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Lane JM, Curtin P, Chelonis JJ, Pantic I, Martinez-Medina S, Téllez-Rojo MM, Wright RO. Prenatal manganese biomarkers and operant test battery performance in Mexican children: Effect modification by child sex. ENVIRONMENTAL RESEARCH 2023; 236:116880. [PMID: 37574101 PMCID: PMC10919280 DOI: 10.1016/j.envres.2023.116880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Manganese (Mn) is essential to healthy neurodevelopment, but both Mn deficiency and over-exposure have been linked to prefrontal cortex (PFC) impairments, the brain region that regulates cognitive and neurobehavioral processes responsible for spatial memory, learning, motivation, and time perception. These processes facilitated by attention, inhibitory control, working memory, and cognitive flexibility are often sexually dimorphic and complex, driven by multiple interconnected neurologic and cognitive domains. OBJECTIVE We investigated the role of child sex as an effect modifier of the association between prenatal Mn exposure and performance in an operant testing battery (OTB) that assessed multiple cognitive and behavioral functional domains. METHODS Children (N = 575) aged 6-8 years completed five OTB tasks. Blood and urinary Mn measurements were collected from mothers in the 2nd and 3rd trimesters. Multiple regression models estimated the association between Mn biomarkers at each trimester with OTB performance while adjusting for socio-demographic covariates. Covariate-adjusted weighted quantile sum (WQS) regression models were used to estimate the association of a Mn multi-media biomarker (MMB) mixture with OTB performance. Interaction terms were used to estimate modification effect by child sex. RESULTS Higher blood Mn exposure was associated with better response rates (more motivation) on the progressive ratio task and higher overall accuracy on the delayed matching-to-sample task. In the WQS models, the MMB mixture was associated with better response rates (more motivation) on the progressive ratio task. Additionally, for the linear and WQS models, we observed a modification effect by child sex in the progressive ratio and delayed matching-to-sample tasks. Higher prenatal Mn biomarker levels were associated with improved task performance for girls and reduced performance in boys. CONCLUSION Higher prenatal blood Mn concentrations and the MMB mixture predicted improved performance on two of five operant tasks. Higher prenatal Mn concentrations regulated executive functions in children in a sexually dimorphic manner. Higher prenatal Mn exposure is associated with improved performance on spatial memory and motivation tasks in girls, suggesting that Mn's nutritional role is sexually dimorphic, and should be considered when making dietary and/or environmental intervention recommendations.
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Affiliation(s)
- Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John J Chelonis
- Division of Neurotoxicology, National Center for Toxicological Research, FDA, Jefferson, AR, USA
| | - Ivan Pantic
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Sandra Martinez-Medina
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, USA
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Merced-Nieves FM, Chelonis J, Pantic I, Schnass L, Téllez-Rojo MM, Braun JM, Paule MG, Wright RJ, Wright RO, Curtin P. Prenatal trace elements mixture is associated with learning deficits on a behavioral acquisition task among young children. New Dir Child Adolesc Dev 2022; 2022:53-66. [PMID: 35429215 PMCID: PMC9492626 DOI: 10.1002/cad.20458] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Children are exposed to many trace elements throughout their development. Given their ubiquity and potential to have effects on children's neurodevelopment, these exposures are a public health concern. This study sought to identify trace element mixture-associated deficits in learning behavior using operant testing in a prospective cohort. We included 322 participants aged 6-7 years recruited in Mexico City with complete data on prenatal trace elements measurements (third trimester blood lead and manganese levels, and & urine cadmium and arsenic levels), demographic covariates, and the Incremental Repeated Acquisition (IRA), an associative learning task. Weighted quantile sum (WQS) regression models were used to estimate the joint association of the mixture of all four trace elements and IRA performance. Performance was adversely impacted by the mixture, with different elements relating to different aspects of task performance suggesting that prenatal exposure to trace element mixtures yields a broad dysregulation of learning behavior.
