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Cainelli E, Vedovelli L, Trevisanuto D, Suppiej A, Bisiacchi P. Prospective assessment of early developmental markers and their association with neuropsychological impairment. Eur J Pediatr 2023; 182:5181-5189. [PMID: 37707588 PMCID: PMC10640515 DOI: 10.1007/s00431-023-05182-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/25/2023] [Accepted: 08/27/2023] [Indexed: 09/15/2023]
Abstract
Children who experience adversities in the pre-perinatal period are at increased risk of developing impairment later in life, despite the absence of overt brain and neurological abnormalities. However, many of these children exhibit sequelae several years after a period of normal appearance. As a result, the need for reliable developmental assessments for the early detection of infants at high risk of adverse neurodevelopmental outcomes has emerged. The Griffiths Mental Developmental Scales have a promising but poorly explored prognostic ability. This longitudinal study evaluated the predictive power of the Griffiths Mental Developmental Scales at 12 and 24 months on the cognitive and neuropsychological profile at 6 years of age in a sample of 70 children with a history of prematurity or perinatal asphyxia but without brain and neurological abnormalities. We found that the Griffiths Mental Developmental Scales at 24 months had good predictive ability on the intelligence quotient at 6 years and the capacity to predict some neuropsychological performances. On the other hand, the Griffiths Mental Developmental Scale at 12 months was not associated with the performance at 6 years or 24 months. Conclusion: Data on brain development converge to indicate that the first two years of age represent a critical stage of development, particularly for children experiencing mild pre-perinatal adversities who are thought to exhibit white matter dysmaturity. For this reason, this age is crucial for identifying which children are at major risk, leaving enough time to intervene before overt deficits become apparent. Brain development in the first 2 years could explain the limited reliability of early neurodevelopmental testing. What is Known: • Pre-perinatal adversities increase the risk of developing neurodevelopmental disorders. • The predictive ability of the Griffith scale is poorly explored in low-grade conditions. What is New: • The predictive ability of the Griffith scale has been investigated in low-risk children. • A complete neuropsychological profile could offer a more accurate prediction than the intellectual quotient.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8 - 35133, Padova, Italy.
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Daniele Trevisanuto
- Department of Woman and Child Health, University Hospital of Padova, Padova, Italy
| | - Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University of Ferrara, Ferrara, Italy
| | - Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8 - 35133, Padova, Italy
- Padova Neuroscience Centre, PNC, Padova, Italy
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Bacchin ME, Vitaliti G, Malaventura C, Meggiolaro S, Zanardo V, Ballardini E, Cainelli E, Suppiej A. Mood and anxiety spectrum disorders detected by neuropsychiatric interviews in young adults born preterm: A prospective cohort study. Eur J Paediatr Neurol 2023; 45:57-60. [PMID: 37307630 DOI: 10.1016/j.ejpn.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 05/11/2023] [Accepted: 06/07/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Psychopathology has not yet been studied beyond pediatric age for all degrees of prematurity, including late-preterm, particularly in those who grew up with no apparent neurodevelopmental sequelae. This study aimed to examine psychopathological outcome following preterm birth and admission to neonatal intensive care in young adults without major neurodevelopmental and psychopathological problems that emerged during childhood. METHODS An Italian single-center prospective cohort study. Eighty-nine young adults (40 admitted to neonatal intensive care unit with less than 37 weeks of gestation and no medical history of other neurological or psychiatric conditions in childhood and 49 healthy peers born at term, matched by age, sex, and education) underwent neuropsychiatric interviews at the age of 20 ± 1 years; MINI International Neuropsychiatric Interview, Beck Depression Inventory and Barratt Impulsive Scale, results were correlated to individual neonatal data and cognitive measures. RESULTS We found a significantly higher prevalence of psychopathology at MINI score (22.5% vs. 4.2%; χ2 = 6.7; p = 0,010) and prevalence of previous stressful life events in the preterm compared to at-term group. B.D.I. (testing depression) and BIS-11(testing impulsivity) did not highlight a statistically significant difference between the groups. All patients had average I.Q., a statistically significant difference (p < 0.001) was observed between groups with a better performance in controls than cases. CONCLUSIONS Preterm infants attaining young adult age with otherwise typical development during childhood are at risk of psychopathology and lower resilience to stressful life events. The MINI interview could be a useful tool to highlight the psychopathology of preterm infants attaining adult age.
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Affiliation(s)
- Maria Elena Bacchin
- Department of Mental Health, "San Bassano" Hospital, A.U.L.S.S. 7, Bassano del Grappa, Italy
| | - Giovanna Vitaliti
- Department of Medical Sciences, Pediatric Section, University of Ferrara, Italy
| | - Cristina Malaventura
- Department of Mental Health, "San Bassano" Hospital, A.U.L.S.S. 7, Bassano del Grappa, Italy
| | | | - Vincenzo Zanardo
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Elisa Ballardini
- Department of Mental Health, "San Bassano" Hospital, A.U.L.S.S. 7, Bassano del Grappa, Italy
| | - Elisa Cainelli
- Department of General Psychology, Lifespan Cognitive Neuroscience Laboratory (L.C.N.L.), University of Padova, Italy
| | - Agnese Suppiej
- Department of Mental Health, "San Bassano" Hospital, A.U.L.S.S. 7, Bassano del Grappa, Italy.
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Cainelli E, Vedovelli L, Carretti B, Bisiacchi P. EEG correlates of developmental dyslexia: a systematic review. Ann Dyslexia 2023; 73:184-213. [PMID: 36417146 DOI: 10.1007/s11881-022-00273-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 10/25/2022] [Indexed: 06/08/2023]
Abstract
Dyslexia is one of the most studied learning disorders. Despite this, its biological basis and main causes are still not fully understood. Electroencephalography (EEG) could be a powerful tool in identifying the underlying mechanisms, but knowledge of the EEG correlates of developmental dyslexia (DD) remains elusive. We aimed to systematically review the evidence on EEG correlates of DD and establish their quality. In July 2021, we carried out an online search of the PubMed and Scopus databases to identify published articles on EEG correlates in children with dyslexia aged 6 to 12 years without comorbidities. We follow the PRISMA guidelines and assess the quality using the Appraisal Tool questionnaire. Our final analysis included 49 studies (14% high quality, 63% medium, 20% low, and 2% very low). Studies differed greatly in methodology, making a summary of their results challenging. However, some points came to light. Even at rest, children with dyslexia and children in the control group exhibited differences in several EEG measures, particularly in theta and alpha frequencies; these frequencies appear to be associated with learning performance. During reading-related tasks, the differences between dyslexic and control children seem more localized in the left temporoparietal sites. The EEG activity of children with dyslexia and children in the control group differed in many aspects, both at rest and during reading-related tasks. Our data are compatible with neuroimaging studies in the same diagnostic group and expand the literature by offering new insights into functional significance.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy.
