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Vernet M, Ducrot S, Chaix Y. A Systematic Review on Visual-Processing Deficits in Neurofibromatosis Type 1: What Possible Impact on Learning to Read? Dev Neuropsychol 2024; 49:111-137. [PMID: 38469855 DOI: 10.1080/87565641.2024.2326151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/27/2024] [Indexed: 03/13/2024]
Abstract
This systematic review aimed to examine the possible implication of visual-perceptual, visuo-attentional and oculomotor processing in the reading deficits frequently experienced by children with Neurofibromatosis type 1 (NF1), as previously shown in dyslexia. Using PRISMA methodological guidelines, we examined 49 studies; most of these reported visual-processing deficits in this population, raising the importance of directly studying the visuo-perceptual and visuo-attentional processes and eye-movement control involved in the learning-to-read process in NF1. The discussion provides a reflection for a better understanding of how visual-processing skills interact with reading deficits in NF1, as well as new avenues for their screening and care.
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Affiliation(s)
- Marie Vernet
- Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France
- Centre de jour enfants, Centre hospitalier de Digne-les-Bains, Digne-les-Bains, France
- TONIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | | | - Yves Chaix
- TONIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
- Neuropediatric Department, Toulouse-Purpan University Hospital, Toulouse, France
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2
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Maziero S, Jucla M, Blais M, Albaret JM, Tallet J, Chaix Y. A preliminary study of the different memory systems in neurofibromatosis type 1: What is impaired and what is spared? Brain Dev 2023; 45:220-230. [PMID: 36609051 DOI: 10.1016/j.braindev.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Since 1990's, the cognitive profile of children with a neurofibromatosis type 1 (NF1) has been refined by many different studies. Children with NF1 may exhibit a variety of cognitive dysfunctions. Memory difficulties have been reported, but the results are contradictory and, compared to other cognitive functions, memory has been less evaluated. OBJECTIVE The aim of this study was to investigate the memory profile in NF1 with a particular population, children with NF1 without attention deficit hyperactivity disorder (ADHD). METHODS Eighteen children with NF1 without ADHD and eighteen typically developing aged from 8 to 12.6 years were compared in terms of both their verbal and visual working memory, anterograde memory, and procedural perceptual-motor memory. We also assessed semantic and autobiographical memory. RESULTS Our results indicate the existence of memory difficulties in children with NF1 without ADHD in verbal working and anterograde memory but not in terms of the visual domain. They also experienced difficulties recalling personal memories but these were improved by cueing. However, semantic memory and procedural perceptual-motor memory was preserved. CONCLUSIONS These results highlight a difference between memory systems in children with NF1 without ADHD and the importance to assess the different memory systems, the nature of information and the processes in long-term memory in NF1 population. However, our results raise questions about the possible links between these difficulties and the executive functions. The specifics of memory profile in children with NF1 must be taken into consideration in these children's clinical follow-up, in order to understand their learning difficulties and to make adaptations to their care.
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Affiliation(s)
- Stéphanie Maziero
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Laboratory of NeuroPsychoLinguistics, University of Toulouse, France.
| | - Mélanie Jucla
- Laboratory of NeuroPsychoLinguistics, University of Toulouse, France
| | - Mélody Blais
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Jean-Michel Albaret
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Jessica Tallet
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
| | - Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France; Centre Hospitalier Universitaire de Toulouse, CHU Purpan, Toulouse, France
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3
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Doser K, Belmonte F, Andersen KK, Østergaard JR, Hove H, Handrup MM, Ejerskov C, Mulvihill JJ, Winther JF, Kenborg L. School performance of children with neurofibromatosis 1: a nationwide population-based study. Eur J Hum Genet 2022; 30:1405-1412. [PMID: 35859011 PMCID: PMC9712673 DOI: 10.1038/s41431-022-01149-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/24/2022] [Accepted: 07/04/2022] [Indexed: 11/09/2022] Open
Abstract
Children with neurofibromatosis 1 (NF1) may have a high burden of somatic disease and cognitive impairments, which can lead to poor academic performance. We evaluated school grades from exams ending mandatory schooling (usually around age 15 or 16 years) of children with NF1 in a population-based registry study using a within-school matched design. The study included 285 children with NF1 and 12,000 NF1-free peers who graduated from the same school and year during 2002-2015. We estimated overall and gender-specific grades by subject and compared the grades of children with NF1 with those of NF1-free peers in linear regression models. We also examined the effect of social and socioeconomic factors (immigration status and parental education, income and civil status) on grades and age at finalizing ninth grade. School grades varied considerably by socioeconomic stratum for all children; however, children with NF1 had lower grades by an average of 11-12% points in all subjects. In the adjusted models, children with NF1 had significantly lower grades than their NF1-free peers, with largest negative differences in grades observed for girls with NF1. Finally, children with NF1 were 0.2 (CI 0.1-0.2) years older than their peers on graduating from ninth grade, but only maternal educational modified the age at graduating. In conclusion, students with NF1 perform more poorly than their peers in all major school subjects. Gender had a strong effect on the association between NF1 and school grades; however, socioeconomic factors had a similar effect on grades for children with NF1 and their peers.
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Affiliation(s)
- Karoline Doser
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Federica Belmonte
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Klaus Kaae Andersen
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - John R Østergaard
- Center for Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Hanne Hove
- The RAREDIS Database, Center for Rare Diseases, Copenhagen University Hospital and Aarhus University Hospital, Aarhus, Denmark
| | - Mette M Handrup
- Center for Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Cecilie Ejerskov
- Center for Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - John J Mulvihill
- Department of Pediatrics, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Jeanette F Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University and University Hospital, Aarhus, Denmark
| | - Line Kenborg
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.
