1
|
Cognitive Functioning in Adults with Phenylketonuria in a Cohort of Spanish Patients. Behav Neurol 2023; 2023:9681740. [PMID: 36815863 PMCID: PMC9931468 DOI: 10.1155/2023/9681740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 02/10/2023] Open
Abstract
The early introduction of a low phenylalanine (Phe) diet has been demonstrated to be the most successful treatment in subjects with phenylketonuria (PKU), especially for preventing severe cognitive and neurological damages. However, it still concerns that even if treated in the first months of life with supplements and following a diet, they can show slight scores below people without PKU in neuropsychological assignments. We investigated 20 adults with classical PKU aged 19-48 years (mean age 29 years) and 20 heathy controls matched by age, gender, and years of education. Patients and controls were assessed with an extended neuropsychological battery, as well as psychological aspects and quality of life, also the last Phe level result was obtained. Results showed that the most affected cognitive domains are processing speed, executive functioning, memory, and also theory of mind, but very well-preserved verbal fluency, language, and visuospatial functioning. In quality of life, some significant results were seen specially in anxiety of Phe levels, anxiety of Phe levels during pregnancy, guilt if poor adherence to supplements, and if dietary protein restriction not followed. No significant results were obtained for the psychological variables. In conclusion, it has been shown that a combination of a low Phe diet, supplement intake, and keeping Phe levels in a low range seems appropriate to have the most normal and alike cognitive performance to persons without PKU.
Collapse
|
2
|
da Silva FGS, e Vairo FP, de Souza CFM, Schwartz IVD. Attention-deficit hyperactivity disorder in Brazilian patients with phenylketonuria. Acta Neurol Belg 2020; 120:893-899. [PMID: 29981005 DOI: 10.1007/s13760-018-0972-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 07/02/2018] [Indexed: 10/28/2022]
Abstract
Recent studies have shown that patients with phenylketonuria (PKU), even with the early diagnosis and continuous treatment, may have symptoms of attention-deficit hyperactivity disorder (ADHD) and that the prevalence of ADHD in this population would be higher than in the general population. This study aims to determine the prevalence of ADHD in a sample of PKU patients from Southern Brazil. Patients were prospectively assessed by clinical interviews, neurological examination, and application of the MTA-SNAP-IV scales for patients aged 5-17 years and the Adult Self-Report Scale for patients over 17 years. Thirty-one patients (mean age = 17.4; early diagnosis = 27) were followed. Patients with ADHD and younger than 17 years had a median Phe in the last 6 months of life higher than those without the diagnosis of ADHD (ADHD patients = 617.1 µmol/L, no-ADHD patients 393.2 µmol/L, and p = 0.03). There was a predominantly hyperactive/impulsivity clinical presentation of ADHD (n = 4/5 patients), which differs from that reported elsewhere in the literature. Future studies are essential to better define the clinical presentation of ADHD in these patients and further elucidate its pathophysiology.
Collapse
|
3
|
González MJ, Polo MR, Ripollés P, Gassió R, Ormazabal A, Sierra C, Roura RC, Artuch R, Campistol J. White matter microstructural damage in early treated phenylketonuric patients. Orphanet J Rare Dis 2018; 13:188. [PMID: 30367646 PMCID: PMC6203973 DOI: 10.1186/s13023-018-0912-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/12/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Despite dietary intervention, individuals with early treated phenylketonuria (ETPKU) could present neurocognitive deficits and white matter (WM) abnormalities. The aim of the present study was to evaluate the microstructural integrity of WM pathways across the whole brain in a cohort of paediatric ETPKU patients compared with healthy controls (HCs), by collecting DTI-MRI (diffusion tensor magnetic resonance imaging) data and diffusion values (mean diffusivity (MD), radial diffusivity (RD) and fractional anisotropy (FA)). METHODS DTI-MRI data and diffusion values (MD, RD, FA) from WM tracts across the whole brain were analized using Tract Based Spatial Statistics (TBSS), in 15 paediatrics TPKU patients (median age: 12 years) and compared with 11 HCs. Areas showing abnormal values in the patient group were correlated (Pearson) with age, lifetime Phe values, last year median and mean Phe, concurrent Phe values in plasma, urine neurotransmitters status biomarkers, and with a processing speed task. RESULTS ETPKU showed bilaterally decreased MD values compared with HCs in the body and splenium of the corpus callosum, superior longitudinal fasciculus, corona radiata and in the posterior limb of the internal capsule. RD values followed a similar pattern, although decreased RD values in PKU patients were also found in the anterior limb of the internal capsule and in the cerebral peduncle. Decreased MD and RD values within the aforementioned regions had significant negative correlations with age, last year median and mean Phe and concurrent Phe values. No correlations were found with monoamines in urine or processing speed task. CONCLUSIONS ETPKU patients showed MD and RD values significantly decreased across the whole brain when compared with HCs, and this damage was associated with high Phe values and the age of patients. Despite this microstructural damage, no affectation in processing speed was observed in patients with good metabolic control. DTI-MRI sequences could be used as a technique to quantify WM damage that is difficult to be detect in T1 or T2-weighted images, but also to quantify damage of WM through the follow up of patients with poor metabolic control in prospective studies.