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Affiliation(s)
- Francheska M Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Chelonis
- Division of Neurotoxicology, National Center for Toxicological Research, FDA, Jefferson, Arkansas, USA
| | - Ivan Pantic
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Lourdes Schnass
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Merle G Paule
- Division of Neurotoxicology, National Center for Toxicological Research, FDA, Jefferson, Arkansas, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Wang C, Liu S, Liu F, Bhutta A, Patterson TA, Slikker W. Application of Nonhuman Primate Models in the Studies of Pediatric Anesthesia Neurotoxicity. Anesth Analg 2022; 134:1203-1214. [PMID: 35147575 DOI: 10.1213/ane.0000000000005926] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Numerous animal models have been used to study developmental neurotoxicity associated with short-term or prolonged exposure of common general anesthetics at clinically relevant concentrations. Pediatric anesthesia models using the nonhuman primate (NHP) may more accurately reflect the human condition because of their phylogenetic similarity to humans with regard to reproduction, development, neuroanatomy, and cognition. Although they are not as widely used as other animal models, the contribution of NHP models in the study of anesthetic-induced developmental neurotoxicity has been essential. In this review, we discuss how neonatal NHP animals have been used for modeling pediatric anesthetic exposure; how NHPs have addressed key data gaps and application of the NHP model for the studies of general anesthetic-induced developmental neurotoxicity. The appropriate application and evaluation of the NHP model in the study of general anesthetic-induced developmental neurotoxicity have played a key role in enhancing the understanding and awareness of the potential neurotoxicity associated with pediatric general anesthetics.
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Affiliation(s)
- Cheng Wang
- From the Division of Neurotoxicology, National Center for Toxicological Research/FDA, Jefferson, Arkansas
| | - Shuliang Liu
- From the Division of Neurotoxicology, National Center for Toxicological Research/FDA, Jefferson, Arkansas
| | - Fang Liu
- From the Division of Neurotoxicology, National Center for Toxicological Research/FDA, Jefferson, Arkansas
| | - Adnan Bhutta
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Tucker A Patterson
- Office of the Director, National Center for Toxicological Research/FDA, Jefferson, Arkansas
| | - William Slikker
- Office of the Director, National Center for Toxicological Research/FDA, Jefferson, Arkansas
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Merced-Nieves FM, Chelonis J, Pantic I, Schnass L, Téllez-Rojo MM, Braun JM, Paule MG, Wright RJ, Wright RO, Curtin P. Sexually dimorphic associations between prenatal blood lead exposure and performance on a behavioral testing battery in children. Neurotoxicol Teratol 2022; 90:107075. [PMID: 35108597 PMCID: PMC8957713 DOI: 10.1016/j.ntt.2022.107075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Associations between lead (Pb) and neurodevelopment have been studied widely in the context of global measures of cognitive function, such as IQ. Operant test batteries consist of behavioral tasks that can be used to target discrete cognitive and behavioral mechanisms, which contribute to global cognitive faculties. OBJECTIVES The goals of this study were to identify Pb-associated deficits in cognitive development and determine the underlying mechanisms involved, utilizing an operant test battery. We evaluated effect modification by child sex. METHODS This study utilized data from a prospective cohort in Mexico City. We included 549 participants aged 6-to-7 years with complete data on prenatal blood Pb measurements, Operant Test Battery (OTB) tasks, and demographic covariates. General linear models were used to examine the association of Pb levels at each prenatal timepoint and OTB performance. Effect modification by child sex was evaluated using 2-way interaction terms. RESULTS In three of the operant tasks, we observed that higher late-pregnancy blood Pb concentrations were associated with greater response latencies. In the temporal processing task, we observed that higher late-pregnancy Pb exposure was associated with worse overall task performance. Further, in two operant tasks, the effects of Pb were dependent on the sex of the child, such that the effects of Pb were more pronounced in females in the condition position responding task, but stronger in males in the temporal processing task. CONCLUSIONS Our results suggest that prenatal Pb concentrations yield broad dysregulation of executive functions, which can be attributed to dysregulation of temporal processing. In addition, we observed sex differences in two operant tasks suggesting that some Pb effects on neurocognitive function may be sexually dimorphic.