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Barbara Carretti
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy
| | - Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35133, Padua, Italy
- Padova Neuroscience Centre, PNC, Padua, Italy
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Gervasi MT, Romero R, Cainelli E, Veronese P, Tran MR, Jung E, Suksai M, Bosco M, Gotsch F. Intra-amniotic inflammation in the mid-trimester of pregnancy is a risk factor for neuropsychological disorders in childhood. J Perinat Med 2023; 51:363-378. [PMID: 36173676 PMCID: PMC10010737 DOI: 10.1515/jpm-2022-0255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Intra-amniotic inflammation is a subclinical condition frequently caused by either microbial invasion of the amniotic cavity or sterile inflammatory stimuli, e.g., alarmins. An accumulating body of evidence supports a role for maternal immune activation in the genesis of fetal neuroinflammation and the occurrence of neurodevelopmental disorders such as cerebral palsy, schizophrenia, and autism. The objective of this study was to determine whether fetal exposure to mid-trimester intra-amniotic inflammation is associated with neurodevelopmental disorders in children eight to 12 years of age. METHODS This is a retrospective case-control study comprising 20 children with evidence of prenatal exposure to intra-amniotic inflammation in the mid-trimester and 20 controls matched for gestational age at amniocentesis and at delivery. Amniotic fluid samples were tested for concentrations of interleukin-6 and C-X-C motif chemokine ligand 10, for bacteria by culture and molecular microbiologic methods as well as by polymerase chain reaction for eight viruses. Neuropsychological testing of children, performed by two experienced psychologists, assessed cognitive and behavioral domains. Neuropsychological dysfunction was defined as the presence of an abnormal score (<2 standard deviations) on at least two cognitive tasks. RESULTS Neuropsychological dysfunction was present in 45% (9/20) of children exposed to intra-amniotic inflammation but in only 10% (2/20) of those in the control group (p=0.03). The relative risk (RR) of neuropsychological dysfunction conferred by amniotic fluid inflammation remained significant after adjusting for gestational age at delivery [aRR=4.5 (1.07-16.7)]. Of the 11 children diagnosed with neuropsychological dysfunction, nine were delivered at term and eight of them had mothers with intra-amniotic inflammation. Children exposed to intra-amniotic inflammation were found to have abnormalities in neuropsychological tasks evaluating complex skills, e.g., auditory attention, executive functions, and social skills, whereas the domains of reasoning, language, and memory were not affected in the cases and controls. CONCLUSIONS Asymptomatic sterile intra-amniotic inflammation in the mid-trimester of pregnancy, followed by a term birth, can still confer to the offspring a substantial risk for neurodevelopmental disorders in childhood. Early recognition and treatment of maternal immune activation in pregnancy may be a strategy for the prevention of subsequent neurodevelopmental disorders in offspring.
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Affiliation(s)
- Maria Teresa Gervasi
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, and Detroit, MI, USA
- Gynaecology and Obstetrics Unit, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, Italy
| | - Roberto Romero
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan, USA
- Detroit Medical Center, Detroit, MI, USA
| | - Elisa Cainelli
- Department of General Psychology, University of Padova, Padova, Italy
| | - Paola Veronese
- Maternal-Fetal Medicine Unit, Department of Women’s and Children’s Health, AOPD, Padua, Italy
| | - Maria Rosa Tran
- Gynaecology and Obstetrics Unit, Department of Women’s and Children’s Health, University Hospital of Padua, Padua, Italy
| | - Eunjung Jung
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Manaphat Suksai
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Mariachiara Bosco
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Francesca Gotsch
- Perinatology Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, and Detroit, MI, USA
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
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Martinato M, Virgis S, Cerantola E, Ocagli H, Cainelli E, Vedovelli L, Comoretto RI, Azzolina D, Monaco E, Gregori D. Parents’ knowledge about their children’s congenital heart disease: an observational study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Congenital heart diseases (CHD) represent abnormalities of cardiovascular structure or function present at birth. The degree of knowledge of parents of children with CHD determines the quality of care and the quality of life of their children. Several studies have shown that parents’ knowledge is still lacking.
Objectives
This study aims to translate and validate in Italian the Leuven Knowledge Questionnaire for Congenital Heart Disease (LKQCHD) and to assess the knowledge of parents of children with CHD about heart defect, treatments, preventive measures, opportunities for physical activity and reproductive problems of their children.
Methods
Translation and validation of the questionnaire were performed using a multistep method: forward translation, backward translation, and pilot testing. Five experts in CHD were included for the validation of the questionnaire. The sample consisted of fifty-four pairs of parents of children with CHD. Parents were contacted by telephone; knowledge was assessed using an electronic questionnaire.
Results
Five items were found to have an Item Content Validity Index (I-CVI) of 0.6, 2 of 0.5, and 2 of 0.2. The Scale ContentValidity Index (S-CVI) was found to be 0.80. Regarding parental knowledge, the results show that almost all parents are able to correctly state the name of the diagnosis and the description and location of the heart defect. However, parental knowledge has important gaps; in particular, parents are less informed about the most characteristic sign of endocarditis, the possibility of contracting endocarditis more than once in a lifetime, and risk factors. Parental knowledge also seems to be lacking regarding symptoms suggesting worsening health status in their children.
Conclusions
The Italian version of the LKQCHD has proved to be a valid tool to measure the level of knowledge of parents of children with CHD, allowing to identify in which areas it is necessary to improve the education addressed to parents.
Key messages
• Assessing the knowledge of parents of children with CHD allows to improve their education.
• The Italian version of the LKQCHD is a valid tool to measure the level of knowledge of parents of children with CHD.
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Affiliation(s)
- M Martinato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova , Padua, Italy
- Department of Statistics, Informatics , Applications, , Firenze, Italy
- Università di Firenze , Applications, , Firenze, Italy
| | - S Virgis
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova , Padua, Italy
| | - E Cerantola
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova , Padua, Italy
| | - H Ocagli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova , Padua, Italy
| | - E Cainelli
- Department of General Psychology, Università di Padova , Padua, Italy
| | - L Vedovelli
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova , Padua, Italy
| | - RI Comoretto
- Department of Sciences of Public Health and Pediatrics, Università di Torino , Turin, Italy
| | - D Azzolina
- Department of Environmental and Preventive Sciences, Università di Ferrara , Ferrara, Italy
| | - E Monaco
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova , Padua, Italy
| | - D Gregori
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova , Padua, Italy
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Cainelli E, Vedovelli L, Gregori D, Suppiej A, Padalino M, Cogo P, Bisiacchi P. Embrace the Complexity: Agnostic Evaluation of Children’s Neuropsychological Performances Reveals Hidden Neurodevelopment Patterns. Children 2022; 9:children9060775. [PMID: 35740712 PMCID: PMC9221792 DOI: 10.3390/children9060775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/02/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022]
Abstract
The most common adverse pre/perinatal events have a great impact on neurodevelopment, with avalanche effects on academic performance, occupational status, and quality of life. Although the injury process starts early, the effects may become evident much later, when life starts to pose more challenging demands. In the present work, we want to address the impact of early insults from an evolutionary perspective by performing unsupervised cluster analysis. We fed all available data, but not the group identification, into the algorithm for 114 children aged 5–10 years, with different adverse medical conditions: healthy (n = 30), premature (n = 28), neonatal hypoxic-ischemic encephalopathy (n = 28), and congenital heart disease (n = 28). We measured general intelligence and many neuropsychological domains (language, attention, memory, executive functions, and social skills). We found three emerging groups that identify children with multiple impairments (cluster 3), children with variable neuropsychological profiles but in the normal range (cluster 2), and children with adequate profiles and good performance in IQ and executive functions (cluster 1). Our analysis divided our patients by severity levels rather than by identifying specific neuropsychological phenotypes, suggesting different developmental trajectories that are characterized by good resilience to early stressful events with adequate development or by pervasive vulnerability to neurodevelopmental disorders.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, 35131 Padova, Italy;
- Correspondence:
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular and Public Health Sciences, University of Padova, 35131 Padova, Italy; (L.V.); (D.G.)
| | - Dario Gregori
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular and Public Health Sciences, University of Padova, 35131 Padova, Italy; (L.V.); (D.G.)
| | - Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University of Ferrara, 44121 Ferrara, Italy;
| | - Massimo Padalino
- Pediatric and Congenital Cardiovascular Surgery Unit, Department of Cardiac, Thoracic, and Vascular Sciences, Padova University Hospital, 35128 Padova, Italy;
| | - Paola Cogo
- Clinica Pediatrica, Department of Medicine, University Hospital Santa Maria della Misericordia, University of Udine, 33100 Udine, Italy;
| | - Patrizia Bisiacchi
- Department of General Psychology, University of Padova, 35131 Padova, Italy;
- Padova Neuroscience Center (PNC), University of Padova, 35129 Padova, Italy
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Cainelli E, Vedovelli L, Bottigliengo D, Boschiero D, Suppiej A. Social skills and psychopathology are associated with autonomic function in children: a cross-sectional observational study. Neural Regen Res 2022; 17:920-928. [PMID: 34472494 PMCID: PMC8530110 DOI: 10.4103/1673-5374.322464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 03/26/2021] [Accepted: 04/15/2021] [Indexed: 11/28/2022] Open
Abstract
In recent years, the increase of psychopathological disorders in the population has become a health emergency, leading to a great effort to understand psychological vulnerability mechanisms. In this scenario, the role of the autonomic nervous system (ANS) has become increasingly important. This study investigated the association between ANS, social skills, and psychopathological functioning in children. As an ANS status proxy, we measured heart rate variability (HRV). Infants admitted to the neonatal intensive care unit of the University Hospital of Padova because of preterm birth or neonatal hypoxic-ischemic encephalopathy were sequentially recruited from January 2011 to June 2013 and followed long-term up to school age in this cross-sectional observational study. We recorded 5 minutes of HRV immediately before measuring performance in social abilities tasks (affect recognition and theory of mind, NEPSY-II) in 50 children (mean age 7.4 ± 1.4 years) with and without risk factors for developing neuropsychiatric disorders due to pre-/perinatal insults without major sequelae. Children also completed extensive cognitive, neuropsychological, and psychosocial assessment. Parents were assessed with psychopathological interviews and a questionnaire (CBCL 6-18). Analysis in a robust Bayesian framework was used to unearth dependencies between HRV, social skills, and psychopathological functioning. Social task scores were associated with HRV components, with high frequency the most consistent. HRV bands were also associated with the psychopathological questionnaire. Only normalized HRV high frequency was able to distinguish impaired children in the affect recognition task. Our data suggest that ANS may be implicated in social cognition both in typical and atypical developmental conditions and that HRV has cross-disease sensitivity. We suggest that HRV parameters may reflect a neurobiological vulnerability to psychopathology. The study was approved by the Ethics Committee of the University Hospital of Padova (Comitato Etico per la Sperimentazione, Azienda Opedaliera di Padova, approval No. 1693P).
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Affiliation(s)
- Elisa Cainelli
- Child Neurology and Clinical Neurophysiology, University Hospital of Padova, Padova, Italy
- Department of General Psychology, University of Padova, Padova, Italy
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | - Daniele Bottigliengo
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
| | | | - Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, University Hospital of Padova, Padova, Italy
- Department of Medical Sciences, Pediatric Section, University of Ferrara, Ferrara, Italy
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8
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Suppiej A, Vitaliti G, Talenti G, Cuteri V, Trevisanuto D, Fanaro S, Cainelli E. Prognostic Risk Factors for Severe Outcome in the Acute Phase of Neonatal Hypoxic-Ischemic Encephalopathy: A Prospective Cohort Study. Children 2021; 8:children8121103. [PMID: 34943299 PMCID: PMC8700551 DOI: 10.3390/children8121103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/20/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022]
Abstract
In the first days after birth, a major focus of research is to identify infants with hypoxic-ischemic encephalopathy at higher risk of death or severe neurological impairment, despite therapeutic hypothermia (TH). This is especially crucial to consider redirection of care, according to neonatal outcome severity. We aimed to seek associations between some neonatal routine parameters, usually recorded in Neonatal Intensive Care Units, and the development of severe outcomes. All consecutive patients prospectively recruited for TH for perinatal asphyxia, born between February 2009 and July 2016, were eligible for this study. Severe outcome was defined as death or major neurological sequelae at one year of age. Among all eligible neonates, the final analysis included 83 patients. Severe outcome was significantly associated with pH and base excess measured in the first hour of life, mode of delivery, Apgar score, Sarnat and Sarnat score, electroencephalogram-confirmed neonatal epileptic seizures, and antiepileptic therapy. Studying univariate analysis by raw relative risk (RR) and 95% confidence intervals (CI), severe outcome was significantly associated with pH (p = 0.011), Apgar score (p = 0.003), Sarnat score (p < 0.001), and Caesarian section (p = 0.015). Conclusions. In addition to clinical examination, we suggest a clinical-electroencephalographic protocol useful to identify neonates at high neurological risk, available before rewarming from TH.
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Affiliation(s)
- Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University of Ferrara, 44124 Ferrara, Italy; (G.V.); (S.F.)
- Correspondence:
| | - Giovanna Vitaliti
- Department of Medical Sciences, Pediatric Section, University of Ferrara, 44124 Ferrara, Italy; (G.V.); (S.F.)
| | - Giacomo Talenti
- Neuroradiology Unit, University Hospital of Padova, 35128 Padova, Italy;
| | - Vittoria Cuteri
- Department of Women and Child Health, University of Padova, 35128 Padova, Italy; (V.C.); (D.T.)
| | - Daniele Trevisanuto
- Department of Women and Child Health, University of Padova, 35128 Padova, Italy; (V.C.); (D.T.)
| | - Silvia Fanaro
- Department of Medical Sciences, Pediatric Section, University of Ferrara, 44124 Ferrara, Italy; (G.V.); (S.F.)
| | - Elisa Cainelli
- Department of General Psychology, University of Padova, 35128 Padova, Italy;
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Cainelli E, Vedovelli L. Over-specialization versus synergy in neuroscience: professionals' integration is more than the sum of its parts. Neural Regen Res 2021; 16:2232-2233. [PMID: 33818506 PMCID: PMC8354120 DOI: 10.4103/1673-5374.310676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/31/2020] [Accepted: 01/26/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, Padova, Italy
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padova, Italy
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10
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Bisiacchi P, Cainelli E. Structural and functional brain asymmetries in the early phases of life: a scoping review. Brain Struct Funct 2021; 227:479-496. [PMID: 33738578 PMCID: PMC8843922 DOI: 10.1007/s00429-021-02256-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/07/2021] [Indexed: 12/13/2022]
Abstract
Asymmetry characterizes the brain in both structure and function. Anatomical asymmetries explain only a fraction of functional variability in lateralization, with structural and functional asymmetries developing at different periods of life and in different ways. In this work, we perform a scoping review of the cerebral asymmetries in the first brain development phases. We included all English-written studies providing direct evidence of hemispheric asymmetries in full-term neonates, foetuses, and premature infants, both at term post-conception and before. The final analysis included 57 studies. The reviewed literature shows large variability in the used techniques and methodological procedures. Most structural studies investigated the temporal lobe, showing a temporal planum more pronounced on the left than on the right (although not all data agree), a morphological asymmetry already present from the 29th week of gestation. Other brain structures have been poorly investigated, and the results are even more discordant. Unlike data on structural asymmetries, functional data agree with each other, identifying a leftward dominance for speech stimuli and an overall dominance of the right hemisphere in all other functional conditions. This generalized dominance of the right hemisphere for all conditions (except linguistic stimuli) is in line with theories stating that the right hemisphere develops earlier and that its development is less subject to external influences because it sustains functions necessary to survive.