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4
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Vernet M, Jover M, Bellocchi S, Maziero S, Jucla M, Tallet J, Danna J, Chaix Y, Ducrot S. Visual-processing deficits in children with neurofibromatosis type 1: A clinical marker of reading difficulties. Eur J Paediatr Neurol 2022; 38:25-32. [PMID: 35381410 DOI: 10.1016/j.ejpn.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 03/07/2022] [Accepted: 03/23/2022] [Indexed: 11/24/2022]
Abstract
Today's estimates indicate that nearly 50% of children with Neurofibromatosis type 1 (NF1) suffer from reading disabilities, with a high impact on their academic achievement. In addition to the well-documented importance of phonological skills in reading acquisition and neurodevelopmental disorders, visual-attention processes also appear as important factors in learning to read. The present study aimed at assessing the role of visual-processing dysfunction in the high prevalence of reading disabilities in NF1 children and providing a useful tool for clinician in the early detection of reading impairment in this neurogenetic disorder. Forty-two children with NF1 and 42 typically developing children (TD) participated in the study. All were right-handed and did not present intellectual disability or attention deficit hyperactivity disorder. Visual-attention processes were assessed with the Developmental Eye Movement (DEM) test, together with the NF1 children's reading level. NF1 children with and without reading disabilities were then compared. The results showed that visual-processing deficits were highly present among the NF1 children included in our study. Furthermore, poor readers with NF1 presented an increased risk of visual-processing deficits compared to peers. This finding supports the role of visual-processing deficits in the reading difficulties encountered in nearly half of children with NF1. Finally, in NF1 children without intellectual or attention disability, visual-processing deficits emerge as one of the clinical markers of reading disabilities. The study holds important clinical implications both for the identification, by providing a useful screening tool, and the management of reading disabilities in NF1 children.
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Affiliation(s)
- Marie Vernet
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France.
| | | | - Stéphanie Bellocchi
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA, 4556, Montpellier, France
| | - Stéphanie Maziero
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Octogone-Lordat, University of Toulouse, Toulouse, France
| | - Mélanie Jucla
- Octogone-Lordat, University of Toulouse, Toulouse, France
| | - Jessica Tallet
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France
| | - Jérémy Danna
- Aix Marseille Univ, CNRS, LNC, Marseille, France
| | - Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, Inserm, UPS, France; Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
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5
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Biotteau M, Tournay E, Baudou E, Destarac S, Iannuzzi S, Faure-Marie N, Castelnau P, Schweitzer E, Rodriguez D, Kemlin I, Dorison N, Rivier F, Carneiro M, Preclaire E, Barbarot S, Lauwers-Cancès V, Chaix Y. Reading Comprehension Impairment in Children With Neurofibromatosis Type 1 (NF1): The Need of Multimodal Assessment of Attention. J Child Neurol 2021; 36:625-634. [PMID: 33507832 DOI: 10.1177/0883073820981270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Attention span, which has been shown to have an impact on reading quality in many other conditions, is one of the main cognitive disorders of neurofibromatosis type 1 (NF1). The aim of this work is to observe the impact of attention on reading comprehension, in NF1 and non-NF1 children. A multicenter, cross-sectional study was conducted on 150 children (8-12 years old) with or without NF1 (75 NF1 vs 75 non-NF1; 72 female, 78 male), matched for age, sex, handedness, and reading level, thus forming a continuum from good to poor readers in both NF1 and non-NF1 groups. Children with intellectual deficiency or neurologic or psychiatric disorder were excluded. Attentional skills were assessed by combining a parent questionnaire (Child Behavior CheckList) and a performance-based assessment (Conner's Continuous Performance Test-Second Edition). Reading comprehension was assessed through a standardized reading comprehension test (ORLEC Lobrot). The performance-based attention scores were associated with text and sentence comprehension ability (P = .0235 and P = .0164, respectively), while indirect questionnaire attention scores were only associated with sentence comprehension (P = .0263). For both groups, the correlations between questionnaire and performance-based measures were low. We have shown that reading comprehension is greatly influenced by attention in NF1 and non-NF1, even if predictors of good reading comprehension also include IQ score and reading accuracy. Indirect observer-rated questionnaires and direct performance-based measures of attention do not assess the same variables, are linked to different components of reading skills, and are not interchangeable assessments of attention difficulties. Both assessments are complementary and must be used simultaneously, leading to recommendations that support multimodal assessment of attention.
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Affiliation(s)
- Maëlle Biotteau
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, 27102Inserm, UPS, France.,Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
| | - Elodie Tournay
- Epidemiology Department, Toulouse University Hospital, Toulouse, France
| | - Eloise Baudou
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, 27102Inserm, UPS, France.,Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
| | - Sandrine Destarac
- Pediatric Clinical Research Unit, Toulouse Clinical Investigation Center, Children's Hospital, Purpan University Hospital, Inserm U1436, Toulouse, France
| | - Stéphanie Iannuzzi
- Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
| | | | - Pierre Castelnau
- Pediatric Neurology, Clocheville Children's Hospital, Tours University Hospital, Tours, France.,UMR 1253, iBrain, University fo Tours, 27102Inserm, Tours, France.,School of Medicine, University of Tours Francois Rabelais, Tours, France
| | - Elisabeth Schweitzer
- Pediatric Neurology, Clocheville Children's Hospital, Tours University Hospital, Tours, France
| | - Diana Rodriguez
- Sorbonne University, APHP.SU, Department of Neuropediatry & Reference Center for Neurogenetics Disabilities, Armand Trousseau University Hospital, Paris, France.,Inserm U1141, FHU I2-D2, Paris, France
| | - Isabelle Kemlin
- Sorbonne University, APHP.SU, Department of Neuropediatry & Reference Center for Neurogenetics Disabilities, Armand Trousseau University Hospital, Paris, France
| | - Nathalie Dorison
- Sorbonne University, APHP.SU, Department of Neuropediatry & Reference Center for Neurogenetics Disabilities, Armand Trousseau University Hospital, Paris, France
| | - François Rivier
- Department of Pediatric Neurology, Montpellier University Hospital, PhyMedExp, University of Montpellier, Inserm, CNRS, Montpellier, France
| | - Maryline Carneiro
- Department of Pediatric Neurology & Reference Center for Language Disabilities, Montpellier University Hospital, France
| | - Elodie Preclaire
- Department of Pediatric Neurology & Reference Center for Language Disabilities, Montpellier University Hospital, France
| | | | | | - Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, University of Toulouse, 27102Inserm, UPS, France.,Children's Hospital, Toulouse-Purpan University Hospital, Toulouse, France
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6
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Abstract
OBJECTIVE Reading difficulties are one of the most significant challenges for children with neurofibromatosis type 1 (NF1). The aims of this study were to identify and categorize the types of reading impairments experienced by children with NF1 and to establish predictors of poor reading in this population. METHOD Children aged 7-12 years with NF1 (n = 60) were compared with typically developing children (n = 36). Poor word readers with NF1 were classified according to impairment type (i.e., phonological, surface, mixed), and their reading subskills were compared. A hierarchical multiple regression was conducted to identify predictors of word reading. RESULTS Compared to controls, children with NF1 demonstrated significantly poorer literacy abilities. Of the 49 children with NF1 classified as poor readers, 20 (41%) were classified with phonological dyslexia, 24 (49%) with mixed dyslexia, and 5 (10%) fell outside classification categories. Children with mixed dyslexia displayed the most severe reading impairments. Stronger working memory, better receptive language, and fewer inattentive behaviors predicted better word reading skills. CONCLUSIONS The majority of children with NF1 experience deficits in key reading skills which are essential for them to become successful readers. Weaknesses in working memory, receptive language, and attention are associated with reading difficulties in children with NF1.
