Friedman Bat-Chen, Hendeles-Amitai Ayelet, Kozminsky Ely, Leiberman Alberto, Friger Michael, Tarasiuk Ariel, Tal Asher
Department of Pediatrics B, Faculty of Health Sciences, Sleep-Wake Disorders Unit, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Sleep. 2003 Dec 15;26(8):999-1005. doi: 10.1093/sleep/26.8.999.
To evaluate neurocognitive functions of children with obstructive sleep apnea syndrome (OSAS), before and after adenotonsillectomy, compared with healthy controls.
Prospective study.
Thirty-nine children with OSAS aged 5 to 9 years (mean age, 6.8 +/- 0.2 years) and 20 healthy children (mean age, 7.4 +/- 1.4 years) who served as controls, underwent a battery of neurocognitive tests containing process-oriented intelligence scales. Twenty-seven children in the OSAS group underwent follow-up neurocognitive testing 6 to 10 months after adenotonsillectomy. Fourteen children in the control group were also reevaluated 6 to 10 months after the first evaluation.
Children with OSAS had lower scores compared with healthy children in some Kaufman Assessment Battery for Children (K-ABC) subtests and in the general scale Mental Processing Composite, indicating impaired neurocognitive function. No correlation was found between neurocognitive performance and OSAS severity. Six to 10 months after adenotonsillectomy, the children with OSAS demonstrated significant improvement in sleep characteristics, as well as in daytime behavior. Their neurocognitive performance improved considerably, reaching the level of the control group in the subtests Gestalt Closure, Triangles, Word Order, and the Matrix analogies, as well as in the K-ABC general scales, Sequential and Simultaneous Processing scales, and the Mental Processing Composite scale. The magnitude of the change expressed as effect sizes showed medium and large improvements in all 3 general scales of the K-ABC tests.
Neurocognitive function is impaired in otherwise healthy children with OSAS. Most functions improve to the level of the control group, indicating that the impaired neurocognitive functions are mostly reversible, at least 3 to 10 months following adenotonsillectomy.
评估阻塞性睡眠呼吸暂停综合征（OSAS）患儿在腺样体扁桃体切除术前和术后的神经认知功能，并与健康对照组进行比较。
前瞻性研究。
39名年龄在5至9岁（平均年龄6.8±0.2岁）的OSAS患儿以及20名作为对照的健康儿童（平均年龄7.4±1.4岁）接受了一系列包含以过程为导向的智力量表的神经认知测试。OSAS组中的27名儿童在腺样体扁桃体切除术后6至10个月接受了随访神经认知测试。对照组中的14名儿童在首次评估后6至10个月也进行了重新评估。
在一些考夫曼儿童评估量表（K-ABC）子测试以及一般量表心理加工综合得分方面，OSAS患儿的得分低于健康儿童，表明神经认知功能受损。未发现神经认知表现与OSAS严重程度之间存在相关性。腺样体扁桃体切除术后6至10个月，OSAS患儿的睡眠特征以及白天行为有显著改善。他们的神经认知表现有了相当大的改善，在完形闭合、三角形、词序和矩阵类比子测试以及K-ABC一般量表、序列和同时加工量表以及心理加工综合量表方面达到了对照组的水平。以效应量表示的变化幅度显示，K-ABC测试的所有3个一般量表都有中等和较大程度的改善。
在其他方面健康的OSAS患儿中，神经认知功能受损。大多数功能改善到对照组的水平，表明受损的神经认知功能大多是可逆的，至少在腺样体扁桃体切除术后3至10个月是这样。