Collapse
Affiliation(s)
- María Julieta González
- Neuropediatric Department, PKU Follow Up Unit, Hospital Sant Joan de Déu (HSJD), Institut de Recerca Sant Joan de Deu (IRSJD), Passeig Sant Joan de Deu 2, Postal code, 08950 Barcelona, Spain
| | - Mónica Rebollo Polo
- Neuroimaging Section, HSJD, IRSJD, Passeig Sant Joan de Deu 2, Postal code, 08950 Barcelona, Spain
| | - Pablo Ripollés
- Neuroimaging Section, HSJD, IRSJD, Passeig Sant Joan de Deu 2, Postal code, 08950 Barcelona, Spain
- Department of Psychology, New York University, 6 Washington Place, 10003 New York, USA
| | - Rosa Gassió
- Neuropediatric Department, PKU Follow Up Unit, Hospital Sant Joan de Déu (HSJD), Institut de Recerca Sant Joan de Deu (IRSJD), Passeig Sant Joan de Deu 2, Postal code, 08950 Barcelona, Spain
| | - Aída Ormazabal
- Clinical Biochemistry Department, HSJD, IRSJD, UB, (CIBERER-ISCIII), Passeig Sant Joan de Deu 2, 08950 Barcelona, Spain
| | - Cristina Sierra
- Clinical Biochemistry Department, HSJD, IRSJD, UB, (CIBERER-ISCIII), Passeig Sant Joan de Deu 2, 08950 Barcelona, Spain
| | - Roser Colomé Roura
- Neuropediatric Department, PKU Follow Up Unit, Hospital Sant Joan de Déu (HSJD), Institut de Recerca Sant Joan de Deu (IRSJD), Passeig Sant Joan de Deu 2, Postal code, 08950 Barcelona, Spain
| | - Rafael Artuch
- Clinical Biochemistry Department, HSJD, IRSJD, UB, (CIBERER-ISCIII), Passeig Sant Joan de Deu 2, 08950 Barcelona, Spain
| | - Jaume Campistol
- Neuropediatric Department, PKU Follow Up Unit, Hospital Sant Joan de Déu (HSJD), Institut de Recerca Sant Joan de Deu (IRSJD), Passeig Sant Joan de Deu 2, Postal code, 08950 Barcelona, Spain
| |
Collapse
|
4
|
Wesonga E, Shimony JS, Rutlin J, Grange DK, White DA. Relationship between age and white matter integrity in children with phenylketonuria. Mol Genet Metab Rep 2016; 7:45-9. [PMID: 27114916 PMCID: PMC4832081 DOI: 10.1016/j.ymgmr.2016.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 03/13/2016] [Indexed: 11/29/2022] Open
Abstract
Diffusion tensor imaging (DTI) has shown poorer microstructural white matter integrity in children with phenylketonuria (PKU), specifically decreases in mean diffusivity (MD), in comparison with healthy children. However, little research has been conducted to investigate the relationship between age and white matter integrity in this population. The present study examined group differences in the relationship between age and MD across a range of brain regions in 31 children with early- and continuously-treated PKU and 51 healthy control children. Relationships among MD, age, and group were explored using hierarchical linear regression and Pearson correlation. Results indicated a stronger age-related decrease in MD for children with PKU in comparison with healthy children in 4 of the 10 brain regions examined, suggesting that the trajectory of white matter development is abnormal in children with PKU. Further research using longitudinal methodology is needed to fully elucidate our understanding of white matter development in children with PKU.