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7
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Farschtschi S, Mautner VF, McLean ACL, Schulz A, Friedrich RE, Rosahl SK. The Neurofibromatoses. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 117:354-360. [PMID: 32657748 DOI: 10.3238/arztebl.2020.0354] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 04/18/2019] [Accepted: 03/20/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Neurofibromatosis of types 1 and 2 (NF1, NF2) and schwannomatosis are the diseases that make up the neurofibromatosis spectrum. With respective incidences of 1 in 3000, 1 in 33 000, and 1 in 60 000 births, they form part of the group of rare tumor-suppressor syndromes. They give rise to a greater tumor burden for the nervous system than any other type of neoplastic disease. New approaches to symptomatic treatment are emerging. METHODS This review is based on articles retrieved by a selective literature search on the pathogenesis, diagnosis, and treatment of the neurofibromatoses. RESULTS NF1 and NF2 are monogenic diseases, while the genetics of schwannomatosis is complex. The three entities are clinically and pathophysiologically distinct. An important aspect of their tumor biology is the alternation of growth phases and growth pauses. Correlations between genotypes and phenotypes are variable, while new mutations and genetic mosaics are common. Ninety-nine percent of patients with NF1 have six or more café-au-lait spots by the age of 12 months; 90-95% of patients with NF2 develop bilateral vestibular schwannomas. In schwannomatosis, pain is the most prominent symptom; two-thirds of those affected develop spinal schwannomas. The severity and prognosis of these disorders are not closely correlated with the radiological findings; rather, neurologic deficits, malignant transformation, and psychosocial stress are of greater clinical importance. Advances in knowledge of pathophysiology have led to the development of targeted treatment approaches. Examples include the off-label treatment of vestibular schwannomas with bevacizumab and of plexiform neurofibromas with MEK inhibitors. CONCLUSION Patients with neurofibromatoses need individualized care. They should be treated in centers of expertise where interdisciplinary consultation is available and new types of pharmacotherapy can be provided.
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Affiliation(s)
- Said Farschtschi
- International Center for Neurofibromatoses (ICNF), Department of Neurology, University MedicalCenter Hamburg-Eppendorf
| | - Victor-Felix Mautner
- International Center for Neurofibromatoses (ICNF), Department of Neurology, University MedicalCenter Hamburg-Eppendorf
| | | | | | - Reinhard E Friedrich
- Department of Oromaxillofacial Surgery, University Medical Center Hamburg-Eppendorf
| | - Steffen K Rosahl
- Neurofibromatosis Center, Department of Neurosurgery, Helios Hospital Erfurt
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8
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Neurofibromatosis Type 1 Implicates Ras Pathways in the Genetic Architecture of Neurodevelopmental Disorders. Behav Genet 2020; 50:191-202. [DOI: 10.1007/s10519-020-09991-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 01/04/2020] [Indexed: 01/12/2023]
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9
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Doser K, Kenborg L, Andersen EW, Bidstrup PE, Kroyer A, Hove H, Østergaard J, Sørensen SA, Johansen C, Mulvihill J, Winther JF, Dalton SO. Educational delay and attainment in persons with neurofibromatosis 1 in Denmark. Eur J Hum Genet 2019; 27:857-868. [PMID: 30820037 DOI: 10.1038/s41431-019-0359-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 12/20/2018] [Accepted: 01/24/2019] [Indexed: 01/17/2023] Open
Abstract
Most research on psychosocial consequences of neurofibromatosis type 1 (NF1) has focused on the relationship between disease factors and cognitive functioning. NF1 may impair domains of learning and attention, resulting in low academic performance. This study is the first nationwide population-based cohort study to investigate educational attainment and delay in completing mandatory school by persons with NF1. Educational information was collected from 550 persons at the age of 30 (born 1965-1984). They were diagnosed with NF1 in Denmark and compared to a cohort of NF1-free persons matched on gender and age (n = 4295). Multinomial logistic models were applied to estimate odds ratios (ORs) for obtaining short (≤9 years) or medium (10-12 years) education compared to long education (>12 years) by the age of 30 years. We calculated the probability of graduating 9th year of mandatory school at different ages in 932 persons with NF1 and 7962 NF1-free persons (born 1965-2000) using quantile regression. The OR of educational completion for short- and medium-term education was three fold (95% CI 2.55-3.99) and 1.29 fold (95% CI 0.99-1.69) higher, respectively, for persons with NF1 than NF1-free persons after adjusting for birth year, gender, psychiatric and somatic morbidity and mother's education. Persons with NF1 were significantly delayed in graduating mandatory school education compared to NF1-free persons. When 90% of persons have graduated, persons with NF1 were 1.2 times older than the NF1-free persons. Experiencing delays in mandatory school likely affect further educational achievements and may impair employment and entering work force.
