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Kozlov G, Franceschi C, Vedunova M. Intricacies of aging and Down syndrome. Neurosci Biobehav Rev 2024; 164:105794. [PMID: 38971514 DOI: 10.1016/j.neubiorev.2024.105794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/26/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
Down syndrome is the most frequently occurring genetic condition, with a substantial escalation in risk associated with advanced maternal age. The syndrome is characterized by a diverse range of phenotypes, affecting to some extent all levels of organization, and its progeroid nature - early manifestation of aspects of the senile phenotype. Despite extensive investigations, many aspects and mechanisms of the disease remain unexplored. The current review aims to provide an overview of the main causes and manifestations of Down syndrome, while also examining the phenomenon of accelerated aging and exploring potential therapeutic strategies.
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Affiliation(s)
- G Kozlov
- Institute of Biology and Biomedicine, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Gagarin ave., 23, 603022, Russia
| | - C Franceschi
- Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Gagarin ave., 23, 603022, Russia
| | - M Vedunova
- Institute of Biology and Biomedicine, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Gagarin ave., 23, 603022, Russia; Prokhorov General Physics Institute of the Russian Academy of Sciences, 38 Vavilov str., 119991 Moscow, Russia.
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Tan B, Tamanyan K, Walter L, Nixon GM, Davey MJ, Ditchfield M, Horne RSC. Cortical grey matter changes, behavior and cognition in children with sleep disordered breathing. J Sleep Res 2024; 33:e14006. [PMID: 37475108 DOI: 10.1111/jsr.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/25/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
This paper investigated cortical thickness and volumetric changes in children to better understand the impact of obstructive sleep disordered breathing (SDB) on the neurodevelopment of specific regions of the brain. We also aimed to investigate how these changes were related to the behavioral and cognitive deficits observed in the condition. Neuroimaging, behavioral, and sleep data were obtained from 30 children (15 non-snoring controls, 15 referred for assessment of SDB) aged 7 to 17 years. Gyral-based regions of interest were identified using the Desikan-Killiany atlas. Student's t-tests were used to compare regions of interest between the controls and SDB groups. We found that the cortical thickness was significantly greater in the right caudal anterior cingulate and right cuneus regions and there were volumetric increases in the left caudal middle frontal, bilateral rostral anterior cingulate, left, right, and bilateral caudate brain regions in children with SDB compared with controls. Neither cortical thickness nor volumetric changes were associated with behavioral or cognitive measures. The findings of this study indicate disruptions to neural developmental processes occurring in structural regions of the brain; however, these changes appear unrelated to behavioural or cognitive outcomes.
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Affiliation(s)
- Brendan Tan
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
| | - Knarik Tamanyan
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
| | - Lisa Walter
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
| | - Gillian M Nixon
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Margot J Davey
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Michael Ditchfield
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
- Department of Radiology, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Rosemary S C Horne
- Department of Pediatrics, Monash University, Melbourne, Victoria, Australia
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Ong MBH, Davey MJ, Nixon GM, Walter LM, Horne RS. Effect of sleep disordered breathing severity in children with Down syndrome on parental wellbeing and social support. Sleep Med 2024; 116:71-80. [PMID: 38432030 DOI: 10.1016/j.sleep.2024.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Sleep disorders, particularly sleep disordered breathing (SDB), are common in children with Down syndrome (DS). We investigated the relationship between SDB severity and parental psychological wellbeing and their perception of social support. METHODS 44 children with DS (3-19 years) underwent overnight polysomnography and were categorised into three groups: primary snoring, Mild and Moderate/Severe obstructive sleep apnoea (OSA). Parents completed questionnaires about their child's behaviour (Child Behavior Checklist), sleep symptoms (Pediatric Sleep Survey Instrument) and SDB-related quality of life (OSA-18), together with the DUKE-UNC Functional Social Support (DUKE) and Psychological General Well-Being Index (PGWBI) questionnaires for themselves. 34 children completed a follow-up study after 2 years. RESULTS There were no significant differences between SDB severity groups for parental perceived social support or psychological wellbeing. Total scores on the DUKE were below average and PGWBI scores were indicative of moderate psychological distress in all three groups. Reduced perceived levels of social support were significantly correlated with externalising child behaviour and sleep disturbance. Diminished parental psychological wellbeing was also significantly correlated with increased sleep disturbances and reduced quality of life in children. At follow-up there were no significant changes in any questionnaire outcome, however parents of children with improved SDB severity had improved PGWBI vitality scores. CONCLUSION The degree of parent-reported sleep disturbance in children with DS was linked to suboptimal perceived parental social support and poor psychological wellbeing. Our results emphasise the need for enhanced awareness of the detrimental effects of sleep problems in children with DS on parental wellbeing.