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Affiliation(s)
- Patrizia Bisiacchi
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy. .,Padova Neuroscience Centre, PNC, Padova, Italy.
| | - Elisa Cainelli
- Department of General Psychology, University of Padova, Via Venezia, 8, 35121, Padova, Italy
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Cainelli E, Vedovelli L, Wigley ILCM, Bisiacchi PS, Suppiej A. Neonatal spectral EEG is prognostic of cognitive abilities at school age in premature infants without overt brain damage. Eur J Pediatr 2021; 180:909-918. [PMID: 32989487 PMCID: PMC7886838 DOI: 10.1007/s00431-020-03818-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/25/2022]
Abstract
Prematurity is a prototype of biological risk that could affect the late neurocognitive outcome; however, the condition itself remains a non-specific marker. This longitudinal 6-year study aimed to evaluate the prognostic role of neonatal spectral EEG in premature infants without neurological complications. The study cohort was 26 children born 23-34 gestational ages; all neonates underwent multichannel EEG recordings at 35 weeks post-conception. EEG data were transformed into the frequency domain and divided into delta (0.5-4 Hz), theta (5-7 Hz), alpha (8-13 Hz), and beta (14-20 Hz) frequency bands. At 6 years, a neuropsychological and behavioral evaluation was performed. Correlations between spectral bands and neuropsychological assessments were performed with a conservative and robust Bayesian correlation model using weakly informative priors. The correlation of neuropsychological tasks to spectral frequency bands highlighted a significant association with visual and auditory attention tests. The performance on the same tests appears to be mainly impaired.Conclusions: We found that spectral EEG frequencies are independent predictors of performance in attention tasks. We hypothesized that spectral EEG might reflect early circuitries' imbalance in the reticular ascending system and cumulative effect on ongoing development, pointing to the importance of early prognostic instruments. What is Known: • Prematurity is a non-specific marker of late neurocognitive risk. • Precise prognostic instruments are lacking, mostly in patients with low-grade conditions. What is New: • Longitudinal long-term studies are scarce but crucial for the inferential attributive process. • Spectral EEG frequencies are independent predictors of performance in attention tasks.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
- Child Neurology and Clinical Neurophysiology, Padua University Hospital, via Giustiniani 3, 35133 Padova, Italy
| | - Luca Vedovelli
- Lab LeSexp, Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, via Loredan 18, 35131 Padova, Italy
| | | | - Patrizia Silvia Bisiacchi
- Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy
- Padova Neuroscience Centre, PNC, Padova, Italy
| | - Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, Padua University Hospital, via Giustiniani 3, 35133 Padova, Italy
- Department of Medical Sciences, Pediatric Section, University of Ferrara, via Aldo Moro 8, 44124 Cona, Fe Italy
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Cainelli E, Bisiacchi PS, Cogo P, Padalino M, Simonato M, Vergine M, Lanera C, Vedovelli L. Detecting neurodevelopmental trajectories in congenital heart diseases with a machine-learning approach. Sci Rep 2021; 11:2574. [PMID: 33510389 PMCID: PMC7843636 DOI: 10.1038/s41598-021-82328-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/12/2021] [Indexed: 01/03/2023] Open
Abstract
We aimed to delineate the neuropsychological and psychopathological profiles of children with congenital heart disease (CHD) and look for associations with clinical parameters. We conducted a prospective observational study in children with CHD who underwent cardiac surgery within five years of age. At least 18 months after cardiac surgery, we performed an extensive neuropsychological (intelligence, language, attention, executive function, memory, social skills) and psychopathological assessment, implementing a machine-learning approach for clustering and influencing variable classification. We examined 74 children (37 with CHD and 37 age-matched controls). Group comparisons have shown differences in many domains: intelligence, language, executive skills, and memory. From CHD questionnaires, we identified two clinical subtypes of psychopathological profiles: a small subgroup with high symptoms of psychopathology and a wider subgroup of patients with ADHD-like profiles. No associations with the considered clinical parameters were found. CHD patients are prone to high interindividual variability in neuropsychological and psychological outcomes, depending on many factors that are difficult to control and study. Unfortunately, these dysfunctions are under-recognized by clinicians. Given that brain maturation continues through childhood, providing a significant window for recovery, there is a need for a lifespan approach to optimize the outcome trajectory for patients with CHD.
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Affiliation(s)
- Elisa Cainelli
- Department of General Psychology, University of Padova, Padua, Italy.
| | - Patrizia S Bisiacchi
- Department of General Psychology, University of Padova, Padua, Italy. .,Padova Neuroscience Centre, PNC, Padua, Italy.
| | - Paola Cogo
- Department of Medicine, Clinica Pediatrica, University Hospital S Maria Della Misericordia, University of Udine, Udine, Italy
| | - Massimo Padalino
- Pediatric and Congenital Cardiovascular Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padova University Hospital, Padua, Italy
| | - Manuela Simonato
- PCare Laboratory, Fondazione Istituto Di Ricerca Pediatrica "Citta Della Speranza", Padua, Italy
| | - Michela Vergine
- Department of Medicine, Clinica Pediatrica, University Hospital S Maria Della Misericordia, University of Udine, Udine, Italy
| | - Corrado Lanera
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
| | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology, and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Padua, Italy
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Suppiej A, Vedovelli L, Boschiero D, Bolzon M, Cainelli E. Abnormal heart rate variability at school age in survivors of neonatal hypoxic-ischemic encephalopathy managed with therapeutic hypothermia. Eur J Paediatr Neurol 2020; 29:66-70. [PMID: 32863129 DOI: 10.1016/j.ejpn.2020.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/13/2020] [Accepted: 08/18/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Major deficits in the autonomic nervous system function, detected by measuring heart rate variability (HRV), are reported in neonatal hypoxic-ischemic encephalopathy (HIE)). However, it is unknown if they will recover in the long-term. Because of the possible implications for the neurological outcome, this study aimed to evaluate the HRV at school age, in a cohort of children who survived HIE managed with therapeutic hypothermia. METHODS A cross-sectional study of HRV in 40 children: 20 HIE survivors and 20 healthy peers. All underwent 5-min plethysmography using the PPG Stress Flow device (BioTekna Italy). Absolute and normalized HRV spectral power in the very low frequency (VLF), low frequency (LF), and high frequency (HF) bands and total power were compared between patients and healthy children. The outcome evaluation included neurological, cognitive (WISC-IV), and psychosocial (Parent Stress Index-Short Form-PSI-SF and psychosocial interview) measures. RESULTS All mean HRV values were significantly higher in survivors of HIE, compared to healthy peers, with the larger effect size for the HF band (Total Power 8.57 ± 0.59 vs 7.82 ± 0.77 ms2, p .003 ES 0.21; HF 7.82 + 0.77 vs 8.57 + 0.59 ms2, p .001 EF 0.24). None of the children had major health, neurological and psychosocial (PSI-SF/interview) problems. The IQ (WISC-IV) was normal in 17/20 patients, borderline in 2, and <70 in 1. CONCLUSIONS HRV measures highlight autonomic dysfunction at school age in survivors of neonatal HIE, in the absence of major neurodevelopmental and psychosocial problems. The significance of this finding for children's future life needs further neuropsychiatric investigations and longer follow-up.