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Affiliation(s)
- Karoline Doser
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.
| | - Line Kenborg
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Anja Kroyer
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Hanne Hove
- The RAREDIS Database, Centre for Rare Diseases, Copenhagen University Hospital and Aarhus University, Aarhus, Denmark
| | - John Østergaard
- Center for Rare Disease, Aarhus University Hospital, Aarhus, Denmark
| | | | - Christoffer Johansen
- Survivorship Unit, Danish Cancer Society Research Center, Copenhagen, Denmark.,Oncology Clinic, Finsen Center, Rigshospitalet, 5073, Copenhagen, Denmark
| | - John Mulvihill
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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10
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Parmeggiani A, Boiani F, Capponi S, Duca M, Angotti M, Pignataro V, Sacrato L, Spinardi L, Vara G, Maltoni L, Cecconi I, Pastore Trossello M, Franzoni E. Neuropsychological profile in Italian children with neurofibromatosis type 1 (NF1) and their relationships with neuroradiological data: Preliminary results. Eur J Paediatr Neurol 2018; 22:822-830. [PMID: 29802023 DOI: 10.1016/j.ejpn.2018.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 04/04/2018] [Accepted: 04/29/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neurofibromatosis type 1 is a genetic disorder associated with cognitive deficits, learning disabilities and behavioral problems. These domains appear to have a still controversial debated association with local areas of T2-hyperintensities on MRI images, called unidentified bright objects (UBOs). METHODS A cohort of 36 children (aged 7-11 years) included consecutively, underwent neuropsychological and behavioral assessment to determine their cognitive and neuropsychological profile, and the frequency of specific learning disabilities. MRI examination was used to determine the impact of UBOs' presence, number, and location on the cognitive, neuropsychological and behavioral profile, and also the presence of optic glioma. RESULTS The mean full intelligence quotient was 104.6; only one child had mild intellectual disability. Forty one percent of children had a diagnosis of specific learning disabilities and reading was mainly involved. Twenty per cent had attention problems. All children had normal scores in visuo-motor and visuo-perceptual tests. UBOs were present in 94.0% of the MRI examinations. Two children had optic glioma. Children with UBOs in a specific location and children with UBOs elsewhere were statistically compared, no one of the location seemed to have an impact on general cognition measured with full intelligence quotient. The thalamus was associated with problems in calculation and striatum with behavioral problems. An inverse relationship between the number of UBOs and the full intelligence quotient was present, but without a statistical significance. CONCLUSIONS In this study, the specific location of UBOs did not seem to influence the general cognitive profile and also the relationship between their number and the full intelligence quotient was not significant; these results are still controversial in literature. Finally, the presence of UBOs in the thalamus and striatum may represent a neuroradiological pattern that influences performances in calculation and behavior respectively in children with Neurofibromatosis type 1.
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Affiliation(s)
- A Parmeggiani
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy.
| | - F Boiani
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - S Capponi
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - M Duca
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - M Angotti
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - V Pignataro
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - L Sacrato
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - L Spinardi
- Neuroradiology Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - G Vara
- Neuroradiology Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - L Maltoni
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - I Cecconi
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - M Pastore Trossello
- Neuroradiology Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - E Franzoni
- Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy
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11
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Thompson HL. Evaluation of phonological processing skills of young children with neurofibromatosis type 1. Dev Med Child Neurol 2018; 60:642. [PMID: 29691847 DOI: 10.1111/dmcn.13794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Heather L Thompson
- Department of Communication Sciences and Disorders, California State University, Sacramento, Sacramento, CA, USA
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12
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Arnold SS, Payne JM, Lorenzo J, North KN, Barton B. Preliteracy impairments in children with neurofibromatosis type 1. Dev Med Child Neurol 2018; 60:703-710. [PMID: 29667706 DOI: 10.1111/dmcn.13768] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2018] [Indexed: 11/29/2022]
Abstract
AIM This cross-sectional study aimed to examine the preliteracy abilities of young children with neurofibromatosis type 1 (NF1) and to identify which of these abilities best predicted conventional literacy (spelling). METHOD Forty-two children with NF1 (23 males, 19 females; mean age [SD] 5y 6mo [6mo]) were compared with 32 unaffected children (15 males, 17 females; mean age [SD] 5y 4mo [6mo]). All children completed a comprehensive cognitive assessment including measures of phonological processing (phonological awareness, phonological memory, rapid automatic naming) and letter-sound knowledge. RESULTS Children with NF1 performed significantly poorer than the comparison group across all cognitive and preliteracy domains, with specific weaknesses evident in phonological awareness (F1,68 =14.13, p<0.001, partial η2 =0.17), phonological memory (F1,68 =13.87, p<0.001, partial η2 =0.17), and letter-sound knowledge (F1,71 =5.65, p=0.020, partial η2 =0.07). Within the group with NF1 group, over a third of children demonstrated impairment in at least one phonological processing domain and the risk of phonological impairment was 5.60 times that of unaffected children. Children's letter-sound knowledge was the strongest predictor of conventional literacy (spelling). INTERPRETATION This study establishes that preliteracy deficits are present and detectable in young children with NF1. As a result of the high incidence of preliteracy impairment, we recommend screening phonological awareness and letter-sound knowledge to identify risk of future learning disorders. WHAT THIS PAPER ADDS Young children with neurofibromatosis type 1 are at elevated risk of preliteracy deficits. The most affected domains are phonological awareness and phonological memory. Letter-sound knowledge is the strongest predictor of conventional literacy (spelling).