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Affiliation(s)
- Miles Beng Hee Ong
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Margot J Davey
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Gillian M Nixon
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Lisa M Walter
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Rosemary Sc Horne
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
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Horne RSC, Shetty M, Davey MJ, Walter LM, Nixon GM. Follow-up of children with Down syndrome and sleep disordered breathing and the effects of treatment on actigraphically recorded sleep, quality of life, behaviour, and daytime functioning. J Sleep Res 2024; 33:e13970. [PMID: 37345340 DOI: 10.1111/jsr.13970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/23/2023] [Accepted: 06/06/2023] [Indexed: 06/23/2023]
Abstract
Children with Down syndrome are at increased risk of obstructive sleep disordered breathing, which has deleterious effects on daytime functioning. We aimed to examine the effects of treatment of sleep disordered breathing on sleep quality and daytime functioning in children with Down syndrome, and hypothesised that these would be improved. Thirty-four children completed a baseline study and a follow-up 2 years later. Measures at both time points included 7 days of actigraphy and parents completed a number of questionnaires assessing sleep, behaviour, daytime functioning, and quality of life. All children had overnight polysomnography at baseline; 15 children (44%) were treated. At baseline the treated group had more severe sleep disordered breathing compared with the untreated group: obstructive apneoa-hypopnoea index 29.3 ± 38.2 events/h versus 3.3 ± 5.2 events/h (p < 0.01). Actigraphy showed no significant differences in total sleep time, sleep efficiency, sleep schedules from baseline to follow up in either group. The sleep disturbance (p < 0.01) and total problems (p < 0.05) scales on the OSA-18 and the sleep disordered breathing subscale on the Paediatric Sleep Problem Survey Instrument (p < 0.01) improved in the treated children. There were no changes in any measure in the untreated children. Treatment of sleep disordered breathing improves symptoms, sleep disturbance and quality of life in children with Down syndrome, but has no demonstrable impact on actigraphic sleep measures or daytime behaviour or function. In contrast, children who were not treated, despite having less severe disease at baseline, had increased sleep disruption and no change in quality of life.
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Affiliation(s)
- Rosemary S C Horne
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Marisha Shetty
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Margot J Davey
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
| | - Lisa M Walter
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Gillian M Nixon
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
- Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Victoria, Australia
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Vandoni M, Giuriato M, Pirazzi A, Zanelli S, Gaboardi F, Carnevale Pellino V, Gazzarri AA, Baldassarre P, Zuccotti G, Calcaterra V. Motor Skills and Executive Functions in Pediatric Patients with Down Syndrome: A Challenge for Tailoring Physical Activity Interventions. Pediatr Rep 2023; 15:691-706. [PMID: 37987287 PMCID: PMC10661287 DOI: 10.3390/pediatric15040062] [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: 08/14/2023] [Revised: 10/13/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023] Open
Abstract
Down syndrome (DS) is one of the most common chromosomal disorders. In addition to this variety of dysmorphic features. DS is also associated with a wide range of diseases and related comorbidities affecting different organs and systems. These comorbidities, together with societal and environmental influences, have a negative impact on physical activity in people with DS. Low levels of physical activity and energy expenditure have been identified as crucial players in worsening the acquisition of motor skills and executive functions. Executive functions are critical for the many skills (creativity, flexibility, self-control, and discipline) impacting our quality of life and make it possible to control impulses, mentally play with ideas, and stay focused. We proposed a broad overview of the available literature regarding motor skills and executive functions in pediatric patients with DS to understand the specific challenges for tailoring physical activity interventions. Motor skill interventions are effective in improving motor competence and performance on cognitive, emotional, and physical aspects in children with DS. Interventions based on executive functions in DS subjects are effective to contrast the cognitive decline and improve the everyday use of executive functions in youth and adults. Targeted interventions are mandatory for maximizing the benefits of physical activity, minimizing potential risks, and ultimately improving the overall health outcomes and quality of life for individuals with DS.
