (p=0.001), and object assembly test (p=0.000) performance was found to be worse in subjects with primary monosymptomatic nocturnal enuresis. Similarity (p=0.021) and judgment tests (p=0.048) of the verbal subtests were also found to be delayed in the nocturnal enuresis cases. Our results suggest that children with nocturnal enuresis have lower performance compared with the control group in terms of abstract thinking, correct expression of thought, cause-result relation, short-term memory, and problem-solving ability. These children should be routinely tested by neurodevelopment tests and receive support in areas in which they are delayed.

Theory of mind deficit in adolescents with major depressive disorder

Objective: This study aims to investigate the two aspects of ToM (social-perceptual and social-cognitive) by comparing patients with major depressive disorder with in adolescents a healthy control group. Methods: The study included 30 adolescent patients with major depression and 31 healthy volunteers matched with patients in terms of age and educational stage. All participants were administered a form for sociodemographic and clinical information and then Kiddie-SADS (Kiddie-Schedule for Affective Disorders and Schizophrenia), Kovacs Children’s Depression Inventory (CDI), The Screen for Child Anxiety Related Disorders (SCARED), Wechsler Intelligence Scale for Chil-dren-Revised (WISC-R), Smarties Test, Ice Cream Van Test, Hinting Test and Eyes Test were performed. Results: ToM deficit was found in patients diagnosed with major depressive disorder. There was a significant difference between the two groups in the parameters of the CDI, SCARED, Ice Cream Van test, Hinting test, and Eyes test. The WISC-R verbal scores of the patients were significantly correlated with the Eyes test. There was a significant relationship between the patients’ depression scale for children and the ice cream van test. Conclusion: In addition to the literature, this study showed us that both dimensions of ToM may be impaired in adolescents with major depression.

Evaluation of the prognostic factors in school age children who experienced neonatal seizures

BackgroundThis prospective study aimed to evaluate long-term neurodevelopmental outcomes and risk factors of the previously reported cohort, at their school age. MethodWe included neonates whose seizures were directly observed by the child neurologist or neonatologist based on clinical observations. They were assessed for cognitive and neurological outcomes at the age of 9–11 years. The test battery included a neurological examination, the Wechsler Intelligence Scale for Children—Revised (WISC-R) test, and patients with the diagnosis of cerebral palsy (CP) were graded according to the Gross Motor Function Classification System (GMFCS). The primary outcome of this study was to determine risk factors for the long-term prognosis of neonatal seizures. ResultsFor the long-term follow-up, 97 out of 112 patients of the initial cohort were available (86.6%). We found that 40 patients (41%) have the normal prognosis, 22 patients (22.7%) have the diagnosis of CP, and 30 patients (30.9%) were diagnosed as having epilepsy. Twelve out of 22 patients with CP had the diagnosis of epilepsy. The WISC-R full-scale IQ scores were <55 points in 27 patients (27.8%) and were >85 points in 40 patients (41.2%). According to GMFCS, 10 patients were classified as levels 1–2, and 12 patients were classified as levels 3–5. In multivariate regression analyses, 5-min APGAR score <6 was found to be an independent risk factor for CP, and 5-min APGAR score <6 and neonatal status epilepticus were independent risk factors for epilepsy. ConclusionsThis prospective cohort study reveals that abnormal school age outcome after neonatal seizures are significantly related to 5-min APGAR score <6 and neonatal status epilepticus.

Placental mitochondrial DNA content is associated with childhood intelligence

BackgroundDevelopmental processes in the placenta and the fetal brain are shaped by the similar biological signals. Evidence accumulates that adaptive responses of the placenta may influence central nervous system development. We hypothesize that placental mtDNA content at birth is associated with intelligence in childhood. In addition, we investigate if intra-pair differences in mtDNA content are associated with intra-pair differences in intelligence.MethodsRelative mtDNA content was measured using qPCR in placental tissue of 375 children of the East Flanders Prospective Twin Survey. Intelligence was assessed with the Wechsler Intelligence Scale for Children-Revised (WISC-R) between 8 and 15 years old. We accounted for sex, gestational age, birth weight, birth year, zygosity and chorionicity, cord insertion, age at measurement, indicators of socioeconomic status, smoking during pregnancy, and urban environment.ResultsIn multivariable adjusted mixed modelling analysis, each doubling in placental mtDNA content was associated with 2.0 points (95% CI 0.02 to 3.9; p = 0.05) higher total and 2.3 points (95% CI 0.2 to 4.3; p = 0.03) higher performance IQ in childhood. We observed no association between mtDNA content and verbal intelligence. Intra-pair differences in mtDNA content and IQ were significantly (p = 0.01) correlated in monozygotic-monochorionic twin pairs, showing that the twin with the highest mtDNA content was 1.9 times more likely (p = 0.05) to have the highest IQ. This was not observed in dichorionic twin pairs.ConclusionsWe provide the first evidence that placental mtDNA content is associated with childhood intelligence. This emphasizes the importance of placental mitochondrial function during in utero life on fetal brain development with long-lasting consequences.