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Affiliation(s)
- Francheska M. Merced-Nieves
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Chelonis
- Division of Neurotoxicology, National Center for Toxicological Research, FDA, Jefferson, AR, USA
| | - Ivan Pantic
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Lourdes Schnass
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Martha M. Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Merle G. Paule
- Division of Neurotoxicology, National Center for Toxicological Research, FDA, Jefferson, AR, USA
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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McCormack JC, Elliffe D, Virués‐Ortega J. Quantifying the effects of the differential outcomes procedure in humans: A systematic review and a meta‐analysis. J Appl Behav Anal 2019; 52:870-892. [DOI: 10.1002/jaba.578] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 04/14/2019] [Indexed: 11/10/2022]
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Performance on the Operant Test Battery in young children exposed to procedures requiring general anaesthesia: the MASK study. Br J Anaesth 2019; 122:470-479. [PMID: 30857603 DOI: 10.1016/j.bja.2018.12.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 12/03/2018] [Accepted: 12/28/2018] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND It is not known whether the neurotoxicity produced by anaesthetics administered to young animals can also occur in children. Exposure of infant macaques to ketamine impairs performance in selected domains of the Operant Test Battery (OTB), which can also be administered to children. This study determined whether a similar pattern of results on the OTB is found in children exposed to procedures requiring general anaesthesia before age 3 yr. METHODS We analysed data from the Mayo Anesthesia Safety in Kids (MASK) study, in which unexposed, singly-exposed, and multiply-exposed children born in Olmsted County, MN, USA, from 1994 to 2007 were sampled using a propensity-guided approach and prospectively underwent OTB testing at ages 8-12 or 15-20 yr, using five tasks that generated 15 OTB test scores. RESULTS In primary analysis, none of the OTB test scores depended upon anaesthesia exposure status when corrected for multiple comparisons. Cluster analysis identified four clusters of subjects, with cluster membership determined by relative performance on the OTB tasks. There was no evidence of association between exposure status and cluster membership. Exploratory factor analysis showed that the OTB scores loaded onto four factors. The score for one factor was significantly less in multiply-exposed children (mean standardised difference -0.28 [95% confidence interval, -0.55 to -0.01; P=0.04]), but significance did not survive a sensitivity analysis accounting for outlying values. CONCLUSIONS These findings provide little evidence to support the hypothesis that children exposed to procedures requiring anaesthesia show deficits on OTB tasks that are similar to those observed in non-human primates.