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Affiliation(s)
- A Suppiej
- Department of Medical Sciences, Paediatric Section, University of Ferrara, Italy; Pediatric University Hospital, Padova, Italy.
| | - L Vedovelli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences, and Public Health, University of Padova, Italy
| | - D Boschiero
- BIOTEKNA Biomedical Technologies, Venice, Italy
| | - M Bolzon
- Neuro-Intensive Care and Anaesthesiology, University Hospital, Borgo Trento Hospital, Verona, Italy
| | - E Cainelli
- Pediatric University Hospital, Padova, Italy; Department of Developmental and Social Psychology, University of Padova, Italy
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Cavallin F, Rubin G, Vidal E, Cainelli E, Bonadies L, Suppiej A, Trevisanuto D. Prognostic role of acute kidney injury on long-term outcome in infants with hypoxic-ischemic encephalopathy. Pediatr Nephrol 2020; 35:477-483. [PMID: 31828471 DOI: 10.1007/s00467-019-04406-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The objective of this study was to evaluate the prognostic role of postnatal acute kidney injury (AKI) on neurodevelopmental outcome in infants with hypoxic-ischemic encephalopathy (HIE) receiving therapeutic hypothermia (TH). METHODS This is a prospective observational study including all neonates with HIE receiving TH between 2009 and 2016 at a single center. AKI was classified according to the Kidney Disease: Improving Global Outcomes definition modified for neonatal age. Child development was assessed using the Griffiths Mental Development Scales (GMDS). Study outcome was defined as unfavorable outcome (including death or disability according to GMDS) or favorable otherwise, at 12 and 24 months. RESULTS One-hundred and one neonates (median gestational age 39 weeks) were included. AKI was diagnosed in 10 neonates (10%). Seven patients died within the first year, 35 patients had disability at 12 months, and 45 patients at 24 months. AKI was associated with increased likelihood of unfavorable outcome at 24 months (100% vs. 59% in neonates without AKI; p = 0.01). AKI showed good positive predictive value (1.00, 95% CI 0.71-1.00) and specificity (1.00, 95% CI 0.88-1.00), but poor negative predictive value (0.41, 95% CI 0.30-0.52) and sensitivity (0.19, 95% CI 0.11-0.32) at 24 months. CONCLUSIONS AKI might be a reliable indicator of death or long-term disability in infants with HIE receiving TH, but the absence of AKI does not guarantee a favorable long-term outcome.
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Affiliation(s)
| | - Giulia Rubin
- Department of Woman's and Child's Health, University of Padova, Via Giustiniani, 3, 35128, Padua, Italy
| | - Enrico Vidal
- Division of Pediatrics, Department of Medicine, University of Udine, Udine, Italy
| | - Elisa Cainelli
- Department of Developmental and Social Psychology, University ofPadova, Padua, Italy
| | - Luca Bonadies
- Department of Woman's and Child's Health, University of Padova, Via Giustiniani, 3, 35128, Padua, Italy
| | - Agnese Suppiej
- Department of Woman's and Child's Health, University of Padova, Via Giustiniani, 3, 35128, Padua, Italy.,Department of Medical Sciences-Pediatric Section, University ofFerrara, Ferrara, Italy
| | - Daniele Trevisanuto
- Department of Woman's and Child's Health, University of Padova, Via Giustiniani, 3, 35128, Padua, Italy.
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Cainelli E, Di Giacomo DL, Mantegazza G, Vedovelli L, Favaro J, Boniver C. Prognostic role of Mini-Mental State Pediatric Examination (MMSPE) on neuropsychological functioning. Neurol Sci 2020; 41:619-623. [PMID: 31729580 DOI: 10.1007/s10072-019-04141-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/05/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the ability of the Mini-Mental State Pediatric Examinations (MMSPE) in the individuation of neuropsychological impairments. METHOD MMSPE was administered to 60 children attending a primary or lower secondary school suffering from neurological diseases, admitted to our neuropsychology services. All children performed both a MMSPE examination and a neuropsychological evaluation. Results of neuropsychological evaluation and MMSPE were dichotomized. Positive predictive value (PPV), negative predictive value (NPV), and accuracy were also calculated. RESULTS The diagnostic performance of MMSPE showed a good overall accuracy (0.83, CI 95% 0.64-0.91), NPV (0.81, CI 95% 0.73-1.00), PPV (0.87, CI 95% 0.68-0.94), specificity (0.91, CI 95% 0.81-1.00), sensitivity (0.74, CI 95% 0.57-0.90), and odds ratio of 28.5 (CI 95% 6.6-123), p < 0.001. CONCLUSIONS MMSPE has a good prognostic ability in predicting neuropsychological problems in the context of different neurological pediatric diseases. We suggest that this instrument could greatly improve pediatric clinical practice in identifying high-risk children.
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Affiliation(s)
- Elisa Cainelli
- Department of Developmental Psychology and Socialization, University of Padova, Via Venezia 8, 35133, Padua, Italy. .,Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy.
| | - Deborah Lidia Di Giacomo
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | | | - Luca Vedovelli
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Jacopo Favaro
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
| | - Clementina Boniver
- Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, Padua, Italy
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Cainelli E, Mioni G, Boniver C, Bisiacchi PS, Vecchi M. Time perception in childhood absence epilepsy: Findings from a pilot study. Epilepsy Behav 2019; 99:106460. [PMID: 31470222 DOI: 10.1016/j.yebeh.2019.106460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/28/2019] [Accepted: 07/28/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES With this explorative study, we aimed to examine time perception in children with childhood absence epilepsy (CAE) and to compare those children with a matched control group. The study also investigated the association between the neuropsychological performance of the group with CAE and time judgment. We hypothesize that children with CAE could fail in time perception and that this may be because of a common underlying substrate with executive impairments. METHODS Thirteen children with CAE, aged 6-13 years, and 17 healthy children were recruited. All children performed the time bisection task; the children with CAE also performed a cognitive and neuropsychological assessment. We performed a univariate analysis using each parameter of the bisection task (bisection point [BP]) and Weber ratio (WR) as dependent variables, the group (patients vs. controls) as fixed factors and age at evaluation and vocabulary scores as covariates. In the subgroup of patients, we correlated bisection task parameters with neuropsychological tests using a nonparametric partial correlation; the analysis has corrected for age at evaluation. RESULTS The BP and WR measures differed between controls and patients with CAE. In the subgroup of patients also performing a neuropsychological assessment, we found a correlation between the WR measure and performance on the inhibition test (r = -0.641, p = .025), coding test (r = -0.815, p = .014), and Trail Making Test B (TMT B) (r = 0.72, p = .042). CONCLUSIONS We found an altered time perception in a pilot study of a small group of children with CAE. A neurophysiological mechanism underlying CAE seems to influence cognitive and behavioral deficits and time sensibility.
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Affiliation(s)
- Elisa Cainelli
- Department of Development and Socialization, University of Padova, Italy; Child Neurology and Clinical Neurophysiology, Women's and Children's Health Department, Padua University Hospital, Padova, Italy.
| | - Giovanna Mioni
- Department of General Psychology, University of Padova, Italy.
| | - Clementina Boniver
- Child Neurology and Clinical Neurophysiology, Women's and Children's Health Department, Padua University Hospital, Padova, Italy.
| | - Patrizia S Bisiacchi
- Department of General Psychology, University of Padova, Italy; Padova Neuroscience Center, PNC.
| | - Marilena Vecchi
- Child Neurology and Clinical Neurophysiology, Women's and Children's Health Department, Padua University Hospital, Padova, Italy; Neuromotor Rehabilitation Center La Nostra Famiglia Association, Vicenza, Italy.