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Affiliation(s)
- Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (M.G.); (A.P.); (V.C.P.)
| | - Matteo Giuriato
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (M.G.); (A.P.); (V.C.P.)
| | - Agnese Pirazzi
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (M.G.); (A.P.); (V.C.P.)
| | - Sara Zanelli
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.Z.); (F.G.); (G.Z.)
| | - Francesca Gaboardi
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.Z.); (F.G.); (G.Z.)
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy; (M.V.); (M.G.); (A.P.); (V.C.P.)
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | | | | | - Gianvincenzo Zuccotti
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.Z.); (F.G.); (G.Z.)
- Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Department, “V. Buzzi” Children’s Hospital, 20154 Milan, Italy; (S.Z.); (F.G.); (G.Z.)
- Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
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Klaiman C, White SP, Saulnier C, Murphy M, Burrell L, Cubells J, Walker E, Mulle JG. A distinct cognitive profile in individuals with 3q29 deletion syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2023; 67:216-227. [PMID: 35297118 DOI: 10.1111/jir.12919] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND 3q29 deletion syndrome is associated with mild to moderate intellectual disability as well as comorbid psychopathology such as ADHD, anxiety, ASD and schizophrenia. A greater understanding of specific profiles that could increase risk for psychopathology is necessary in order to best understand and support individuals with 3q29 deletion syndrome. The goal of this study was to thus carefully outline the strengths and weaknesses of these individuals. A second goal was to ask whether the cognitive impact of the deletion predicted psychopathology in other domains. METHODS We systematically evaluated cognitive ability, adaptive behaviour and psychopathology in 32 individuals with the canonical 3q29 deletion using gold-standard instruments and a standardised phenotyping protocol. RESULTS Mean full scale IQ was 73 (range 40-99). Verbal subtest score (mean 80, range 31-106) was slightly higher and had a greater range than non-verbal subtest score (mean 75, range 53-98). Spatial ability was evaluated in a subset (n = 24) and was lower than verbal and non-verbal ability (mean 71, range 34-108). There was an average 14-point difference between verbal and non-verbal subset scores; 60% of the time the verbal subset score was higher than the non-verbal subset score. Study subjects with a verbal ability subtest score lower than the non-verbal subtest score were four times more likely to have a diagnosis of intellectual disability (suggestive, P value 0.07). The age at which a child first spoke two-word phrases was strongly associated with measures of verbal ability (P value 2.56e-07). Cognitive ability was correlated with adaptive behaviour measures (correlation 0.42, P value 0.02). However, although group means found equivalent scores, there was, on average, a 10-point gap between these skills (range -33 to 33), in either direction, in about 50% of the sample, suggesting that cognitive measures only partially inform adaptive ability. Cognitive ability scores did not have any significant relationship to cumulative burden of psychopathology nor to individual neurodevelopmental or psychiatric diagnoses. CONCLUSIONS Individuals with 3q29 deletion syndrome have a complex pattern of cognitive disability. Two-thirds of individuals with the deletion will exhibit significant strength in verbal ability; this may mask deficits in non-verbal reasoning, leading to an overestimation of overall ability. Deficits in verbal ability may be the driver of intellectual disability diagnosis. Cognitive ability is not a strong indicator of other neurodevelopmental or psychiatric impairment; thus, individuals with 3q29 deletion syndrome who exhibit IQ scores within the normal range should receive all recommended behavioural evaluations.