Collapse
Affiliation(s)
- Erika Wesonga
- Department of Psychological & Brain Sciences, One Brookings Drive, Campus Box 1125, Washington University, St. Louis, MO 63130, USA
| | - Joshua S Shimony
- Mallinckrodt Institute of Radiology, Campus Box 8131, Washington University, St. Louis, MO 63110, USA
| | - Jerrel Rutlin
- Department of Psychiatry, Campus Box 8134, Washington University, St. Louis, MO 63110, USA
| | - Dorothy K Grange
- Department of Pediatrics, Campus Box 8116, Washington University, St. Louis, MO 63110, USA
| | - Desiree A White
- Department of Psychological & Brain Sciences, One Brookings Drive, Campus Box 1125, Washington University, St. Louis, MO 63130, USA; Department of Pediatrics, Campus Box 8116, Washington University, St. Louis, MO 63110, USA
| |
Collapse
|
5
|
Nazi S, Rohani F, Sajedi F, Biglarian A, Setoodeh A. Motor development skills of 1- to 4-year-old Iranian children with early treated phenylketonuria. JIMD Rep 2013; 12:85-9. [PMID: 23918467 DOI: 10.1007/8904_2013_248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 06/24/2013] [Accepted: 06/25/2013] [Indexed: 03/07/2023] Open
Abstract
Objective : To gauge the gross and fine motor development of early treated phenylketonuria (ETPKU) in children in the age range of 1-4 years. Methods : A cross-sectional analytic study was conducted in PKU clinics (reference clinics for PKU follow-up), Tehran, Iran. Seventy children with ETPKU were selected as the case group for the study. ETPKU children were those with early and continuous treatment with a phenylalanine-restricted diet (the mean of blood phenylalanine level during the recent 6 months was 2-6 mg/dL or 120-360 μmol/L). Also, 100 healthy and normal children matched with the ETPKU group for age were randomly selected from 4 kindergartens in four parts of Tehran as a control group. The measurements consisted of a demographic questionnaire, Peabody Developmental Motor Scale-2 (PDMS-2), and pediatrician assessment. Motor quotients were determined by PDMS-2 and then compared in both groups by two independent samples t-test. Results : The mean ages in case and control group were 28.5 (± 11.6) and 29.7 (± 11.3) months, respectively. Comparison of the mean fine, gross, and total developmental motor quotients (DMQs) showed statistically significant differences between the two groups (p < 0.05). The fine and total DMQs of ETPKU children were also correlated with age. In addition, there was a negative correlation between the phenylalanine level and fine (p < 0.001) and total (p = 0.001) DMQs. Conclusion : It seems that ETPKU Iranian children, regardless of following a phenylalanine-restricted diet or not, have lower motor development. It is recommended to plan programs for early detection and intervention of developmental delays in these children.
Collapse
Affiliation(s)
- Sepideh Nazi
- Occupational therapy Department, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | | | | | | |
Collapse
|
6
|
Antenor-Dorsey JAV, Hershey T, Rutlin J, Shimony JS, McKinstry RC, Grange DK, Christ SE, White DA. White matter integrity and executive abilities in individuals with phenylketonuria. Mol Genet Metab 2013; 109:125-31. [PMID: 23608077 PMCID: PMC3678378 DOI: 10.1016/j.ymgme.2013.03.020] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2013] [Revised: 03/31/2013] [Accepted: 03/31/2013] [Indexed: 01/16/2023]
Abstract
Previous studies have revealed white matter abnormalities in the brains of individuals with phenylketonuria (PKU), but the microstructural nature of these abnormalities and their relationship to phenylalanine (Phe) levels and cognitive outcomes are poorly understood. In the current study, the microstructural integrity of white matter in 29 individuals with early-treated PKU and 12 healthy controls was examined using two complementary diffusion tensor imaging (DTI) approaches: region-of-interest (ROI) based analysis and voxel-wise tract based spatial statistics (TBSS) analysis. Relationships among DTI, executive abilities, and Phe level findings were explored. DTI revealed widespread lowering of mean diffusivity (MD) in the white matter of the PKU group in comparison with the control group. Executive abilities were also poorer for individuals with PKU than controls. Within the PKU group, lower MD was associated with higher Phe level and poorer executive abilities. These findings are the first to demonstrate the interplay among microstructural white matter integrity, executive abilities, and Phe control in individuals with PKU.