The importance of the residential greenness on neurocognitive and neurobehavioral development in children living in urban vs rural environments

OPS 29: Green space and neurological effects, Room 411, Floor 4, August 28, 2019, 1:30 PM - 3:00 PM Background: Exposure to greenness has been associated with beneficial effect on cognitive and behaviour development. However, so far no studies addressed intelligence as outcome. We studied if the level of urbanicity can modify the association between residential greenness and intelligence and behaviour in children. Methods: Intelligence was assessed with the Wechsler Intelligence Scale for Children-Revised (WISC-R) in 614 children (307 twin pairs) between 7 and 15 years old. From a subset of 436 twins neurobehaviour was determined based on the Achenbach Child Behaviour Checklist (CBCL). Prenatal and adulthood residential addresses were geocoded and used to assign greenness indicators. Mixed modelling was performed to investigate greenness in association with intelligence and problem behaviour while adjusting for potential confounding factors. Results: We found that the association between residential greenness and both IQ and behaviour in children was modified by the degree of urbanicity (p for interaction = <0.0001). In children living in an urban environment, multivariable adjusted mixed modelling analysis revealed that an IQR increment of residential greenness (3000 m radius) was associated with a 2.7 points (95% CI: 1.4 to 4.0; p=0.0008) higher total IQ and 2.3 points (95% CI: -4.4 to -0.3; p=0.03) lower child behaviour total score. In children residing in a rural or suburban environment no association between residential greenness indicators and IQ or behaviour was found. Conclusions: Our results indicate that children living in urban regions might benefit more from residential greenness than children living in rural areas. These findings are relevant for policy makers and urban planners designing urban environments to create an optimal environment for children to develop their full neuro-cognitive potential.

Neurocognitive profile in children with arachnoid cysts before and after surgical intervention.

Treatment indications for arachnoid cysts are not clear. Some surgeons take improvement in neurocognitive function into account as a surgical indication for arachnoid cysts. However, only a few studies have evaluated the relationship between arachnoid cysts and neurocognitive function. Furthermore, studies that analyze neurocognitive function as an effect of arachnoid cyst surgery are even rarer. The purpose of this study was to analyze the neurocognitive function scores of children with arachnoid cysts before and after surgery and to examine whether surgical treatment led to improved neurocognitive function. From June 2009 to August 2012, data for 24 children diagnosed with arachnoid cysts who underwent surgery at Seoul National University Children's Hospital were analyzed. Pre-operative and post-operative cyst volume was assessed and neurocognitive function was tested using the Korean version of the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Bender-Gestalt Test (BGT). Comparison of pre- and post-operative profiles by laterality of the arachnoid cyst was performed. Patients had age-appropriate full-scale intelligent quotients (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) pre-operatively, which were maintained after surgery. Of the subtests, Block Design showed significant improvement post-operatively (p = 0.021). This means that visuo-spatial integration and mental construction abilities were improved after surgery. Patients with left or right arachnoid cysts did not show statistically significant changes in FSIQ, VIQ, or PIQ after surgery (110.21 versus 113.95, p = 0.307; 108.92 versus 111.54, p = 0.368; 107.88 versus 111.04, p = 0.152, respectively). Subanalysis showed that the pre- and post-operation VIQ mean scores of the patients with right arachnoid cysts were significantly higher (p < 0.054) than those of the patients with left arachnoid cysts, and there was no significant change after the surgery. There was no significant association among cyst volume reduction, laterality, and clinical neurocognitive function improvement. The present findings indicate a limited role for surgical intervention in improving the intellectual abilities of children with arachnoid cysts.