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Vedovelli L, Cogo P, Cainelli E, Suppiej A, Padalino M, Tassini M, Simonato M, Stellin G, Carnielli VP, Buonocore G, Longini M. Pre-surgery urine metabolomics may predict late neurodevelopmental outcome in children with congenital heart disease. Heliyon 2019; 5:e02547. [PMID: 31667397 PMCID: PMC6812188 DOI: 10.1016/j.heliyon.2019.e02547] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/21/2019] [Accepted: 09/26/2019] [Indexed: 11/25/2022] Open
Abstract
Background From fetal life until cardiac surgery, complex congenital heart diseases (CHD) exhibit different hemodynamic and oxygenation patterns that can lead to alteration of the metabolic profile. We used a metabolomic approach to identify urine metabolic markers before cardiac surgery, aiming to define the physiology of patients with complex CHD and to contribute to predict their neurodevelopmental outcome. Methods In a prospective, observational, single-center study we enrolled 28 patients with complex biventricular and univentricular CHD aged less than 5 years, on stable hemodynamic conditions, and with no genetic anomalies. We analyzed urine samples, collected at the induction of anesthesia, by 1H NMR spectroscopy. Profiles of 1H NMR spectra were submitted to unsupervised (principal component) and supervised (partial least squares-discriminant) multivariate analysis. Neurodevelopment was assessed by neuropsychological and adaptive functioning testing. Results Principal components analysis divided CHD patients metabolic profiles in two distinct clusters (RED and BLACK). Metabolic profiles belonging to the RED cluster showed higher levels of accumulation of citric acid cycle intermediates and glucose compared to the profiles in the BLACK cluster, indicating a possible switching to anaerobic metabolism. Patients belonging to the RED cluster were significantly more prone to show an adverse neurodevelopment pattern (p = 0.01). Conclusions The application of metabolomic analysis to CHD children permitted a deeper insight on their metabolic status that could help to obtain a better understanding of the physiological implications and to predict long-term neurodevelopmental outcome.
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Affiliation(s)
- Luca Vedovelli
- PCare Laboratory, Fondazione Istituto di Ricerca Pediatrica "Città della Speranza", Corso Stati Uniti 4F, Padova, 35127, Italy
| | - Paola Cogo
- Division of Pediatrics, Department of Medicine, University of Udine, Piazzale Kolbe 4, Udine, 33100, Italy
| | - Elisa Cainelli
- Department of Developmental Psychology and Socialization, University of Padova, via Venezia 8, Padova, 35133, Italy
| | - Agnese Suppiej
- Department of Medical Sciences, Pediatric Section, University of Ferrara, via Aldo Moro 8, Cona, Ferrara, 44124, Italy
| | - Massimo Padalino
- Pediatric and Congenital Cardiovascular Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padova University Hospital, Via Giustiniani 3, Padova, 35128, Italy
| | - Maria Tassini
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via Aldo Moro, 2, Siena, 53100, Italy
| | - Manuela Simonato
- PCare Laboratory, Fondazione Istituto di Ricerca Pediatrica "Città della Speranza", Corso Stati Uniti 4F, Padova, 35127, Italy
| | - Giovanni Stellin
- Pediatric and Congenital Cardiovascular Surgery Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padova University Hospital, Via Giustiniani 3, Padova, 35128, Italy
| | - Virgilio P Carnielli
- Division of Neonatology, Department of Clinical Sciences, Polytechnic University of Marche and Azienda Ospedaliero-Universitaria Ospedali Riuniti, Via F.Corridoni 11, Ancona, 60123, Italy
| | - Giuseppe Buonocore
- Department of Molecular and Developmental Medicine, University of Siena, Viale Bracci, Siena, 53100, Italy
| | - Mariangela Longini
- Department of Molecular and Developmental Medicine, University of Siena, Viale Bracci, Siena, 53100, Italy
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Suppiej A, Toffoli E, Festa I, Cervesi C, Cappellari A, Manara R, Magarotto M, Cainelli E. Perinatal carotid artery ischemic stroke: Report of two cases. J Neonatal Perinatal Med 2019; 12:479-485. [PMID: 31450516 DOI: 10.3233/npm-1816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The mechanisms of perinatal stroke are poorly understood but preclinical studies point to the crucial role of perinatal inflammation. Carotid artery occlusion represents a very rare and severe cause of perinatal stroke. We describe two cases diagnosed with extensive ischemic stroke due to carotid artery occlusion. In both cases, we demonstrated placental vasculopathy. High levels of C-reactive protein in mother and/or neonates suggested inflammatory mechanism as a potential trigger. Both cases underwent hypothermic treatment without complications because of initial diagnosis of perinatal asphyxia. The prognosis at the time of the last follow up was severe including cerebral palsy, epilepsy and cognitive impairment. Our cases contribute to the actual debate on pathogenic mechanisms and treatment options for this rare condition.
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Affiliation(s)
- A Suppiej
- Department of Medical Sciences, Pediatric Section, University of Ferrara, Ferrara, Italy.,Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy
| | - E Toffoli
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy
| | - I Festa
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy
| | - C Cervesi
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy
| | - A Cappellari
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy
| | - R Manara
- Department of Neurosciences, Neuroradiology Unit, University of Salerno, Salerno, Italy
| | - M Magarotto
- Neonatal Intensive Care Unit, Pediatric University Hospital, Padua, Italy
| | - E Cainelli
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy
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Cainelli E, Vedovelli L, Bolzon M, Santangelo L, Suppiej A. Heart rate variability in the healthy school-age children. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cainelli E, Trevisanuto D, Cavallin F, Suppiej A. Evoked potentials predict psychomotor development in neonates with normal MRI after hypothermia for hypoxic-ischemic encephalopathy. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Spagnolo V, Agatiello M, Trevisanuto D, Talenti G, Cainelli E, Suppiej A. Clinical and electroencephalographic risk factors for severe outcome in asphyxiated neonates undergoing therapeutic hypothermia. Clin Neurophysiol 2019. [DOI: 10.1016/j.clinph.2018.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cainelli E, Trevisanuto D, Cavallin F, Manara R, Suppiej A. Evoked potentials predict psychomotor development in neonates with normal MRI after hypothermia for hypoxic-ischemic encephalopathy. Clin Neurophysiol 2018; 129:1300-1306. [PMID: 29689487 DOI: 10.1016/j.clinph.2018.03.043] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/21/2018] [Accepted: 03/26/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To assess the prognostic role of evoked potentials (EP) in neonates with normal magnetic resonance imaging (MRI) after therapeutic hypothermia (TH) for hypoxic-ischemic encephalopathy (HIE). METHODS Thirty-five neonates recruited for TH because of HIE, having normal neonatal MRI, performed neonatal somatosensory (SEP), visual (VEP) evoked potentials and electroencephalogram (EEG). The effect of SEP, VEP or EEG abnormalities on Griffith's developmental scales at 12 and 24 months was measured; positive (PPV) and negative (NPV) predictive value, sensitivity, specificity and accuracy were calculated. RESULTS At 24 months, 28% had global psychomotor impairment and 57% had isolated impairments. VEP abnormality was associated with impaired hearing-language score (p = 0.002) and performance score (p < 0.0001). VEP achieved best PPV (0.91, 95% C.I. 0.62-0.99) and specificity (0.93, 95% C.I. 0.70-0.99). The combination of neurophysiological tests achieved the best NPV (0.85, 95% C.I. 0.58-0.96), sensitivity (0.90, 95% C.I. 0.70-0.97), overall accuracy (0.83, 95% C.I. 0.67-0.92). CONCLUSIONS Psychomotor sequelae may occur in survivors of neonatal HIE with normal MRI. VEP is the single best neurophysiological prognostic marker but the combination of neurophysiological tests has a better value. SIGNIFICANCE When facing the challenge of neurodevelopmental prognosis in infants with normal MRI after TH, EPs are useful prognostic tools, complementary to EEG.