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Arnold MA, Newland MC. Variable behavior and repeated learning in two mouse strains: Developmental and genetic contributions. Behav Processes 2018; 157:509-518. [DOI: 10.1016/j.beproc.2018.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 06/05/2018] [Accepted: 06/15/2018] [Indexed: 12/16/2022]
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Walters JL, Paule MG. Review of preclinical studies on pediatric general anesthesia-induced developmental neurotoxicity. Neurotoxicol Teratol 2017; 60:2-23. [DOI: 10.1016/j.ntt.2016.11.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/16/2016] [Accepted: 11/16/2016] [Indexed: 11/24/2022]
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Walters JL, Chelonis JJ, Fogle CM, Orser BA, Paule MG. Single and repeated exposures to the volatile anesthetic isoflurane do not impair operant performance in aged rats. Neurotoxicology 2016; 56:159-169. [PMID: 27498192 DOI: 10.1016/j.neuro.2016.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 07/27/2016] [Accepted: 07/29/2016] [Indexed: 01/12/2023]
Abstract
Postoperative Cognitive Dysfunction (POCD) is a complication that can occur in the elderly after anesthesia and surgery and is characterized by impairments in information processing, memory, and executive function. Currently, it is unclear whether POCD is due to the effects of surgery, anesthesia, or perhaps some interaction between these or other perioperative variables. Studies in rodents suggest that the development of POCD may be related directly to anesthesia-induced neuroactivity. Volatile anesthetics have been shown to increase cellular inflammation and apoptosis within the hippocampus of aged rodents, while producing corresponding impairments in hippocampal-dependent brain functions. However, it is unclear whether volatile anesthetics can affect additional aspects of cognition that do not primarily depend upon the hippocampus. The purpose of this study was to use established operant tests to examine the effects of isoflurane on aspects of behavioral inhibition, learning, and motivation in aged rats. Twenty-one adult Sprague-Dawley rats (11 male, 10 female) were trained to perform fixed consecutive number (FCN), incremental repeated acquisition (IRA), and progressive ratio (PR) tasks for a minimum of 15 months prior to receiving anesthesia. At 23 months of age, rats were exposed to 1.3% isoflurane or medical grade air for 2h. Initial results revealed that a 2h exposure to isoflurane had no effect on IRA, FCN, or PR performance. Thus, rats received 3 additional exposures to 1.3% isoflurane or medical grade air: 2, 4 and 6h exposures with 2 weeks elapsing before exposure two, 3 weeks elapsing between exposures two and three, and 2 weeks elapsing between exposures three and four. These additional exposures had no observable effects on performance of any operant task. These results suggest that single and repeated exposures to isoflurane do not impair the performance of aged rats in tasks designed to measure behavioral inhibition, learning, and motivation. This lack of significant effect suggests that the impairments associated with isoflurane exposure may not generalize to all aspects of cognition, but may be selective to tasks that primarily measure spatial memory processes.
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Affiliation(s)
- Jennifer L Walters
- National Center for Toxicological Research (NCTR)/FDA, Division of Neurotoxicology, 3900 NCTR Road, Jefferson, AR 72079, United States.
| | - John J Chelonis
- National Center for Toxicological Research (NCTR)/FDA, Division of Neurotoxicology, 3900 NCTR Road, Jefferson, AR 72079, United States
| | - Charles M Fogle
- National Center for Toxicological Research (NCTR)/FDA, Division of Neurotoxicology, 3900 NCTR Road, Jefferson, AR 72079, United States
| | - Beverley A Orser
- University of Toronto, Department of Physiology, Medical Sciences Building, Room 3318, 1 Kings College Circle, Toronto, Ontario M5S1A8, Canada
| | - Merle G Paule
- National Center for Toxicological Research (NCTR)/FDA, Division of Neurotoxicology, 3900 NCTR Road, Jefferson, AR 72079, United States
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Examination of clozapine and haloperidol in improving ketamine-induced deficits in an incremental repeated acquisition procedure in BALB/c mice. Psychopharmacology (Berl) 2016; 233:485-98. [PMID: 26514554 DOI: 10.1007/s00213-015-4120-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 10/15/2015] [Indexed: 02/02/2023]
Abstract
RATIONALE Ketamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist, causes locomotor hyperactivity, aberrant prepulse inhibition and impaired reversal learning among other deficits. There are numerous clinical and pre-clinically uses of NMDAR antagonists and a growing need to characterize their neurobehavioral effects. OBJECTIVES The present study was designed to characterize 1) ketamine's effect on incremental repeated acquisition (IRA), a procedure that taps multiple neurobehavioral functions and has performance measures correlated with IQ in humans, and 2) the extent to which clozapine (CLZ) and haloperidol (HAL) block ketamine's detrimental effects. METHODS AND RESULTS In experiment 1 (Exp. 1), BALB/c mice nose-poked under an IRA procedure for sucrose pellets. Systemic ketamine (1-30 mg/kg) dose-dependently decreased measures of cognitive and motor function. CLZ pretreatment (CLZ 0.1-4.0 mg/kg) dose-dependently attenuated ketamine-induced (30 mg/kg) deficits; the effective dose range of CLZ was 0.3-1.0 mg/kg. HAL pretreatment (0.01-0.1 mg/kg) did not attenuate any ketamine-induced deficits. In experiment 2 (Exp. 2), BALB/c mice lever-pressed under an IRA procedure for sweetened condensed milk. Ketamine (30 mg/kg) produced a global impairment in the IRA procedure and CLZ pretreatment (0.3-1.0 mg/kg) dose-dependently attenuated that impairment; motor-based performance recovered to a greater extent than cognitive performance. When tested alone, these doses of CLZ had little effect on IRA performance. CONCLUSIONS These findings support the notion that CLZ is more effective than HAL at blocking ketamine-induced deficits. The IRA procedure may be beneficial for distinguishing the efficacy of drugs that seek to alleviate deficits in complex behavior that result from acute NMDAR antagonism.