Collapse
Affiliation(s)
- Jo Ann V. Antenor-Dorsey
- Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Tamara Hershey
- Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, St. Louis, MO, USA, 63110
- Mallinckrodt Institute of Radiology, Campus Box 8131, Washington University School of Medicine, St. Louis, MO, USA, 63110
- Department of Neurology, Campus Box 8111, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Jerrel Rutlin
- Department of Psychiatry, Campus Box 8134, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Joshua S. Shimony
- Mallinckrodt Institute of Radiology, Campus Box 8131, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Robert C. McKinstry
- Mallinckrodt Institute of Radiology, Campus Box 8131, Washington University School of Medicine, St. Louis, MO, USA, 63110
- Department of Pediatrics, Campus Box 8116, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Dorothy K. Grange
- Department of Pediatrics, Campus Box 8116, Washington University School of Medicine, St. Louis, MO, USA, 63110
| | - Shawn E. Christ
- Department of Psychological Sciences, 210 McAlester Hall, University of Missouri, Columbia, MO, USA, 65211
| | - Desirée A. White
- Department of Psychology, Campus Box 1125, Washington University, St. Louis, MO, USA, 63130
| |
Collapse
|
7
|
Janos AL, Grange DK, Steiner RD, White DA. Processing speed and executive abilities in children with phenylketonuria. Neuropsychology 2012; 26:735-43. [PMID: 22866986 PMCID: PMC3526340 DOI: 10.1037/a0029419] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Phenylketonuria (PKU) is a hereditary metabolic disorder that often results in neuropsychological impairment, even in individuals treated early and continuously. This study was conducted to examine processing speed, variability in processing speed, and the relationship between processing speed variables and executive abilities in children with early and continuously treated PKU. METHOD Participants were 42 children with PKU and 81 typically developing children from 7 to 18 years of age. Children completed 3 computerized reaction time (RT) tasks (simple RT, go/no-go, stimulus-response compatibility) and 7 tasks assessing executive abilities (working memory, inhibitory control, strategic processing). RESULTS Performance of children with PKU was significantly slower and more variable than that of controls across the 3 tasks administered. When age was considered, it was shown that processing speed improved with age to a comparable degree for both groups. Variability in processing speed, however, decreased more with age for the PKU than control group, reflecting the fact that variability in younger, but not older, children with PKU was greater than that of controls. With regard to executive abilities, processing speed and variability contributed to performance on most, but not all, executive tasks; and after controlling for processing speed and variability, executive impairments were still identified in working memory and inhibitory control (not strategic processing). CONCLUSIONS These findings indicate that information processing is slower and less efficient in children with PKU. In addition, processing speed and variability contribute to some, but not all, of the impairments in executive abilities observed in children with PKU.
Collapse
Affiliation(s)
- Alicia L. Janos
- Department of Psychology, Washington University in St. Louis
| | - Dorothy K. Grange
- Department of Pediatrics, Division of Genetics and Genomic Medicine, Washington University School of Medicine, St. Louis Children’s Hospital
| | - Robert D. Steiner
- Departments of Pediatrics and Molecular & Medical Genetics, Child Development and Rehabilitation Center/Doernbecher Children’s Hospital, Oregon Health & Science University
| | | |
Collapse
|
8
|
Christ SE, Moffitt AJ, Peck D, White DA, Hilgard J. Decreased functional brain connectivity in individuals with early-treated phenylketonuria: evidence from resting state fMRI. J Inherit Metab Dis 2012; 35:807-16. [PMID: 22231384 DOI: 10.1007/s10545-011-9439-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Revised: 12/07/2011] [Accepted: 12/13/2011] [Indexed: 10/14/2022]
Abstract
Previous histological and neuroimaging studies have documented structural abnormalities in the white matter of the brain in individuals with early-treated phenylketonuria (ETPKU). It remains unclear, however, the extent to which the function of the brain's interconnections are impacted by this condition. Presently, we utilized functional magnetic resonance imaging (fMRI) to evaluate the synchronization of neural signals (i.e., functional connectivity) among brain regions comprising the default mode network (DMN) in a sample of 11 individuals with ETPKU and 11 age- and gender-matched neurologically intact controls. The DMN is a group of interconnected brain regions that are known to be generally more active during rest than during task performance. Data analysis revealed decreased functional connectivity among DMN regions for the ETPKU group compared with the control group. Within the PKU group, we also found a significant relationship between blood phenylalanine (phe) levels and the functional connectivity between select regions of the DMN. In conjunction with findings from another recent fMRI study (Christ, Moffitt et al. 2010), the present results suggest that ETPKU-related deficiencies in functional connectivity are pervasive. The current findings also provide initial evidence that the extent of such impairment may be moderated in part by blood phe levels.