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Affiliation(s)
- Elisa Cainelli
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital of Padua, Italy
| | | | | | | | - Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital of Padua, Italy.
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Cione G, Cainelli E, Cappellari A, Di Capua M, Janes A, Pro S, Vittorini R, Manara R, Suppiej A. 36. Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Suppiej A, Cappellari A, Talenti G, Cainelli E, Di Capua M, Janes A, Longo D, Mardari R, Marinaccio C, Pro S, Sciortino P, Trevisanuto D, Vittorini R, Manara R. Bilateral loss of cortical SEPs predict severe MRI lesions in neonatal hypoxic ischemic encephalopathy treated with hypothermia. Clin Neurophysiol 2017; 129:95-100. [PMID: 29172116 DOI: 10.1016/j.clinph.2017.10.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 10/18/2017] [Accepted: 10/27/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The introduction of therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy calls for reevaluation of the prognostic role of somatosensory evoked potentials (SEPs). METHODS Among 80 consecutive neonates undergoing hypothermia for hypoxic-ischemic encephalopathy, 58 performed SEPs and MRI at 4-14 days of life and were recruited in this multicenter study. SEPs were scored as: 0 (bilaterally/unilaterally recorded N20) or 1 (bilaterally absent N20). The severity of brain injury was scored using MRI. RESULTS Bilaterally absent N20 was observed in 10/58 neonates (17%); all had moderate/severe MRI abnormalities; 36/48 neonates (75%) with score 0 at SEPs had normal MRI. The positive predictive value of SEPs on MRI outcome was of 1.00, while the negative predictive value 0.72, sensitivity 0.48, specificity 1.00, with an accuracy of 0.78 (p < .001). CONCLUSIONS Bilateral absence of cortical SEPs predicts moderate/severe MRI pattern of injury. SIGNIFICANCE Therapeutic hypothermia does not seem to significantly affect prognostic reliability of SEPs.
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Affiliation(s)
- Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital of Padova, Italy.
| | - Ambra Cappellari
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital of Padova, Italy
| | | | - Elisa Cainelli
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital of Padova, Italy
| | - Matteo Di Capua
- Neurophysiology Unit, Department of Neuroscience, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Augusta Janes
- Terapia Intensiva Neonatale Azienda Sanitaria Unica Integrata SMM Udine, Italy
| | - Daniela Longo
- Neuroradiology Unit, Ospedale Pediatrico Bambino Gesù - IRCCS - Roma, Italy
| | - Rodica Mardari
- Neuroradiology Unit, University Hospital of Padova, Italy
| | - Cristina Marinaccio
- SC Neuropsichiatria Infantile Dipartimento di Pediatria e Specialità Pediatriche, A.O.U. Città della Salute e della Scienza Torino, Presidio OIRM, Italy
| | - Stefano Pro
- Neurophysiology Unit, Department of Neuroscience, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Paola Sciortino
- SC Neuroradiologia, Dipartimento di Diagnostica per Immagini e Radioterapia, A.O.U. Città della Salute e della Scienza Torino, Presidio CTO, Italy
| | - Daniele Trevisanuto
- Neonatal Intensive Care Unit, Pediatric University Hospital of Padova, Italy
| | - Roberta Vittorini
- SC Neuropsichiatria Infantile Dipartimento di Pediatria e Specialità Pediatriche, A.O.U. Città della Salute e della Scienza Torino, Presidio OIRM, Italy
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Suppiej A, Cainelli E, Cappellari A, Trevisanuto D, Balao L, Di Bono MG, Bisiacchi PS. Spectral analysis highlight developmental EEG changes in preterm infants without overt brain damage. Neurosci Lett 2017; 649:112-115. [DOI: 10.1016/j.neulet.2017.04.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 04/09/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
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Agatiello M, Cainelli E, Fava E, Toffoli E, Tessari L, Scarabel F, Cappellari A, Sole M, Di Capua M, Suppiej A. 87. Median nerve SEPs predict motor outcome in neonatal ipossic-ischemic encephalopathy treated with hypothermia. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Santangelo L, Cainelli E, Nosadini M, Sartori S, Sole M, Suppiej A. 3. Evaluation of long term cognitive risks associated with the presence of seizure during acute disseminated encephalomyelitis. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nosadini M, Boniver C, Zuliani L, de Palma L, Cainelli E, Battistella PA, Toldo I, Suppiej A, Sartori S. Longitudinal electroencephalographic (EEG) findings in pediatric anti-N-methyl-D-aspartate (anti-NMDA) receptor encephalitis: the Padua experience. J Child Neurol 2015; 30:238-45. [PMID: 24396130 DOI: 10.1177/0883073813515947] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To contribute to characterize electroencephalographic (EEG) activity in pediatric anti-N-methyl-d-aspartate (anti-NMDA) receptor encephalitis, we reviewed electroclinical data of 5 children with anti-NMDA receptor encephalitis diagnosed in our department. We identified 4 longitudinal electroencephalographic phases: in the early phase, background activity was normal, with intermixed nonreactive slow waves; in the florid phase, background activity deteriorated with appearance of sequences of peculiar rhythmic theta and/or delta activity unrelated to clinical changes, unresponsive to stimuli and antiepileptic medications; in the recovery phase, these sequences decreased and reactive posterior rhythm re-emerged; electroencephalogram normalized 2 to 5 months after onset. In conclusion, in the presence of evocative clinical history, recognizing a characteristic longitudinal electroencephalographic activity could provide ancillary aspects addressing the diagnosis and the overall management of children with anti-N-methyl-d-aspartate receptor encephalitis; in particular, knowing that peculiar and recurrent paroxysmal nonepileptic rhythmic theta-delta patterns can occur in these patients could help distinguish paroxysmal epileptic and nonepileptic electroencephalographic activity.
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Affiliation(s)
- Margherita Nosadini
- Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy
| | - Clementina Boniver
- Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy
| | - Luigi Zuliani
- Department of Neurology, Ca' Foncello Hospital, Treviso, Italy
| | - Luca de Palma
- Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy
| | - Elisa Cainelli
- Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy Pediatric Neurophysiology Unit, Department of Pediatrics, University of Padua, Italy Lifespan Cognitive Neuroscience Laboratory, Department of General Psychology, University of Padua, Italy
| | | | - Irene Toldo
- Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy
| | - Agnese Suppiej
- Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy
| | - Stefano Sartori
- Pediatric Neurology Unit, Department of Pediatrics, University of Padua, Italy
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Cainelli E, Cappellari A, Bisiacchi P, Sole M, Di Bono M, Suppiej A. 19. Early brain connectivity differences in premature infants. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sole M, Cainelli E, Cappellari A, Bisiacchi P, Suppiej A. 27. Prognostic role of spectral analysis of the EEG in premature infants. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Cainelli E, de Palma L, Nosadini M, Sartori S, Boniver C, Suppiej A. 20. Spectral analysis of the eeg in paediatric anti-NMDAR encephalitis. Clin Neurophysiol 2015. [DOI: 10.1016/j.clinph.2014.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Suppiej A, Cainelli E, Casara G, Cappellari A, Nosadini M, Sartori S. Long-term neurocognitive outcome and quality of life in pediatric acute disseminated encephalomyelitis. Pediatr Neurol 2014; 50:363-7. [PMID: 24630282 DOI: 10.1016/j.pediatrneurol.2013.12.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Revised: 12/02/2013] [Accepted: 12/04/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Acute disseminated encephalomyelitis is an inflammatory-demyelinating disorder of the central nervous system usually with a monophasic course and a favorable neurological outcome. Long-term neurocognitive sequelae and quality of life have not yet been fully investigated. AIM To examine neurocognitive outcome and quality of life in pediatric monophasic acute disseminated encephalomyelitis. METHODS Of the 36 patients diagnosed with acute disseminated encephalomyelitis at our institution, six were lost to follow-up and eight relapsed (two with multiphasic forms and six with multiple sclerosis). The outcome of the 22 remaining patients was evaluated using four subscales of the Wechsler Intelligence Scales for estimation of IQ, a battery of neuropsychological tests, and semistructured and PedsQL questionnaires for quality of life. The effect of age at onset, neuroradiological recovery, and time elapsed from the acute event on outcome was also investigated. RESULTS Estimated IQ, neuropsychological mean group scores, and quality of life at follow-up were within the normal range, but 23% of the patients had pathological scores in various neuropsychological functions, among which attention was the most clearly affected. The neuroradiological recovery was not correlated with the result of the neuropsychological tests. Age at onset correlated with linguistic skills, whereas the time elapsed from the acute event had a significant effect on attention tasks: scores were worse in the group of patients with a follow-up shorter than 7 years. CONCLUSION Our results suggest that pediatric monophasic acute disseminated encephalomyelitis has a favorable neurocognitive outcome. Patients with longer follow-up had a better outcome, suggesting a neurocognitive course that is different from that of multiple sclerosis and a potential for long-term recovery of affected functions.
