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Ng R, Kalinousky A, Harris J. Epigenetics of cognition and behavior: insights from Mendelian disorders of epigenetic machinery. J Neurodev Disord 2023; 15:16. [PMID: 37245029 PMCID: PMC10224589 DOI: 10.1186/s11689-023-09482-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 04/04/2023] [Indexed: 05/29/2023] Open
Abstract
Epigenetics, one mechanism by which gene expression can change without any changes to the DNA sequence, was described nearly a century ago. However, the importance of epigenetic processes to neurodevelopment and higher order neurological functions like cognition and behavior is only now being realized. A group of disorders known as the Mendelian disorders of the epigenetic machinery are caused by the altered function of epigenetic machinery proteins, which consequently affects downstream expression of many genes. These disorders almost universally have cognitive dysfunction and behavioral issues as core features. Here, we review what is known about the neurodevelopmental phenotypes of some key examples of these disorders divided into categories based on the underlying function of the affected protein. Understanding these Mendelian disorders of the epigenetic machinery can illuminate the role of epigenetic regulation in typical brain function and can lead to future therapies and better management for a host of neurodevelopmental and neuropsychological disorders.
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Affiliation(s)
- Rowena Ng
- Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Allison Kalinousky
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacqueline Harris
- Kennedy Krieger Institute, Baltimore, MD, USA.
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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2
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Ajmone PF, Giani L, Allegri B, Michelini G, Dall'Ara F, Rigamonti C, Monti F, Vizziello PG, Selicorni A, Milani D, Scaini S, Costantino A. The developmental trajectories of the behavioral phenotype and neuropsychiatric functioning in Cornelia de Lange and Rubinstein Taybi syndromes: A longitudinal study. Am J Med Genet A 2023; 191:424-436. [PMID: 36373849 PMCID: PMC10099472 DOI: 10.1002/ajmg.a.63039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 10/14/2022] [Accepted: 10/21/2022] [Indexed: 11/16/2022]
Abstract
Several changes in the behavioral phenotype arise with the growth of children affected by Cornelia de Lange Syndrome (CdLS) and Rubinstein-Taybi Syndrome (RSTS). However, previous research relied on a cross-sectional study design turning into age-related comparisons of different syndromic cohorts to explore age-dependent changes. We aim to outline the variating pathways of the neuropsychiatric functioning across the lifespan in CdLS and RSTS, through the setting up of a longitudinal study design. The sample included 14 patients with CdLS and 15 with RSTS. The assessments were carried out in two different timepoints. Our findings highlight that the cognitive profile of CdLS is subjected to a worsening trend with decreasing Intellectual Quotient (IQ) scores from T0 to T1, whereas RSTS shows a stable IQ over time. Patients affected by RSTS show greater improvements compared to CdLS in communication, daily living skills, social abilities, and motor skills across the lifespan. Both syndromes report an upward trend in behavioral and emotional difficulties even if CdLS exhibit a significant and major deterioration compared to individuals with RSTS. Being aware of the early dysfunctional patterns which might pave the way for later neuropsychiatric impairments is the first step for planning preventive interventions.
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Affiliation(s)
- Paola Francesca Ajmone
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ludovica Giani
- Child and Youth Lab, Sigmund Freud University of Milan, Milan, Italy
| | - Beatrice Allegri
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Francesca Dall'Ara
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Claudia Rigamonti
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federico Monti
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Giovanna Vizziello
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Donatella Milani
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Scaini
- Child and Youth Lab, Sigmund Freud University of Milan, Milan, Italy
| | - Antonella Costantino
- Child and Adolescent Neuropsychiatry Service (UONPIA), Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Waite J, Beck SR, Powis L, Oliver C. The Executive Function Account of Repetitive Behavior: Evidence From Rubinstein-Taybi Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2023; 128:49-65. [PMID: 36548376 DOI: 10.1352/1944-7558-128.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/29/2022] [Indexed: 06/17/2023]
Abstract
In this study, we focus on Rubinstein-Taybi syndrome (RTS) to explore the associations between executive function deficits and repetitive behaviors. Thirty individuals with RTS completed direct assessments of inhibition, working memory and set-shifting. Informants completed repetitive behavior and executive function questionnaires. Repetitive questions were associated with poorer inhibition and working memory. Stereotypy was associated with poorer inhibition. Adherence to routines was associated with poorer set-shifting, but only on the parental report measure. No other associations were evident. There is evidence of an association between specific repetitive behaviors and executive functioning in RTS, suggesting executive dysfunction may underpin behavioral difference in RTS. The findings point towards specific associations that are of interest for further research across populations in which repetitive behaviors are present.