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Affiliation(s)
- Shelley S Arnold
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan M Payne
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Vic., Australia.,Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Jennifer Lorenzo
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Kathryn N North
- Murdoch Children's Research Institute, The Royal Children's Hospital, Melbourne, Vic., Australia.,Department of Pediatrics, University of Melbourne, Melbourne, Vic., Australia
| | - Belinda Barton
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.,Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia
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13
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Neuropsychological performance in neurofibromatosis type 1. ANALES DE PEDIATRÍA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.anpede.2016.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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14
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Hernández del Castillo L, Martínez Bermejo A, Portellano Pérez JA, Tirado Requero P, Garriz Luis A, Velázquez Fragua R. Rendimiento neuropsicológico en la neurofibromatosis tipo 1. An Pediatr (Barc) 2017; 87:73-77. [DOI: 10.1016/j.anpedi.2016.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 07/18/2016] [Accepted: 07/24/2016] [Indexed: 11/16/2022] Open
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Van Eylen L, Plasschaert E, Wagemans J, Boets B, Legius E, Steyaert J, Noens I. Visuoperceptual processing in children with neurofibromatosis type 1: True deficit or artefact? Am J Med Genet B Neuropsychiatr Genet 2017; 174:342-358. [PMID: 28512747 DOI: 10.1002/ajmg.b.32522] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/12/2016] [Indexed: 12/21/2022]
Abstract
Impairments in visuoperceptual processing have long been considered a hallmark deficit of individuals with Neurofibromatosis type 1 (NF1). However, it is unclear which specific visuoperceptual subprocesses are impaired and whether impairments on these tasks really result from visuoperceptual impairments or rather from confounding factors like Executive Functioning (EF) impairments, lower intelligence (IQ) and/or co-occurring symptoms of Autism Spectrum Disorder (ASD). To answer these questions, we administered four visuoperceptual tasks and two control tasks in 39 children with NF1, 52 typically developing children and 52 children with ASD (8-18 years), all matched for age and gender. Furthermore, EF, IQ, and symptoms of ASD were assessed. Children with NF1 displayed intact visual form discrimination and intact information integration along the dorsal visual pathway. Moreover, their reduced performance on a task requiring integration of information along the ventral visual stream and their more detail-oriented processing style appeared to result from confounding EF impairments and not from visuoperceptual impairments per se. The co-occurring ASD symptoms and lower IQ of the children with NF1 did not impact substantially upon their visuoperceptual performance. These findings point to the large impact of EF impairments on the performance of visuoperceptual task and suggest that individuals with NF1 show intact visual form discrimination, intact visual integration, and typical visual processing style when potential confounding factors are controlled for. This may have large repercussions for the interpretation of other findings on visuoperceptual processing in individuals with NF1. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Lien Van Eylen
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium.,Research Group Psychiatry, UPC-KU Leuven, Leuven, Belgium
| | - Ellen Plasschaert
- Department of Human Genetics, KU Leuven, Leuven, Belgium.,Center for Human Genetics, University Hospital Leuven, Leuven, Belgium
| | - Johan Wagemans
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Brain and Cognition, KU Leuven, Leuven, Belgium
| | - Bart Boets
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Research Group Psychiatry, UPC-KU Leuven, Leuven, Belgium
| | - Eric Legius
- Department of Human Genetics, KU Leuven, Leuven, Belgium.,Center for Human Genetics, University Hospital Leuven, Leuven, Belgium
| | - Jean Steyaert
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Department of Child Psychiatry, UPC-KU Leuven, Leuven, Belgium.,Department of Clinical Genetics, University Hospital Maastricht, Maastricht, the Netherlands
| | - Ilse Noens
- Leuven Autism Research (LAuRes), KU Leuven, Leuven, Belgium.,Parenting and Special Education Research Unit, KU Leuven, Leuven, Belgium
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16
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Chaix Y, Lauwers-Cancès V, Faure-Marie N, Gentil C, Lelong S, Schweitzer E, Rodriguez D, Iannuzzi S, Kemlin I, Dorison N, Rivier F, Carniero M, Preclaire E, Barbarot S, Lion-François L, Castelnau P. Deficit in phonological processes: a characteristic of the neuropsychological profile of children with NF1. Child Neuropsychol 2017; 24:558-574. [DOI: 10.1080/09297049.2017.1313970] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Yves Chaix
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
- Children’s Hospital, Purpan University Hospital, Toulouse, France
| | | | | | - Catherine Gentil
- Epidemiology Department, Toulouse University Hospital, Toulouse, France
| | - Sandrine Lelong
- Children’s Hospital, Purpan University Hospital, Toulouse, France
- Pediatric Clinical Research Unit, Toulouse Clinical Investigation Center, Children’s Hospital, Purpan University Hospital, Toulouse, France
| | - Elisabeth Schweitzer
- Neuropediatrics & Disabilities Unit, Gatien de Clocheville Children’s Hospital, Tours University Hospital, Tours, France
| | - Diana Rodriguez
- Pediatric Neurology Department & Neurofibromatosis Referral Center, Armand Trousseau Hospital, East Paris University Hospital, Paris, France
- University of Paris VI Pierre & Marie Curie, Sorbonne Universities, Paris, France
- “Neuroprotection of the Developing Brain” Joint Research Unit (U1141), INSERM, Paris, France
| | | | - Isabelle Kemlin
- Pediatric Neurology Department & Neurofibromatosis Referral Center, Armand Trousseau Hospital, East Paris University Hospital, Paris, France
| | - Nathalie Dorison
- Pediatric Neurology Department & Neurofibromatosis Referral Center, Armand Trousseau Hospital, East Paris University Hospital, Paris, France
| | - François Rivier
- Neuropediatric Department & Language Disorders Referral Center, Montpellier Regional University Hospital, Montpellier, France
- Faculty of Medicine, University of Montpellier, Montpellier, France
- “Physiology & Experimental Medicine” Research Unit (U1046 INSERM & UMR 9214 CNRS), University of Montpellier, Montpellier, France
| | - Maryline Carniero
- Neuropediatric Department & Language Disorders Referral Center, Montpellier Regional University Hospital, Montpellier, France
| | - Elodie Preclaire
- Neuropediatric Department & Language Disorders Referral Center, Montpellier Regional University Hospital, Montpellier, France
| | | | | | - Pierre Castelnau
- “Brain & Imaging” Joint Research Unit (UMR 930), Bretonneau Hospital, Tours Regional University Hospital, Tours, France
- University of Tours François Rabelais, Tours, France
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17
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Torres Nupan MM, Velez Van Meerbeke A, López Cabra CA, Herrera Gomez PM. Cognitive and Behavioral Disorders in Children with Neurofibromatosis Type 1. Front Pediatr 2017; 5:227. [PMID: 29164079 PMCID: PMC5670111 DOI: 10.3389/fped.2017.00227] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 10/05/2017] [Indexed: 11/13/2022] Open
Abstract
AIM The last systematic review of research on the behavior of children with neurofibromatosis type 1 (NF1) was in 2012. Since then, several important findings have been published. Therefore, the study aim was to synthesize recent relevant work related to this issue. METHOD We conducted a systematic review of the literature. Relevant articles were identified using the electronic databases PubMed, PsycINFO, and Scopus and a manual search of references lists. Thirty of 156 articles identified met the inclusion criteria. A quality evaluation of the articles was performed and the information was synthesized using a narrative approach. RESULTS Compared with controls, children and adolescents with NF1 present significant alterations in language, reading, visuospatial skills, motor function, executive function, attention, behavior, emotion, and social skills. The prevalence of attention-deficit/hyperactivity disorder (ADHD) is important and can affect cognition and executive function variables. A high prevalence of autistic traits and autistic spectrum disorder were reported. The benefits of using statins to treat cognitive deficits are unclear. However, children with NF1 and ADHD seem to benefit from methylphenidate treatment. The presence of hyperintensities in brain magnetic resonance imaging data seem to be related to poor cognitive performance. Analysis of these lesions could help to predict cognitive alterations in children with NF1. INTERPRETATION There has been important progress to evaluate cognitive characteristics of children with NF1 and to determine the physiological mechanisms of the concomitant disorders. However, discrepancies in relation to intelligence, learning disabilities, attention deficits, and treatment remain. Further investigations on this topic are recommended.