An evaluation of attention deficit hyperactivity disorder and specific learning disorder in children born to diabetic gravidas: a case control study

Objective: Children born after risky pregnancies are known to have an increased disposition to neurodevelopmental disorders. The purpose of our study was to investigate the relationship between diabetic pregnancy and attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD). Methods: One hundred thirty-seven children of mothers with diabetic pregnancies and 128 children of mothers without a history of diabetic pregnancy were enrolled. Forty-nine of the case group had a history of insulin-dependent diabetes mellitus (IDDM) and 88 of gestational diabetes mellitus (GDM). All participants were evaluated using The Kiddie Schedule for Affective Disor-ders and Schizophrenia for School-Age Children (6-18) (K-SADS PL), the Wechsler Intelligence Scale for Children-Revised (WISC-R), and the SLD Battery. The results were then subjected to statistical analysis. Results: A statisti-cally significant difference was determined between the case and control groups in terms of levels of diagnosis of ADHD and SLD. Significant differences were determined between verbal/performance/total IQ scores when IDDM and GDM were compared with the control group. When the IDDM and GDM subgroups were compared among themselves, no significant difference was determined between verbal/performance/total IQ scores. Significant varia-tion was observed between the IDDM and GDM groups in terms of ADHD and SLD diagnoses. IQ scores decreased as fasting blood sugar increased in all parameters. Conclusion: Significantly, more diagnoses of ADHD and SLD were observed in children born to diabetic mothers compared to those of non-diabetic mothers. Further, wide-ranging studies on the subject of the effect of diabetic pregnancy and blood sugar control on infant neurodevel-opmental disorders are now needed.

Homocysteine, Pyridoxine, Folate and Vitamin B12 Levels in Children with Attention Deficit Hyperactivity Disorder.

In our study, we aimed to evaluate the serum homocysteine levels, pyridoxine, folate and vitamin B12 levels in children with attention deficit hyperactivity disorders (ADHD). This study included 30 newly diagnosed drug-naive children with ADHD (23 males and 7 female, mean age 9.3±1.8 years) and 30 sex-and age matched healthy controls. The diagnosis of ADHD was made according to DSM-V criteria. Children and adolescents were administered the Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Lifetime Version, the Conners' Parent Rating Scale-Revised, Long Form, the Conners' Teacher Rating Scale and the Wechsler Intelligence Scale for Children Revised (WISC-R) for all participants. Homocysteine, pyridoxine, folate and vitamin B12 levels were measured with enzyme-linked immunosorbent assay. Homocysteine, pyridoxine, folate and vitamin B12 levels were significantly lower in children with ADHD compared with their controls (p<0.05). A positive significant correlation was observed between the all WISC-R scores and vitamin B12 level in patients (r=0.408, p=0.025). The results obtained in this study showed that reduced homocysteine, pyridoxine, folate and vitamin B12 levels could be a risk factor in the etiology of ADHD.

Relationship between intelligence quotient (IQ) and cerebral metabolic rate of oxygen in patients with neurobehavioural disability after traumatic brain injury

ABSTRACTObjective: Cerebral metabolism may play a significant role in neurobehavioural disability following traumatic brain injury (TBI). In this study, we examined the relationship between intelligence quotient (IQ) and the cerebral metabolic rate of oxygen (CMRO2) in the lateral prefrontal cortex, which was measured by 15O-labelled gas positron emission tomography (PET), in patients with TBI.Materials and methods: The subjects were 12 patients (eight males and four females) who suffered from neurobehavioural disability following TBI. Their mean age was 33.3 years. The cause of injury was traffic accidents in all patients and the mean period after injury was 44.8 months. These patients underwent 15O-labelled gas PET and tests using either the Wechsler Adult Intelligence Scale-Revised (WAIS-R) or the Wechsler Intelligence Scale for Children-Revised (WISC-R). Pearson’s correlation between CMRO2 and total IQ (TIQ) was calculated.Results: A statistically significant correlation was observed between TIQ and CMRO2 in the right Brodmann areas (BAs) 44 and 45. The lower the WAIS score, the higher the CMRO2 in both areas.Conclusion: Neurological function negatively correlated with the metabolism of oxygen. It was possible that changes in brain networks increased the neuronal activity in the undamaged areas and that the increased activity compensated for the function decline.