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Affiliation(s)
- Jane Waite
- Jane Waite, College of Health and Life Sciences, School of Psychology, Aston University, Birmingham, UK
| | - Sarah R Beck
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Laurie Powis
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Chris Oliver
- Sarah R. Beck, Laurie Powis, and Chris Oliver, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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Vale AR, de Avó LRDS, Pilotto RF, Germano CMR, Melo DG. Quality of life of Brazilian families who have children with Rubinstein-Taybi syndrome: An exploratory cross-sectional study. Am J Med Genet A 2022; 188:3294-3305. [PMID: 35913016 DOI: 10.1002/ajmg.a.62914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/03/2022] [Accepted: 07/10/2022] [Indexed: 01/31/2023]
Abstract
This exploratory cross-sectional study aimed to examine the family quality of life (FQoL) among 51 Brazilian families who have children with Rubinstein-Taybi syndrome, a rare genetic disorder. Data were collected using sociodemographic and clinical data forms, as well as the Beach Center FQoL Scale, a 5-point Likert scale ranging from "very dissatisfied" (1) to "very satisfied" (5). The average score of the overall FQoL was 3.93 ± 0.64. Families' scores were higher for family interaction (4.17 ± 0.76), parenting (4.13 ± 0.61), and disability-related support (4.08 ± 0.76) domains, and lower for the family's emotional well-being (3.31 ± 0.96) and physical/material well-being (3.76 ± 0.82) domains. Family income, attendance at religious services, presence of ocular abnormalities, and aggressive behavior explained 46.2% of the variance in the overall FQoL. In summary, FQoL seems to be anchored in aspects such as family interaction and the care of parents, and be negatively affected by emotional issues, physical, and material limitations. In this context, psychological assistance should be provided to both parents and siblings whenever indicated, for improving emotional well-being and increasing family resilience. Additionally, investments in social policies, services, and human and material resources are needed to improve the physical and material conditions of families, promote better health care, and therefore reduce the family burden.
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Affiliation(s)
- Amanda Rodrigues Vale
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil
| | - Lucimar Retto da Silva de Avó
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rui Fernando Pilotto
- Department of Genetics, Federal University of Paraná (UFPR), Curitiba, Paraná, Brazil
| | - Carla Maria Ramos Germano
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
| | - Débora Gusmão Melo
- Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, Brazil.,National Institute on Population Medical Genetics, INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil
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Awan N, Pearson E, Shelley L, Greenhill C, Tarver J, Waite J. The behavioral phenotype of Rubinstein-Taybi syndrome: A scoping review of the literature. Am J Med Genet A 2022; 188:2536-2554. [PMID: 35730128 PMCID: PMC9542155 DOI: 10.1002/ajmg.a.62867] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 01/24/2023]
Abstract
Rubinstein-Taybi syndrome (RTS) is a rare genetic syndrome associated with growth delay, phenotypic facial characteristics, microcephaly, developmental delay, broad thumbs, and big toes. Most research on RTS has focused on the genotype and physical phenotype; however, several studies have described behavioral, cognitive, social, and emotional characteristics, elucidating the behavioral phenotype of RTS. The reporting of this review was informed by PRISMA guidelines. A systematic search of CINAHL, Medline, and PsychINFO was carried out in March 2021 to identify group studies describing behavioral, cognitive, emotional, psychiatric, and social characteristics in RTS. The studies were quality appraised. Characteristics reported include repetitive behavior, behaviors that challenge, intellectual disability, mental health difficulties, autism characteristics, and heightened sociability. Findings were largely consistent across studies, indicating that many characteristics are likely to form part of the behavioral phenotype of RTS. However, methodological limitations, such as a lack of appropriate comparison groups and inconsistency in measurement weaken these conclusions. There is a need for multi-disciplinary studies, combining genetic and psychological measurement expertise within single research studies. Recommendations are made for future research studies in RTS.