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Affiliation(s)
- C Klaiman
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, USA
| | - S P White
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, USA
| | - C Saulnier
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Neurodevelopmental Assessment & Consulting Services, Atlanta, GA, USA
| | - M Murphy
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - L Burrell
- Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA, USA
- Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA, USA
| | - J Cubells
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychiatry and Behavioral Science, Emory University School of Medicine, Atlanta, GA, USA
| | - E Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - J G Mulle
- Department of Psychiatry, Robert Wood Johnson School of Medicine, Rutgers University, Piscataway, New Jersey, USA
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson School of Medicine, Rutgers University, Piscataway, New Jersey, USA
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Fucà E, Cirillo F, Celestini L, Alfieri P, Valentini D, Costanzo F, Vicari S. Assessment of oppositional defiant disorder and oppositional behavior in children and adolescents with Down syndrome. Front Psychiatry 2023; 13:1062201. [PMID: 36727089 PMCID: PMC9884820 DOI: 10.3389/fpsyt.2022.1062201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
Introduction Children and adolescents with intellectual disability (ID) exhibit higher rates of oppositional defiant disorder (ODD) than typically developing (TD) peers. However, studies focusing on the investigation of ODD prevalence in youth with Down syndrome (DS) are still limited. Methods The current study aimed to investigate the prevalence of ODD clinical and subclinical symptoms in a group of 101 youth with DS (63 boys, 38 girls) ranging in age from 6 to 18 years. Moreover, the prevalence of ODD symptoms, as detected by means of three parent-report questionnaires, was compared with that detected by a semi-structured psychopathological interview, namely, the Schedule for Affective Disorders and Schizophrenia for School Aged Children Present and Lifetime (K-SADS) Version Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5). Results We found that 17% of participants met diagnostic criteria for ODD on the K-SADS, whereas 24% exhibited subclinical symptoms. Results also suggest good specificity of Swanson, Nolan, and Pelham-IV Rating Scale (SNAP-IV), Conners' Parent Rating Scales Long Version (CPRS) and Child Behavior Checklist (CBCL) in detecting ODD symptoms. The investigation of the agreement in the prevalence rates of clinical and subclinical symptoms of ODD between K-SADS and the parent-report questionnaires indicated CPRS as the parent-report questionnaire with the best agreement with K-SADS. Discussion This study provides support for the use of parent-report questionnaires to assess ODD symptoms in children and adolescents with DS by evaluating their levels of agreement with a semi-structured psychopathological interview. In particular, our results suggest that CPRS could be considered a suitable screening tool for ODD clinical and subclinical symptoms in youth with DS.
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Affiliation(s)
- Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Flavia Cirillo
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Laura Celestini
- Pediatric Unit, Pediatric Emergency Department (DEA), Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paolo Alfieri
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Diletta Valentini
- Pediatric Unit, Pediatric Emergency Department (DEA), Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
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Fatty Acids: A Safe Tool for Improving Neurodevelopmental Alterations in Down Syndrome? Nutrients 2022; 14:nu14142880. [PMID: 35889838 PMCID: PMC9323400 DOI: 10.3390/nu14142880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 02/06/2023] Open
Abstract
The triplication of chromosome 21 causes Down syndrome (DS), a genetic disorder that is characterized by intellectual disability (ID). The causes of ID start in utero, leading to impairments in neurogenesis, and continue into infancy, leading to impairments in dendritogenesis, spinogenesis, and connectivity. These defects are associated with alterations in mitochondrial and metabolic functions and precocious aging, leading to the early development of Alzheimer’s disease. Intense efforts are currently underway, taking advantage of DS mouse models to discover pharmacotherapies for the neurodevelopmental and cognitive deficits of DS. Many treatments that proved effective in mouse models may raise safety concerns over human use, especially at early life stages. Accumulating evidence shows that fatty acids, which are nutrients present in normal diets, exert numerous positive effects on the brain. Here, we review (i) the knowledge obtained from animal models regarding the effects of fatty acids on the brain, by focusing on alterations that are particularly prominent in DS, and (ii) the progress recently made in a DS mouse model, suggesting that fatty acids may indeed represent a useful treatment for DS. This scenario should prompt the scientific community to further explore the potential benefit of fatty acids for people with DS.
