Miller Jennifer, Kranzler John, Liu Yijun, Schmalfuss Ilona, Theriaque Douglas W, Shuster Jonathan J, Hatfield Ann, Mueller O Thomas, Goldstone Anthony P, Sahoo Trilochan, Beaudet Arthur L, Driscoll Daniel J
Department of Pediatrics and the Center for Mammalian Genetics, University of Florida, College of Medicine, Gainesville, Florida 32610-0296, USA.
J Pediatr. 2006 Aug;149(2):192-8. doi: 10.1016/j.jpeds.2006.04.013.
To examine whether early-onset morbid obesity is associated with cognitive impairment, neuropathologic changes, and behavioral problems.
This case-control study compared head MRI scans and cognitive, achievement, and behavioral evaluations of subjects with Prader-Willi syndrome (PWS), early-onset morbid obesity (EMO), and normal-weight sibling control subjects from both groups. Head MRI was done on 17 PWS, 18 EMO, and 21 siblings, and cognitive, achievement, and behavioral evaluations were done on 19 PWS, 17 EMO, and 24 siblings.
The mean General Intellectual Ability score of the EMO group was 77.4 +/- 17.8; PWS, 63.3 +/- 14.2; and control subjects, 106.4 +/- 13.0. Achievement scores for the three groups were EMO, 78.7 +/- 18.8; PWS, 71.2 +/- 17.0; and control subjects, 104.8 +/- 17.0. Significant negative behaviors and poor adaptive skills were found in the EMO group. White matter lesions were noted on brain MRI in 6 subjects with PWS and 5 with EMO. None of the normal-weight control subjects had these findings.
Individuals with EMO have significantly lower cognitive function and more behavioral problems than control subjects with no history of childhood obesity. Both EMO and PWS subjects have white matter lesions on brain MRI that have not previously been described.
研究早发性病态肥胖是否与认知障碍、神经病理变化及行为问题相关。
本病例对照研究比较了普拉德-威利综合征（PWS）患者、早发性病态肥胖（EMO）患者以及两组正常体重的同胞对照者的头部MRI扫描结果、认知、学业及行为评估情况。对17名PWS患者、18名EMO患者和21名同胞进行了头部MRI检查，对19名PWS患者、17名EMO患者和24名同胞进行了认知、学业及行为评估。
EMO组的平均一般智力能力得分为77.4±17.8；PWS组为63.3±14.2；对照组为106.4±13.0。三组的学业成绩分别为：EMO组78.7±18.8；PWS组71.2±17.0；对照组104.8±17.0。在EMO组中发现了显著的负面行为和较差的适应能力。脑部MRI显示，6名PWS患者和5名EMO患者有白质病变。正常体重的对照者均无这些表现。
与无儿童肥胖史的对照者相比，EMO患者的认知功能显著较低，行为问题更多。EMO患者和PWS患者在脑部MRI上均有白质病变，此前未见相关描述。