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Affiliation(s)
- Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, Paediatric University Hospital, Padua, Italy.
| | - Elisa Cainelli
- Child Neurology and Clinical Neurophysiology, Paediatric University Hospital, Padua, Italy; Lifespan Cognitive Neuroscience Laboratory, Department of General Psychology, University of Padua, Padua, Italy
| | - Giulia Casara
- Child Neurology and Clinical Neurophysiology, Paediatric University Hospital, Padua, Italy
| | - Ambra Cappellari
- Child Neurology and Clinical Neurophysiology, Paediatric University Hospital, Padua, Italy
| | - Margherita Nosadini
- Child Neurology and Clinical Neurophysiology, Paediatric University Hospital, Padua, Italy
| | - Stefano Sartori
- Child Neurology and Clinical Neurophysiology, Paediatric University Hospital, Padua, Italy
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Abstract
Cognitive and neuropsychological impairments are well documented in adult multiple sclerosis (MS). Research has only recently focused on cognitive disabilities in pediatric cases, highlighting some differences between pediatric and adult cases. Impairments in several functions have been reported in children, particularly in relation to attention, processing speed, visual-motor skills, and language. Language seems to be particularly vulnerable in pediatric MS, unlike in adults in whom it is usually preserved. Deficits in executive functions, which are considered MS-specific in adults, have been inconsistently reported in children. In children, as compared to adults, the relationship between cognitive dysfunctions and the two other main symptoms of MS, fatigue and psychiatric disorders, was poorly explored. Furthermore, data on the correlations of cognitive impairments with clinical and neuroimaging features are scarce in children, and the results are often incongruent; interestingly, involvement of corpus callosum and reduced thalamic volume differentiated patients identified as having a cognitive impairment from those without a cognitive impairment. Further studies about pediatric MS are needed in order to better understand the impact of the disease on brain development and the resulting effect on cognitive functions, particularly with respect to different therapeutic strategies.
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Affiliation(s)
- Agnese Suppiej
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy
| | - Elisa Cainelli
- Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy ; Lifespan Cognitive Neuroscience Laboratory (LCNL), Department of General Psychology, University of Padua, Italy
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Cappellari A, Cainelli E, Trevisanuto D, Mardari R, Manara R, Suppiej A. 7. Bilateral absence of cortical SEP and neuroimaging: Study of a cohort of 40 neonates suffering from hypoxic-ischemic encephalopathy treated with therapeutic hypothermia. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Toffoli E, Carlo DD, Cappellari A, Cainelli E, Trevisanuto D, Suppiej A. 113. Neurophysiology in neonatal stroke undergoing therapeutic hypotermia: An illustrative case. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tessari L, Bizzaro E, Toffoli E, Cappellari A, Cainelli E, Suppiej A. 111. The utility of video EEG in very early prematurity: A case of twin babies. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cainelli E, Cappellari A, Bisiacchi P, Trevisanuto D, Suppiej A. 60. Spectral analysis of the neurophysiological activity in the human developing brain. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nosadini M, Sartori S, Toldo I, Cappellari A, de Palma L, Cainelli E, Zuliani L, Giometto B, Boniver C, Suppiej A. 114. Movement disorder and EEG patterns in anti-NMDAr antibodies encephalitis. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.06.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bartolini L, Sartori S, Lenzini E, Rigon C, Cainelli E, Agrati C, Toldo I, Donà M, Trevisson E. De novo trisomy 20p characterized by array comparative genomic hybridization: report of a novel case and review of the literature. Gene 2013; 524:368-72. [PMID: 23612255 DOI: 10.1016/j.gene.2013.04.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 03/11/2013] [Accepted: 04/02/2013] [Indexed: 10/26/2022]
Abstract
We report on a boy with speech delay, mental retardation, motor clumsiness, hyperactivity, dysmorphic facial features, brachytelephalangy and short stature. Electrocardiogram, echocardiography, renal ultrasound, electroencephalogram, fundoscopic exam and auditory brainstem responses were all normal. Brain magnetic resonance imaging showed a left temporal arachnoid cyst and a small pineal gland cyst. High resolution karyotype and FISH analysis detected a de novo duplication of the short arm of chromosome 20. A molecular characterization of the chromosomal anomaly was performed by array-CGH, confirming a 17.98 Mb duplication of the short arm of chromosome 20 associated with a small duplication on chromosome 3p, that was shown to be maternally inherited. This is one of the few cases of de novo trisomy 20p with extensive workup, characterization at molecular level and close follow-up from the neonatal period to age 30 months. We also compared the phenotype of our patient with that previously reported in literature, therefore contributing to better define the trisomy 20p syndrome and helping pediatricians and geneticists to better counsel families about the developmental prognosis of these children.
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Affiliation(s)
- Luca Bartolini
- Child Neurology Unit, Department of Women's and Children's Health, University of Padua, Italy.
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Suppiej A, Cainelli E, De Benedittis M, Rizzardi E, Bisiacchi PS, Ermani M, Orzan E, Zanardo V. Failure of hearing screening in high-risk neonates does not increase parental anxiety. J Matern Fetal Neonatal Med 2013; 26:932-5. [PMID: 23327442 DOI: 10.3109/14767058.2013.766687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to determine whether a failure of neonatal hearing screening affected the anxiety level of parents of high-risk infants. METHODS Two hundred and eighty-eight parents of infants included in the neonatal hearing screening protocol of our Institution were tested with the Spielberger State-Trait Anxiety Inventory and with an open-question questionnaire investigating parents' attitude to hearing problems in their child, done at the time of audiological follow-up. 105 were parents of high-risk infants who had been discharged from neonatal intensive care unit (NICU) and 183 of low-risk infants discharged from well-baby nursery. RESULTS No differences in anxiety levels were seen between parents of high-risk infants passing and failing neonatal hearing screening using homogeneous case-control pairs. Additionally, no differences in the level of anxiety were found between parents of high- and low-risk infants failing neonatal auditory screening. CONCLUSIONS Failure of neonatal auditory screening does not affect the anxiety levels of parents of high-risk infants at post discharge from NICU. This finding is a key factor to be considered when evaluating the costs and benefits of tests for universal neonatal hearing screening.
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Affiliation(s)
- A Suppiej
- Child Neurology and Clinical Neurophysiology, Paediatric University Hospital, Padua, Italy.
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