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Affiliation(s)
- Martha Milade Torres Nupan
- Neurosciences Research Group, Medicine and Health Sciences School, Universidad del Rosario, Bogota, Colombia
| | - Alberto Velez Van Meerbeke
- Neurosciences Research Group, Medicine and Health Sciences School, Universidad del Rosario, Bogota, Colombia
| | | | - Paula Marcela Herrera Gomez
- Neurosciences Research Group, Medicine and Health Sciences School, Universidad del Rosario, Bogota, Colombia
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18
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Arnold SS, Barton B, McArthur G, North KN, Payne JM. Phonics Training Improves Reading in Children with Neurofibromatosis Type 1: A Prospective Intervention Trial. J Pediatr 2016; 177:219-226.e2. [PMID: 27480199 DOI: 10.1016/j.jpeds.2016.06.037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 04/19/2016] [Accepted: 06/10/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To examine the efficacy of a phonics-training program in children with neurofibromatosis type 1 (NF1) and reading difficulties. STUDY DESIGN Thirty children (7-12 years of age) with NF1 completed a double-baseline, 24-week intervention trial. Literacy outcome measures were assessed at 4 time points: (1) at baseline; (2) after an 8-week no-treatment period; (3) immediately post-treatment; and (4) at follow-up 8 weeks post-treatment. Repeated-measures ANOVA were conducted to examine change over time for all outcome measures, and significant main effects were explored with planned comparisons. Predictors of treatment effects were examined by linear regressions. RESULTS Ninety percent of participants completed the intervention. Intervention-specific improvements were observed across a range of literacy outcomes, including reading accuracy (nonword reading, Cohen d = 1.10; regular-word reading, Cohen d = 0.32), letter-sound knowledge (Cohen d = 0.80), blending (Cohen d = 0.88), repetition of nonsense words (Cohen d = 0.94), phonemic decoding fluency (Cohen d = 0.55), and reading comprehension (Cohen d = 0.31). Improvements were maintained 8 weeks post-treatment. Age (P = .03) and working memory (P = .02) significantly influenced efficacy, with greatest improvements observed in older children with stronger verbal working memory capacity. CONCLUSIONS Home-based, computerized reading intervention was effective in improving the reading and reading-related abilities of children with NF1 and reading difficulty. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry: ACTRN12611000779976.
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Affiliation(s)
- Shelley S Arnold
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Australia
| | - Belinda Barton
- Institute for Neuroscience and Muscle Research, The Children's Hospital at Westmead, Australia; Discipline of Paediatrics and Child Health, Faculty of Medicine, University of Sydney, Australia; Children's Hospital Education Research Institute, The Children's Hospital at Westmead, Australia
| | - Genevieve McArthur
- Department of Cognitive Science, ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, NSW, Australia
| | - Kathryn N North
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Australia; Department of Paediatrics, University of Melbourne, VIC, Australia
| | - Jonathan M Payne
- Murdoch Childrens Research Institute, The Royal Children's Hospital, Australia; Department of Paediatrics, University of Melbourne, VIC, Australia.
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19
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BARQUERO LAURAA, SEFCIK ANGELAM, CUTTING LAURIEE, RIMRODT SHERYLL. Teaching reading to children with neurofibromatosis type 1: a clinical trial with random assignment to different approaches. Dev Med Child Neurol 2015; 57:1150-8. [PMID: 25907848 PMCID: PMC4618264 DOI: 10.1111/dmcn.12769] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2015] [Indexed: 12/01/2022]
Abstract
AIM Neurofibromatosis type 1 (NF1) is a genetic disorder with a cognitive profile that includes visual-spatial perception deficits and a high incidence of reading disability. There is a paucity of information about how this cognitively complex population responds to mainstream reading interventions. The clinical trial goals were to determine whether children and adolescents with NF1 and reading deficits (NF+RD) benefit from mainstream remedial reading programs and whether responsiveness varies with differences in program-related visual-spatial demands. METHOD Forty-nine participants (28 males, 21 females; aged 8-14y) with either NF+RD (n=17, 11 males, six females) or idiopathic reading deficit (IRD) (n=32, 17 males, 15 females) were randomly assigned to intensive remedial teaching using one of two multisensory reading programs: one with greater kinesthetic demands and the other with greater visual-spatial demands. Two control groups - wait-list IRD (n=14, 11 males, three females) and typically developing readers (n=26, 13 males, 13 females) - received no treatment. Repeated measures and multivariate ANOVA analyses compared each group's growth in reading achievement from pre- to post-testing. RESULTS Treated groups showed significant growth whereas untreated groups did not. Comparing treated groups, the IRD group responded equally well to both interventions, whereas the NF+RD group showed a better response to the more kinesthetic approach. INTERPRETATION Results suggest that multisensory remedial reading teaching that emphasizes kinesthetic demands more than visual-spatial demands is suitable for students with NF+RD.