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Affiliation(s)
- Neelam Awan
- School of Life Sciences and EducationStaffordshire UniversityStoke‐on‐TrentUK
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
- Present address:
Royal Manchester Children's HospitalManchesterUK
| | - Effie Pearson
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Lauren Shelley
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Courtney Greenhill
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Joanne Tarver
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
| | - Jane Waite
- School of PsychologyCollege of Health and Life Sciences, Aston UniversityBirminghamUK
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Adrien JL, Taupiac E, Thiébaut E, Paulais MA, Van-Gils J, Kaye K, Blanc R, Gattegno MP, Contejean Y, Michel G, Dean A, Barthélémy C, Lacombe D. A comparative study of cognitive and socio-emotional development in children with Rubinstein-Taybi syndrome and children with Autism Spectrum Disorder associated with a severe intellectual disability, and in young typically developing children with matched developmental ages. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 116:104029. [PMID: 34271530 DOI: 10.1016/j.ridd.2021.104029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 03/19/2021] [Accepted: 07/08/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Cognitive and socio-emotional profiles of children with CREBBP-related Rubinstein-Taybi syndrome (RSTS 1), children with Autism Spectrum Disorder (ASD) with severe intellectual disability and developmental ages (DA) under 24 months, and typically developing (TD) children with similar DA were compared. PARTICIPANTS Thirty-one children with RSTS 1 (mean chronological age, CA = 59,8 months; 33-87) and thirty children with ASD, matched on CA and DA and developmental quotients (DQ), were compared to thirty TD children (CA ranged from 12 to 24 months). METHODS Cognitive and socio-emotional developmental levels, DA and DQ were assessed with appropriated tests. RESULTS More socio-emotional developmental similarities were observed between TD and RSTS 1 than between TD and ASD children. Clinical groups displayed similar developmental delays in cognitive (self-image, symbolic play, means-ends, and object permanence) and socio-emotional domains (language and imitation). Children with RSTS 1 exhibited higher developmental levels in behavior regulation, joint attention, affective relations, emotional expression domains, and a lower developmental level in spatial relations domain. CONCLUSIONS Common interventions centered on symbolic play, self-image, language, and imitation for both clinical groups, and differentiated interventions centered on spatial abilities for RSTS 1 children and on social abilities for ASD could be used by caregivers were suggested.
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Affiliation(s)
- Jean-Louis Adrien
- Laboratory of Psychopathology and Health Processes (EA n°4057), Department of Psychology, University of Paris, 71 avenue Edouard Vaillant, 92774 Boulogne-Billancourt, France.