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Voss JL, O'Neil JT, Kharitonova M, Briggs-Gowan MJ, Wakschlag LS. Adolescent development of context-dependent stimulus-reward association memory and its neural correlates. Front Hum Neurosci 2015; 9:581. [PMID: 26578926 PMCID: PMC4623208 DOI: 10.3389/fnhum.2015.00581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/05/2015] [Indexed: 11/13/2022] Open
Abstract
Expression of learned stimulus-reward associations based on context is essential for regulation of behavior to meet situational demands. Contextual regulation improves during development, although the developmental progression of relevant neural and cognitive processes is not fully specified. We therefore measured neural correlates of flexible, contextual expression of stimulus-reward associations in pre/early-adolescent children (ages 9-13 years) and young adults (ages 19-22 years). After reinforcement learning using standard parameters, a contextual reversal manipulation was used whereby contextual cues indicated that stimulus-reward associations were the same as previously reinforced for some trials (consistent trials) or were reversed on other trials (inconsistent trials). Subjects were thus required to respond according to original stimulus-reward associations vs. reversed associations based on trial-specific contextual cues. Children and young adults did not differ in reinforcement learning or in relevant functional magnetic resonance imaging (fMRI) correlates. In contrast, adults outperformed children during contextual reversal, with better performance specifically for inconsistent trials. fMRI signals corresponding to this selective advantage included greater activity in lateral prefrontal cortex (LPFC), hippocampus, and dorsal striatum for young adults relative to children. Flexible expression of stimulus-reward associations based on context thus improves via adolescent development, as does recruitment of brain regions involved in reward learning and contextual expression of memory. HighlightsEarly-adolescent children and young adults were equivalent in reinforcement learning.Adults outperformed children in contextual expression of stimulus-reward associations.Adult advantages correlated with increased activity of relevant brain regions.Specific neurocognitive developmental changes support better contextual regulation.