Psychiatric symptomatology, behaviors related to executive functions and social responsiveness in children and youth with spina bifida

The present study aimed: 1. To determine if children with SB demonstrate psychiatric disorders more than typically developing children 2. To assess if children with SB have more problems in executive functions and social responsiveness than TD children. 3. To investigate their relationship with neurologic level, ambulation status and presence of hydrocephalus. Thirty-one patients (age 6–15 years) with spina bifida and age-and gender-matched 36 controls without any chronic health condition, were assessed by a detailed form for sociodemographic characteristics. Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version for clinical psychiatric diagnoses were also evaluated. Also, four subtests of Wechsler Intelligence Scale for Children-Revised (WISC-R) and Childhood Autism Rating Scale were administered by the clinician. Parents of the participants completed Behavioral Rating Inventory of Executive Functions (BRIEF), Social Responsiveness Scale (SRS) and Aberrant Behavior Checklist. Compared to healthy controls; psychiatric disorder rates, SRS total scores, BRIEF planning and organization subscores were higher in children and adolescents with spina bifida. Furthermore, WISC-R subtest scores were lower in this group. Psychiatric diagnosis rate did not differ among spinal lesion levels (upper vs. lower). Initiate and organization of materials subscores of BRIEF were significantly higher in lower lesion level group than upper lesion level cases. And also metacognition index, initiate and organization of materials were significantly higher in community ambulators than non-community ambulators. SRS total score was significantly higher in children with spina bifida ( P = 0.021). Children with spina bifida have more psychiatric problems, demonstrated impairments in planning and organization and may have problems in social functioning when compared to their same age peers without chronic disease. Lesion level and mobility status have an impact on metacognition index, initiate and organization of materials subscales of BRIEF.

P.3.004 - Neuropsychological correlates of ADRA2A(rs1800544) and COMT(rs4680) polymorphisms in Turkish ADHD patients

Introduction The complex etiology of ADHD has a strong genetic component. ADRA2A (rs1800544) and COMT (rs4680) polymorphisms are two of the most studied gene polymorphisms in ADHD etiology. However, there is still debate about their indication ofcreating different neuropsychological phenotypes in ADHD.In this study, we aimed to investigate the effects of these polymorphisms on neuropsychological traits among Turkish ADHD patients. Also, the relationship between ADHD symptoms, subtypes and neuropsychological test variables were studied. Methods To examine the phenotypic discrepencies of these genotypes, Continuous Performance Test(CPT) and Trail Making Tests (TMTA-TMTB) were conducted for 121 genotyped ADHD patients between 6-18 years old. Omission- commission errors and mean response time were used as CPT variables. Besides this, completing times, errors and corrections were the variables recorded for TMTA and TMTB. Mental retardation was excluded with Wechsler Intelligence Scale for Children-4 (WISC4)/Wechsler Intelligence Scale for Children –Revised (WISC-R) in the study. Diagnosis and subtype discrimination were confirmed and comorbidities except learning and disruptive behaviour disorders were excluded by using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Clinical Global Impression –Severity Scale (CGI-S) documented clinical severity, whereas Global Assesment of Functioning Scale (GAS) stated clinical functionality. Conners’ Parent (CPRS) and Teacher Rating Scales (CTRS) were used for determining ADHD symptoms and severity. The statistical analyses were conducted with SPSS 21.0. Mann-Whitney U, Kruskal–Wallis, Spearman correlation tests were used and p Results No relationship was detected between ADRA2A,COMT polymorphisms and CPT,TMT variables. CPT commission errors were found more frequent in the combined subtype, while TMTA corrections were more seen in the inattentive subtype.The learning problem subscale of CPRS and hyperactivity, behaviour problem subscales of CTRS were found associated with CPT commission errors. The hyperactivity, oppositional behaviour subscales of CPRS were related to TMTA errors and corrections whereas behaviour problem subscale of CPRS was only associated with TMTA corrections. The hyperactivity and behaviour problem subscales of CTRS were found correlated with TMTA completing time, errors and corrections. Only attention deficiency subscale of CTRS was found associated both with TMTA corrections and TMTB completing time and errors. CPT parameters were found associated with neither clinical severity nor functioning.However, low clinical functionality ( Conclusions ADRA2A and COMT polymorphisms were not found to be associated with a specific neuropsychological phenotype. While CPT did not predict clinical severity or functioning, longer TMT completing time and more TMT corrections were found associated with lower functionality. Although the results of neuropsychological tests were in accordance with ADHD subtypes, neuropsychological traits did not differ in a homogeneous manner in ADHD patients. Consequently, instead of using the neuropsychological traits in distinguishing groups, they may be helpfully used for supporting clinical evaluation in ADHD. In addition, further studies with whole genome sequencing technics are warrented to better understand the role of polymorphisms in ADHD etiology.