| | - Emmanuelle Taupiac
- Department of Medical Genetics, CHU Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France
| | - Eric Thiébaut
- Lorrain Laboratory of Psychology and Neuroscience of Behavior Dynamics (2LPN), University of Lorraine, 34, Cours Léopold, BP 3397, 54015 Nancy, France
| | - Marie-Anna Paulais
- Psychology Practice ESPAS-Sup, 18, rue René-Firmin, 60700 Pont-Ste-Maxence, France
| | - Julien Van-Gils
- Department of Medical Genetics, CHU Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France; INSERM Unit 1211, Laboratory "Rare Diseases: Genetics and Metabolism", University of Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France
| | - Kelley Kaye
- Child Psychiatry Department of Sainte Anne Hospital, CREDAT, 1, rue Cabanis 75014, Paris, France
| | - Romuald Blanc
- Laboratory of Psychopathology and Health Processes (EA n°4057), Department of Psychology, University of Paris, 71 avenue Edouard Vaillant, 92774 Boulogne-Billancourt, France; Child Psychiatry Department of University Hospital Bretonneau, 2, boulevard Tonnellé, 37000 Tours, France; Direction of the Scientific Interest Grouping for Autism and Neurodevelopmental Disorders, INSERM, Paris, France
| | - Maria Pilar Gattegno
- Laboratory of Psychopathology and Health Processes (EA n°4057), Department of Psychology, University of Paris, 71 avenue Edouard Vaillant, 92774 Boulogne-Billancourt, France; Psychology Practice ESPAS-Sup, 3 rue Victoire-Américaine, 33000 Bordeaux, France
| | - Yves Contejean
- Child Psychiatry Department of Sainte Anne Hospital, CREDAT, 1, rue Cabanis 75014, Paris, France
| | - Grégory Michel
- Institute of Criminal Sciences and Justice (ISCJ - EA 4061), University Victor Segalen Bordeaux 2, 4, rue du Maréchal Joffre - CS, 61752 - 33075 Bordeaux Cedex, France
| | - Annika Dean
- Fondation Les Amis de l'Atelier, 17 rue de l'égalité, 92290 Châtenay-Malabry, France
| | - Catherine Barthélémy
- Direction of the Scientific Interest Grouping for Autism and Neurodevelopmental Disorders, INSERM, Paris, France
| | - Didier Lacombe
- Department of Medical Genetics, CHU Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France; INSERM Unit 1211, Laboratory "Rare Diseases: Genetics and Metabolism", University of Bordeaux, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France
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An Observational Study of Social Interaction Skills and Behaviors in Cornelia de Lange, Fragile X and Rubinstein-Taybi Syndromes. J Autism Dev Disord 2020; 50:4001-4010. [PMID: 32189229 PMCID: PMC7560922 DOI: 10.1007/s10803-020-04440-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We directly assessed the broader aspects of sociability (social enjoyment, social motivation, social interaction skills and social discomfort) in individuals with Cornelia de Lange (CdLS), fragile X (FXS) and Rubinstein-Taybi syndromes (RTS), and their association with autism characteristics and chronological age in these groups. Individuals with FXS (p < 0.01) and RTS (p < 0.01) showed poorer quality of eye contact compared to individuals with CdLS. Individuals with FXS showed less person and more object attention than individuals with CdLS (p < 0.01). Associations between sociability and autism characteristics and chronological age differed between groups, which may indicate divergence in the development and aetiology of different components of sociability across these groups. Findings indicate that individuals with CdLS, FXS and RTS show unique profiles of sociability.
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Yu PT, Luk HM, Lo IFM. Rubinstein-Taybi syndrome in Chinese population with four novel mutations. Am J Med Genet A 2020; 185:267-273. [PMID: 33063428 DOI: 10.1002/ajmg.a.61922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/31/2020] [Accepted: 09/21/2020] [Indexed: 01/19/2023]
Abstract
Rubinstein-Taybi syndrome (RSTS, OMIM*180849) is a rare autosomal dominant disorder, characterized by distinctive facial features, short stature, broad and often angulated thumbs and halluces, with occasional congenital anomalies. Characteristic facial dysmorphic features include downslanting palpebral fissures, low hanging columella. RSTS is caused by pathogenic variants in two ubiquitously expressed and highly homologous genes, CREBBP (OMIM*600140) and EP300 (OMIM*600140). Clinical features were well reported especially in Caucasian ethnicity. We would like to report the clinical phenotype of RSTS in our Chinese population and highlight four novel mutations in CREBBP gene.