Collapse
Affiliation(s)
- Shawn E Christ
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65203, USA.
| | | | | | | | | |
Collapse
|
9
|
O’Shea CJ, Sloan JL, Wiggs EA, Pao M, Gropman A, Baker EH, Manoli I, Venditti CP, Snow J. Neurocognitive phenotype of isolated methylmalonic acidemia. Pediatrics 2012; 129:e1541-51. [PMID: 22614770 PMCID: PMC3362903 DOI: 10.1542/peds.2011-1715] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Methylmalonic acidemia (MMA) is a metabolic disorder with a poorly defined long-term neurocognitive phenotype. We studied the neuropsychological outcomes of patients and examined clinical covariates that influenced cognition. METHODS A diverse cohort with mut, cblA, or cblB subtypes of isolated MMA (N = 43), ages 2 to 32 years, were evaluated at a single center over a 6-year period. The influence of clinical, laboratory, and metabolic parameters on neuropsychological testing results was determined. RESULTS Early-onset mut patients (n = 21) manifested the most severe neurocognitive impairments, with a mean ± SD full-scale IQ (FSIQ) of 71.1 ± 14.75. Late-onset mut patients (n = 6) had a mean FSIQ of 88.5 ± 27.62. cblA (n = 7), cblB (n = 6), and mut patients diagnosed prenatally or by newborn screening (n = 3) obtained mean FSIQs in the average range (100.7 ± 10.95, 96.6 ± 10.92, and 106.7 ± 6.66, respectively). Hyperammonemia at diagnosis and the presence of a seizure disorder were associated with a lower FSIQ (P = .001 and P = .041, respectively), but other clinical variables, including basal ganglia injury and mutation status, did not. FSIQ remained stable over longitudinal testing (n = 10). Decreased scores on processing speed, compared with all other intellectual domains, emerged as a specific neurocognitive manifestation. CONCLUSIONS The neurocognitive outcomes seen in isolated MMA are highly variable. An earlier age of disease onset, the presence of hyperammonemia at diagnosis, and a history of seizures were associated with more severe impairment. In all patient subtypes, selective deficits in processing speed were present.
Collapse
Affiliation(s)
- Colin J. O’Shea
- Office of the Clinical Director, National Institute of Mental Health
| | - Jennifer L. Sloan
- Genetics and Molecular Biology Branch, National Human Genome Research Institute
| | - Edythe A. Wiggs
- Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, and
| | - Maryland Pao
- Office of the Clinical Director, National Institute of Mental Health
| | - Andrea Gropman
- Genetics and Molecular Biology Branch, National Human Genome Research Institute,,Division of Neurology, Children’s National Medical Center, Washington, District of Columbia
| | - Eva H. Baker
- Radiology and Imaging Sciences, National Institutes of Health, Bethesda, Maryland; and
| | - Irini Manoli
- Genetics and Molecular Biology Branch, National Human Genome Research Institute
| | - Charles P. Venditti
- Genetics and Molecular Biology Branch, National Human Genome Research Institute
| | - Joseph Snow
- Office of the Clinical Director, National Institute of Mental Health
| |
Collapse
|
10
|
de Sonneville LMJ, Huijbregts SCJ, Licht R, Sergeant JA, van Spronsen FJ. Pre-attentive processing in children with early and continuously-treated PKU. Effects of concurrent Phe level and lifetime dietary control. J Inherit Metab Dis 2011; 34:953-62. [PMID: 21541727 PMCID: PMC3137776 DOI: 10.1007/s10545-011-9321-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Revised: 03/08/2011] [Accepted: 03/21/2011] [Indexed: 11/10/2022]
Abstract
Sixty-four children, aged 7 to 14 years, with early-treated PKU, were compared with control children on visual evoked potential (VEP) amplitudes and latencies and auditory mismatch negativity (MMN) amplitudes. It was further investigated whether indices of dietary control would be associated with these evoked potentials parameters. There were no significant differences between controls and children with PKU in VEP- and MMN-indices. However, higher lifetime Phe levels were, in varying degree and stronger than concurrent Phe level, related to increased N75 amplitudes, suggesting abnormalities in attention, and longer P110 latencies, indicating a reduction in speed of neural processing, possibly due to deficits in myelination or reduced dopamine levels in brain and retina. Similarly, higher lifetime Phe levels and Index of Dietary Control (IDC) were associated with decreased MMN amplitudes, suggesting a reduced ability to respond to stimulus change and poorer triggering of the frontally mediated attention switch. In summary, the present study in children with PKU investigated bottom-up information processing, i.e., triggered by external events, a fundamental prerequisite for the individual's responsiveness to the outside world. Results provide evidence that quality of dietary control may affect the optimal development of these pre-attentive processes, and suggest the existence of windows of vulnerability to Phe exposure.