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Affiliation(s)
- LAURA A BARQUERO
- Education and Brain Sciences Research Laboratory, Peabody School of Education, Vanderbilt University, Nashville, TN
| | - ANGELA M SEFCIK
- Education and Brain Sciences Research Laboratory, Peabody School of Education, Vanderbilt University, Nashville, TN
| | - LAURIE E CUTTING
- Peabody School of Education, Department of Special Education, Vanderbilt University, Nashville, TN
| | - SHERYL L RIMRODT
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
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20
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Schwetye KE, Gutmann DH. Cognitive and behavioral problems in children with neurofibromatosis type 1: challenges and future directions. Expert Rev Neurother 2014; 14:1139-52. [PMID: 25161109 DOI: 10.1586/14737175.2014.953931] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cognitive and behavioral disorders affect nearly 80% of all children with the neurofibromatosis type 1 inherited cancer syndrome, and are among the most significant clinical manifestations for patients and their families. One of the barriers to successful therapeutic intervention is the wide spectrum of clinical phenotypic expression, ranging from visuospatial learning problems to social perceptual deficits (autism). Leveraging numerous small-animal models of neurofibromatosis type 1, several promising targets have been identified to treat the learning, attention, and autism spectrum phenotypes in this at-risk population. In this review, we provide an up-to-date summary of our current understanding of these disorders in NF1, and propose future research directions aimed at designing more effective therapeutic approaches and clinical trials.
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Affiliation(s)
- Katherine E Schwetye
- Department of Pathology, Division of Neuropathology, Washington University School of Medicine, Box 8111, 660 S. Euclid Avenue, St. Louis MO 63110, USA
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21
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Orraca-Castillo M, Estévez-Pérez N, Reigosa-Crespo V. Neurocognitive profiles of learning disabled children with neurofibromatosis type 1. Front Hum Neurosci 2014; 8:386. [PMID: 24936179 PMCID: PMC4048011 DOI: 10.3389/fnhum.2014.00386] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 05/15/2014] [Indexed: 12/01/2022] Open
Abstract
Neurofibromatosis 1 (NF1) is a genetic condition generally associated with intellectual deficiency and learning disabilities. Although there have been groundbreaking advances in the understanding of the molecular, cellular, and neural systems underlying learning deficits associated to NF1 in animal models, much remains to be learned about the spectrum of neurocognitive phenotype associated with the NF1 clinical syndrome. In the present study, 32 children with NF1 ranging from 7 to 14 years were evaluated with neurocognitive tests dedicated to assess basic capacities which are involved in reading and mathematical achievement. Deficits in lexical and phonological strategies and poor number facts retrieval were found underlying reading and arithmetic disorders, respectively. Additionally, efficiencies in lexical/phonological strategies and mental arithmetic were significant predictors of individual differences in reading attainment and math. However, deficits in core numeric capacities were not found in the sample, suggesting that it is not responsible for calculation dysfluency. The estimated prevalence of Developmental Dyscalculia was 18.8%, and the male:female ratio was 5:1. On the other hand, the prevalence of Developmental Dyslexia was almost 3 times as high (50%), and no gender differences were found (male: female ratio = 1:1). This study offers new evidence to the neurocognitive phenotype of NF1 contributing to an in depth understanding of this condition, but also to possible treatments for the cognitive deficits associated with NF1.
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Affiliation(s)
| | - Nancy Estévez-Pérez
- Department of Developmental Cognitive Neuroscience, Cuban Centre for Neuroscience Havana, Cuba
| | - Vivian Reigosa-Crespo
- Department of Developmental Cognitive Neuroscience, Cuban Centre for Neuroscience Havana, Cuba
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22
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Batista PB, Lemos SMA, Rodrigues LOC, de Rezende NA. Auditory temporal processing deficits and language disorders in patients with neurofibromatosis type 1. JOURNAL OF COMMUNICATION DISORDERS 2014; 48:18-26. [PMID: 24447521 DOI: 10.1016/j.jcomdis.2013.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 12/20/2013] [Accepted: 12/23/2013] [Indexed: 06/03/2023]
Abstract
UNLABELLED Previous findings from a case report led to the argument of whether other patients with neurofibromatosis type 1 (NF1) may have abnormal central auditory function, particularly auditory temporal processing. We hypothesized that it is associated with language and learning disabilities in this population. The aim of this study was to measure central auditory temporal function in NF1 patients and correlate it with the results of language evaluation tests. A descriptive/comparative study including 25 NF1 individuals and 22 healthy controls compared their performances on audiometric evaluation and auditory behavioral testing (Sequential Verbal Memory, Sequential Non-Verbal Memory, Frequency Pattern, Duration Pattern, and Gaps in Noise Tests). To assess language performance, two tests (phonological and syntactic awareness) were also conducted. The study showed that all participants had normal peripheral acoustic hearing. Differences were found between the NF1 and control groups in the temporal auditory processing tests [Sequential Verbal Memory (P=0.009), Sequential Non-Verbal Memory (P=0.028), Frequency Patterns (P=0.001), Duration Patterns (P=0.000), and Gaps in Noise (P=0.000)] and in language tests. The results of Pearson correlation analysis demonstrated the presence of positive correlations between the phonological awareness test and Frequency Patterns humming (r=0.560, P=0.001), Frequency Patterns labeling (r=0.415, P=0.022) and Duration Pattern humming (r=0.569, P=0.001). These results suggest that the neurofibromin deficiency found in NF1 patients is associated with auditory temporal processing deficits, which may contribute to the cognitive impairment, learning disabilities, and attention deficits that are common in this disorder. LEARNING OUTCOMES The reader will be able to: (1) describe the auditory temporal processing in patients with neurofibromatosis type 1; and (2) describe the impact of the auditory temporal deficits in language in this population.
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Affiliation(s)
| | | | - Luiz Oswaldo Carneiro Rodrigues
- Clinical Coordinator at the Neurofibromatosis Outpatient Reference Center (NFRC), Dermatology Service, Clinics Hospital of the Federal University of Minas Gerais, Brazil
| | - Nilton Alves de Rezende
- Clinical Director of NFRC, Department of Internal Medicine, Federal University of Minas Gerais, Brazil.