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Affiliation(s)
- Pui Tak Yu
- Clinical Genetic Service, Department of Health, Kowloon, Hong Kong
| | - Ho-Ming Luk
- Clinical Genetic Service, Department of Health, Kowloon, Hong Kong
| | - Ivan F M Lo
- Clinical Genetic Service, Department of Health, Kowloon, Hong Kong
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Lavery WJ, Barski A, Wiley S, Schorry EK, Lindsley AW. KMT2C/D COMPASS complex-associated diseases [K CDCOM-ADs]: an emerging class of congenital regulopathies. Clin Epigenetics 2020; 12:10. [PMID: 31924266 PMCID: PMC6954584 DOI: 10.1186/s13148-019-0802-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/23/2019] [Indexed: 12/15/2022] Open
Abstract
The type 2 lysine methyltransferases KMT2C and KMT2D are large, enzymatically active scaffold proteins that form the core of nuclear regulatory structures known as KMT2C/D COMPASS complexes (complex of proteins associating with Set1). These evolutionarily conserved proteins regulate DNA promoter and enhancer elements, modulating the activity of diverse cell types critical for embryonic morphogenesis, central nervous system development, and post-natal survival. KMT2C/D COMPASS complexes and their binding partners enhance active gene expression of specific loci via the targeted modification of histone-3 tail residues, in general promoting active euchromatic conformations. Over the last 20 years, mutations in five key COMPASS complex genes have been linked to three human congenital syndromes: Kabuki syndrome (type 1 [KMT2D] and 2 [KDM6A]), Rubinstein-Taybi syndrome (type 1 [CBP] and 2 [EP300]), and Kleefstra syndrome type 2 (KMT2C). Here, we review the composition and biochemical function of the KMT2 complexes. The specific cellular and embryonic roles of the KMT2C/D COMPASS complex are highlight with a focus on clinically relevant mechanisms sensitive to haploinsufficiency. The phenotypic similarities and differences between the members of this new family of disorders are outlined and emerging therapeutic strategies are detailed.
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Affiliation(s)
- William J Lavery
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center (CCHMC), 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
| | - Artem Barski
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center (CCHMC), 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA
- Division of Human Genetics, CCHMC, Cincinnati, OH, USA
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, CCHMC, Cincinnati, OH, USA
| | | | - Andrew W Lindsley
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center (CCHMC), 3333 Burnet Avenue, Cincinnati, OH, 45229-3026, USA.
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Trickett J, Oliver C, Heald M, Denyer H, Surtees A, Clarkson E, Gringras P, Richards C. Sleep in children with Smith–Magenis syndrome: a case–control actigraphy study. Sleep 2019; 43:5601233. [DOI: 10.1093/sleep/zsz260] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 09/18/2019] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study Objectives
The objectives of the study were (1) to compare both actigraphy and questionnaire-assessed sleep quality and timing in children with Smith–Magenis syndrome (SMS) to a chronologically age-matched typically developing (TD) group and (2) to explore associations between age, nocturnal and diurnal sleep quality, and daytime behavior.
Methods
Seven nights of actigraphy data were collected from 20 children with SMS (mean age 8.70; SD 2.70) and 20 TD children. Daily parent/teacher ratings of behavior and sleepiness were obtained. Mixed linear modeling was used to explore associations between total sleep time and daytime naps and behavior.
Results
Sleep in children with SMS was characterized by shorter total sleep time (TST), extended night waking, shorter sleep onset, more daytime naps, and earlier morning waking compared to the TD group. Considerable inter-daily and inter-individual variability in sleep quality was found in the SMS group, so caution in generalizing results is required. An expected inverse association between age and TST was found in the TD group, but no significant association was found for the SMS group. No between-group differences in sleep hygiene practices were identified. A bidirectional negative association between TST and nap duration was found for the SMS group. In the SMS group, increased afternoon sleepiness was associated with increased irritability (p = .007) and overactivity (p = .005).
Conclusion
These findings evidence poor sleep quality in SMS and the need to implement evidence-based interventions in this population.
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Affiliation(s)
- Jayne Trickett
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham
- Department of Health Sciences, College of Life Sciences, University of Leicester, Leicester
| | - Chris Oliver
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham
| | - Mary Heald
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham
- Forward Thinking Birmingham, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham
| | - Hayley Denyer
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham
- Great Ormond Street Institute of Child Health, University College London, London
| | - Andrew Surtees
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham
- Forward Thinking Birmingham, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham
| | | | - Paul Gringras
- Evelina London Children’s Sleep Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Caroline Richards
- Cerebra Centre for Neurodevelopmental Disorders, School of Psychology, University of Birmingham, Birmingham
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