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Betavani VMP, Davey MJ, Nixon GM, Walter LM, Horne RSC. Effects of Treatment of Sleep Disordered Breathing on Sleep Macro- and Micro-Architecture in Children with Down Syndrome. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9070984. [PMID: 35883968 PMCID: PMC9317623 DOI: 10.3390/children9070984] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/03/2022] [Accepted: 06/27/2022] [Indexed: 12/04/2022]
Abstract
Background: Children with Down syndrome (DS) are at increased risk of obstructive sleep disordered breathing (SDB), which is associated with intermittent hypoxia and sleep disruption affecting daytime functioning. We aimed to examine the effects of treatment of SDB on sleep quality and daytime functioning in children with DS. Methods: Children with DS and SDB (n = 24) completed a baseline and follow-up overnight polysomnographic (PSG) study 22 ± 7 months (mean ± SD) later. Sleep micro-architecture was assessed using EEG spectral analysis, and parents completed a number of questionnaires assessing sleep, behavior, daytime functioning, and quality of life (QOL). Results: A total of nine children (38%) were treated. At baseline, the treated group had more severe SDB compared to the untreated group. SDB severity was significantly improved from 40.3 ± 46.9 events/h to 17.9 ± 26.9 events/h (p < 0.01) at follow up in children who were treated. There were no significant differences in sleep macro-architecture parameters from baseline to follow up in either the treated or untreated group. Sleep micro-architecture was not different between studies in the treated group, however this tended to improve in the untreated group, particularly in REM sleep. Daytime functioning and behavior were not different between the studies in either group, however, QOL improved after treatment. Conclusions: Our study identified that treatment of SDB improves severity of the disease as defined by PSG, and this was associated with parental reports of improved QOL, despite treatment having no demonstrable impacts on sleep quality, behavior, or daytime functioning.
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Affiliation(s)
- Viecky M. P. Betavani
- Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia; (V.M.P.B.); (M.J.D.); (G.M.N.); (L.M.W.)
| | - Margot J. Davey
- Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia; (V.M.P.B.); (M.J.D.); (G.M.N.); (L.M.W.)
- Melbourne Children’s Sleep Centre, Monash Children’s Hospital, Melbourne, VIC 3168, Australia
| | - Gillian M. Nixon
- Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia; (V.M.P.B.); (M.J.D.); (G.M.N.); (L.M.W.)
- Melbourne Children’s Sleep Centre, Monash Children’s Hospital, Melbourne, VIC 3168, Australia
| | - Lisa M. Walter
- Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia; (V.M.P.B.); (M.J.D.); (G.M.N.); (L.M.W.)
| | - Rosemary S. C. Horne
- Department of Paediatrics, Monash University, Melbourne, VIC 3168, Australia; (V.M.P.B.); (M.J.D.); (G.M.N.); (L.M.W.)