Collapse
Affiliation(s)
- Leo M J de Sonneville
- Leiden Institute for Brain and Cognition, and Dept. of Clinical Child and Adolescent Studies, Faculty of Social Sciences, Leiden University, Wassenaarseweg 52, 2333, AK, Leiden, The Netherlands.
| | | | | | | | | |
Collapse
|
11
|
Banerjee P, Grange DK, Steiner RD, White DA. Executive strategic processing during verbal fluency performance in children with phenylketonuria. Child Neuropsychol 2010; 17:105-17. [PMID: 21140312 DOI: 10.1080/09297049.2010.525502] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In the current study, we examined a specific aspect of executive abilities, strategic processing, in 32 children with early-treated phenylketonuria (PKU) and 41 typically-developing control children. To do so, clustering and switching were assessed during semantic (animal, food/drink) and phonemic (S, F) fluency tasks. Specifically, number of words generated, number of subcategory clusters, number of words in subcategory clusters, and number of switches between subcategories were analyzed to provide a refined analysis of strategic processing. Compared with controls, children with PKU generated significantly fewer words and made significantly fewer switches between subcategories in the food/drink trial and the phonemic fluency condition. Number of switches was associated with number of words generated in these tasks. In addition, a significant interaction between age and group in number of switches for the food/drink trial reflected a greater increase in number of switches for the control than PKU group as a function of increasing age. These results suggest impairment in frontally-mediated aspects of strategic processing in children with early-treated PKU and indicate that strategic processing should be evaluated carefully as these children age.
Collapse
Affiliation(s)
- Pia Banerjee
- Department of Psychology, Washington University in St. Louis, MO 63130, USA
| | | | | | | |
Collapse
|
12
|
White DA, Connor LT, Nardos B, Shimony JS, Archer R, Snyder AZ, Moinuddin A, Grange DK, Steiner RD, McKinstry RC. Age-related decline in the microstructural integrity of white matter in children with early- and continuously-treated PKU: a DTI study of the corpus callosum. Mol Genet Metab 2010; 99 Suppl 1:S41-6. [PMID: 20123469 PMCID: PMC3640282 DOI: 10.1016/j.ymgme.2009.09.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Revised: 09/25/2009] [Accepted: 09/28/2009] [Indexed: 01/08/2023]
Abstract
Structural, volumetric, and microstructural abnormalities have been reported in the white matter of the brain in individuals with phenylketonuria (PKU). Very little research, however, has been conducted to investigate the development of white matter in children with PKU, and the developmental trajectory of their white matter microstructure is unknown. In the current study, diffusion tensor imaging (DTI) was used to examine the development of the microstructural integrity of white matter across six regions of the corpus callosum in 34 children (7-18 years of age) with early- and continuously-treated PKU. Comparison was made with 61 demographically-matched healthy control children. Two DTI variables were examined: mean diffusivity (MD) and relative anisotropy (RA). RA was comparable to that of controls across all six regions of the corpus callosum. In contrast, MD was restricted for children with PKU in anterior (i.e., genu, rostral body, anterior midbody) but not posterior (posterior midbody, isthmus, splenium) regions of the corpus callosum. In addition, MD restriction became more pronounced with increasing age in children with PKU in the two most anterior regions of the corpus callosum (i.e., genu, rostral body). These findings point to an age-related decrement in the microstructural integrity of the anterior white matter of the corpus callosum in children with PKU.
Collapse
Affiliation(s)
- Desiree A White
- Department of Psychology, Campus Box 1125, Washington University, One Brookings Drive, St. Louis, MO 63130, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|