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Affiliation(s)
- Joel L Voss
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine Chicago, IL, USA ; Ken and Ruth Davee Department of Neurology and Interdepartmental Neuroscience Program, Northwestern University Feinberg School of Medicine Chicago, IL, USA
| | - Jonathan T O'Neil
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine Chicago, IL, USA
| | - Maria Kharitonova
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine Chicago, IL, USA
| | | | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine Chicago, IL, USA ; Institute for Policy Research, Northwestern University Evanston, IL, USA
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Gleich SJ, Flick R, Hu D, Zaccariello MJ, Colligan RC, Katusic SK, Schroeder DR, Hanson A, Buenvenida S, Wilder RT, Sprung J, Voigt RG, Paule MG, Chelonis JJ, Warner DO. Neurodevelopment of children exposed to anesthesia: design of the Mayo Anesthesia Safety in Kids (MASK) study. Contemp Clin Trials 2014; 41:45-54. [PMID: 25555440 DOI: 10.1016/j.cct.2014.12.020] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/22/2014] [Accepted: 12/24/2014] [Indexed: 11/24/2022]
Abstract
There is increasing evidence that exposure of developing brains in animals, including nonhuman primates, to commonly-utilized anesthetic agents may cause adverse effects on cognition and behavior. In this paper, we summarize our methodology for a population-based, propensity-matched study to evaluate possible anesthesia-related sequelae in preschool children when evaluated in elementary or high school. A cohort of all children born in Olmsted County, Minnesota between the years 1994 and 2007 who are currently local residents has been identified. Existing medical records are being used to identify all episodes of exposure to general anesthesia prior to the age of 3 years (i.e., prior to their 3rd birthday). Children with multiple, single, and no anesthesia exposure are sampled for testing between the ages of 8 and 12 years or 15 and 19 years during the period 2012-2016. To match children in different exposure groups as closely as possible, sampling is guided by propensity-matching for the likelihood of receiving anesthesia. Selected children are invited to participate in a single 4-hour session of neuropsychological testing, including the National Center for Toxicological Research-Operant Test Battery, which has been used to study anesthetic neurotoxicity in nonhuman primates. The results of this testing will be compared among children with different anesthetic exposure histories. The expected products of this research will be a detailed phenotype of possible anesthetic-associated neurotoxicity in humans, utilizing a robust patient database and neuropsychological testing battery, and the first comparison of effects of anesthetic exposure in children and nonhuman primates performing nearly identical behavioral tasks.
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Affiliation(s)
- Stephen J Gleich
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States
| | - Randall Flick
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States
| | - Danqing Hu
- Mayo Graduate School, Mayo Clinic, Rochester, MN, United States
| | | | | | - Slavica K Katusic
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Darrell R Schroeder
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Andrew Hanson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Shonie Buenvenida
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States
| | - Robert T Wilder
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States
| | - Juraj Sprung
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States
| | - Robert G Voigt
- Department of Pediatric Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Merle G Paule
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States
| | - John J Chelonis
- National Center for Toxicological Research, Food and Drug Administration, Jefferson, AR, United States
| | - David O Warner
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States.
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Shephard E, Jackson GM, Groom MJ. Learning and altering behaviours by reinforcement: neurocognitive differences between children and adults. Dev Cogn Neurosci 2013; 7:94-105. [PMID: 24365670 PMCID: PMC6987908 DOI: 10.1016/j.dcn.2013.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 11/17/2013] [Accepted: 12/02/2013] [Indexed: 11/26/2022] Open
Abstract
This study examined neurocognitive differences between children and adults in the ability to learn and adapt simple stimulus-response associations through feedback. Fourteen typically developing children (mean age=10.2) and 15 healthy adults (mean age=25.5) completed a simple task in which they learned to associate visually presented stimuli with manual responses based on performance feedback (acquisition phase), and then reversed and re-learned those associations following an unexpected change in reinforcement contingencies (reversal phase). Electrophysiological activity was recorded throughout task performance. We found no group differences in learning-related changes in performance (reaction time, accuracy) or in the amplitude of event-related potentials (ERPs) associated with stimulus processing (P3 ERP) or feedback processing (feedback-related negativity; FRN) during the acquisition phase. However, children's performance was significantly more disrupted by the reversal than adults and FRN amplitudes were significantly modulated by the reversal phase in children but not adults. These findings indicate that children have specific difficulties with reinforcement learning when acquired behaviours must be altered. This may be caused by the added demands on immature executive functioning, specifically response monitoring, created by the requirement to reverse the associations, or a developmental difference in the way in which children and adults approach reinforcement learning.
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Affiliation(s)
- E Shephard
- Division of Psychiatry, University of Nottingham, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, UK.
| | - G M Jackson
- Division of Psychiatry, University of Nottingham, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, UK
| | - M J Groom
- Division of Psychiatry, University of Nottingham, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, UK
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