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23
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Lehtonen A, Howie E, Trump D, Huson SM. Behaviour in children with neurofibromatosis type 1: cognition, executive function, attention, emotion, and social competence. Dev Med Child Neurol 2013; 55:111-125. [PMID: 22934576 DOI: 10.1111/j.1469-8749.2012.04399.x] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM This systematic review aimed to pull together the findings from research into behavioural systems and attention in children with neurofibromatosis type 1 (NF1) and to identify areas that need further study. METHOD Relevant papers were identified through searches of electronic databases (MEDLINE, PsycINFO, EMBASE) and manual searches through reference lists. In total, 5746 articles were identified and 57 met the inclusion criteria. The data were synthesized using the narrative approach, as the studies varied considerably in terms of participants and measures. RESULTS The results of the review showed that intelligence, academic skills, visuospatial skills, social competence, and attention are impaired in children with NF1. Evidence of deficits in memory, motor functioning, language, and executive functions was less clear. INTERPRETATION Research has made marked progress in outlining the behavioural phenotype of NF1. However, although the general areas of impairment are becoming better known, the exact nature of the impairment is still not understood in many areas of behaviour. Care needs to be taken with the way in which behavioural constructs are defined and measured, and the variability of problems in NF1 is a particular challenge. Nevertheless, research is steadily moving towards comprehensive understanding of behaviour in children with NF1.
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Affiliation(s)
- Annukka Lehtonen
- Genetic Medicine, St Mary's Hospital, Manchester Academic Health Science Centre, University of Manchester
| | - Emma Howie
- Paediatric Psychosocial Department, Royal Manchester Children's Hospital, Manchester Academic Health Science Centre, Manchester, UK
| | - Dorothy Trump
- Genetic Medicine, St Mary's Hospital, Manchester Academic Health Science Centre, University of Manchester
| | - Susan M Huson
- Genetic Medicine, St Mary's Hospital, Manchester Academic Health Science Centre, University of Manchester
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24
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Armstrong BC, Le Boutillier JC, Petit TL. Ultrastructural synaptic changes associated with neurofibromatosis type 1: a quantitative analysis of hippocampal region CA1 in a Nf1(+/-) mouse model. Synapse 2011; 66:246-55. [PMID: 22121000 DOI: 10.1002/syn.21507] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 10/28/2011] [Accepted: 11/02/2011] [Indexed: 11/06/2022]
Abstract
Neurofibromatosis type 1 (NF1) is one of the most frequently diagnosed autosomal dominant inherited disorders resulting in neurological dysfunction, including an assortment of learning disabilities and cognitive deficits. To elucidate the neural mechanisms underlying the disorder, we employed a mouse model (Nf1(+/-) ) to conduct a quantitative analysis of ultrastructural changes associated with the NF1 disorder. Using both serial light and electron microscopy, we examined reconstructions of the CA1 region of the hippocampus, which is known to play a central role in many of the dysfunctions associated with NF1. In general, the morphology of synapses in both the Nf1(+/-) and wild-type groups of animals were similar. No differences were observed in synapse per neuron density, pre- and postsynaptic areas, or lengths. However, concave synapses were found to show a lower degree of curvature in the Nf1(+/-) mutant than in the wild type. These results indicate that the synaptic ultrastructure of Nf1(+/-) mice appears relatively normal with the exception of the degree of synaptic curvature in concave synapses, adding further support to the importance of synaptic curvature in synaptic plasticity, learning, and memory.
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Affiliation(s)
- Blair C Armstrong
- Department of Psychology and Center for the Neural Basis of Cognition, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
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Hachon C, Iannuzzi S, Chaix Y. Behavioural and cognitive phenotypes in children with neurofibromatosis type 1 (NF1): the link with the neurobiological level. Brain Dev 2011; 33:52-61. [PMID: 20106617 DOI: 10.1016/j.braindev.2009.12.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Accepted: 12/27/2009] [Indexed: 11/19/2022]
Abstract
Neurofibromatosis type 1 (NF1) is one of the most frequent monogenetic disorder encountered in children. Approximately 50% of children with NF1 develop learning disabilities notably for reading. Understanding the reasons of reading impairment in this context may lead to improve therapeutic methods in NF1 and more generally in reading developmental disorders. An interesting challenge is to disentangle the connections between the different levels of description proposed in the etiological approach. This is the aim of this review based on recent advances in analysis of cognitive deficits observed in children with NF1 and on results of recent brain imaging (structural and functional) or animal model studies.
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Affiliation(s)
- Caroline Hachon
- Unité de Neurologie Pediatrique, Hôpital des Enfants, Toulouse, France
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Cutting LE, Levine TM. Cognitive profile of children with neurofibromatosis and reading disabilities. Child Neuropsychol 2010; 16:417-32. [PMID: 20521183 DOI: 10.1080/09297041003761985] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A large percentage of children with Neurofibromatosis Type 1(NF-1) have learning disabilities, often in the realm of reading. Previous studies have indicated that children with NF-1 show a neuropsychological profile similar to idiopathic reading disabilities (IRD); however, studies typically have not subdivided children with NF-1 into those who do and do not have RD (NF+RD and NFnoRD, respectively). The current study examined the cognitive profile of children with NF-1 with and without RD and compared them to children with IRD as well as to typically developing readers (Controls). Findings showed that children with NF+RD performed similarly to children with IRD on phonological, rapid naming, and reading comprehension measures; however, children with NF+RD displayed pronounced visual-spatial deficits as compared to IRD and Control groups. In addition, when comparing the NF-1 groups to each other as well as to the control and IRD groups, the current study reported that there were no oral language differences; lack of findings in the realm of oral language was attributed to the fact that groups were equated on IQ. Overall, findings suggest that a more refined classification of children with NF-1 may be helpful for tailoring academic interventions.
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Affiliation(s)
- Laurie E Cutting
- Department of Special Education, Vanderbilt University, Nashville, TN, USA.
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Sangster J, Shores EA, Watt S, North KN. The cognitive profile of preschool-aged children with neurofibromatosis type 1. Child Neuropsychol 2010; 17:1-16. [PMID: 20503125 DOI: 10.1080/09297041003761993] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Few studies have examined the cognitive profile of young children with NF1. In this study, 26 children with NF1 (M(age) = 5 years 3 months) were compared with 21 peer comparisons (M(age) = 4 years 8 months) and available normative data on neuropsychological measures. Children with NF1 demonstrated the characteristic downward shift in IQ, poor visuospatial constructional skills, and inattention. Working memory deficits were common in parental ratings. These findings suggest that at least some of the cognitive deficits associated with NF1 can be identified in the preschool-age group, highlighting the need for early assessment and intervention.
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Affiliation(s)
- Jennifer Sangster
- Department of Psychology, Macquarie University, New South Wales, Australia
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