- Department of Paediatrics, Level 5, Monash Children’s Hospital, 246 Clayton Road, Clayton, Melbourne, VIC 3168, Australia
- Correspondence: ; Tel.: +61-385722827
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Bartesaghi R, Vicari S, Mobley WC. Prenatal and Postnatal Pharmacotherapy in Down Syndrome: The Search to Prevent or Ameliorate Neurodevelopmental and Neurodegenerative Disorders. Annu Rev Pharmacol Toxicol 2022; 62:211-233. [PMID: 34990205 PMCID: PMC9632639 DOI: 10.1146/annurev-pharmtox-041521-103641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Those with Down syndrome (DS)-trisomy for chromosome 21-are routinely impacted by cognitive dysfunction and behavioral challenges in children and adults and Alzheimer's disease in older adults. No proven treatments specifically address these cognitive or behavioral changes. However, advances in the establishment of rodent models and human cell models promise to support development of such treatments. A research agenda that emphasizes the identification of overexpressed genes that contribute demonstrably to abnormalities in cognition and behavior in model systems constitutes a rational next step. Normalizing expression of such genes may usher in an era of successful treatments applicable across the life span for those with DS.
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Affiliation(s)
- Renata Bartesaghi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Stefano Vicari
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, 00168 Rome, Italy,Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00165-00146 Rome, Italy
| | - William C. Mobley
- Department of Neurosciences, University of California, San Diego, La Jolla, California 92093, USA
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Wijayaratne PR, Williams K, Davey MJ, Horne RSC, Nixon GM. Factors associated with referral for polysomnography in children with Down syndrome. Sleep Med 2021; 82:29-36. [PMID: 33878521 DOI: 10.1016/j.sleep.2021.03.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Children with Down syndrome (DS) are recommended to undergo polysomnography (PSG) by the age of four years due to the high prevalence of obstructive sleep apnea (OSA) in this group, but compliance is incomplete. To further understand referral patterns for PSG in this condition, we aimed to compare demographics, PSG results, OSA severity, behavior, daytime functioning and quality of life (QOL) between children with DS referred for sleep testing and those recruited from the community. STUDY DESIGN Children 3-19 years with DS was included: 20 referred clinically for assessment of OSA and 24 volunteers from the community. Demographic and anthropometric data, PSG parameters, sleep-related symptoms and QOL, behavior and daytime functioning were compared between groups. RESULTS OSA severity did not differ between groups: 50% of the clinical and 42% of the community group had moderate/severe OSA. The clinical group had a higher weight z-score, BMI z-score, waist and hip circumference and neck-to-waist ratio. Questionnaire scores for daytime functioning, behavior and QOL were not different between groups. CONCLUSIONS Despite not being referred for clinical sleep assessment, 42% of children with DS recruited from the community had moderate/severe OSA. There was no difference in the QOL, behavior, daytime functioning and sleep symptoms questionnaires although the clinical group had a higher BMI-Z score and overt signs of obesity. These findings underscore the importance of PSG screening of all children with DS.
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Affiliation(s)
| | - Katrina Williams
- Department of Paediatrics, Monash University, Melbourne, Australia; Developmental Paediatrics, Monash Children's Hospital, Melbourne, Australia
| | - Margot J Davey
- Department of Paediatrics, Monash University, Melbourne, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia
| | - Rosemary S C Horne
- Department of Paediatrics, Monash University, Melbourne, Australia; The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, Australia
| | - Gillian M Nixon
- Department of Paediatrics, Monash University, Melbourne, Australia; Melbourne Children's Sleep Centre, Monash Children's Hospital, Melbourne, Australia.
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12
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Iasevoli F, Barone A, Buonaguro EF, Vellucci L, de Bartolomeis A. Safety and tolerability of antipsychotic agents in neurodevelopmental disorders: a systematic review. Expert Opin Drug Saf 2020; 19:1419-1444. [DOI: 10.1080/14740338.2020.1820985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Felice Iasevoli
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Annarita Barone
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Elisabetta Filomena Buonaguro
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Licia Vellucci
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Andrea de Bartolomeis
- Section of Psychiatry, Department of Neuroscience, School of Medicine, University of Naples Federico II, Naples, Italy
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