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学龄期患有 Shwachman-Diamond 综合征儿童的行为表型表明存在神经认知功能障碍,其 Shwachman-Bodian-Diamond 综合征基因功能丧失。

The behavioral phenotype of school-age children with shwachman diamond syndrome indicates neurocognitive dysfunction with loss of Shwachman-Bodian-Diamond syndrome gene function.

机构信息

Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada.

出版信息

J Pediatr. 2010 Mar;156(3):433-8. doi: 10.1016/j.jpeds.2009.09.026. Epub 2009 Nov 10.

Abstract

OBJECTIVE

To investigate the cognitive, behavioral and adaptive functioning of children with Shwachman-Diamond syndrome (SDS).

STUDY DESIGN

Thirty-two children with SDS (6-17 years) were evaluated by use of standardized neuropsychological tests. Results were compared with normative data, unaffected siblings (n = 13), and age-and sex-matched children with cystic fibrosis (CF; n = 20).

RESULTS

Although intragroup variability in performance was evident, children with SDS displayed weaker overall intellectual reasoning, higher-order language skills, perceptual reasoning, visual-motor processing speed, visual motor- integration, visual executive problem-solving, attention, and aspects of academic achievement, as well as lower functional level of independence relative to the general population. Significant issues with behavior were also identified, including prior formal diagnoses and social problems. Lower abilities were found relative to sibling and CF control subjects and were not associated with secondary complications of SDS, age, or sex.

CONCLUSION

Neurocognitive deficits in subjects with SDS are largely independent of family environment and having a chronic illness and are likely the consequences of Shwachman-Bodian-Diamond syndrome gene dysfunction. There is a need for a broad-based approach to the assessment of cognitive function and appropriate remediation of individuals with SDS.

摘要

目的

研究 Shwachman-Diamond 综合征(SDS)患儿的认知、行为和适应功能。

研究设计

对 32 名 SDS 患儿(6-17 岁)进行了标准化神经心理学测试评估。将结果与正常数据、无影响的同胞(n=13)和年龄及性别匹配的囊性纤维化(CF;n=20)患儿进行了比较。

结果

尽管组内个体的表现存在差异,但 SDS 患儿的整体智力推理能力、高级语言技能、感知推理能力、视觉运动处理速度、视觉运动整合能力、视觉执行问题解决能力、注意力以及学业成绩的某些方面较弱,且相对于一般人群,其独立生活的功能水平较低。还发现了明显的行为问题,包括先前的正式诊断和社交问题。与同胞和 CF 对照组相比,SDS 患儿的能力较低,且与 SDS 的次要并发症、年龄或性别无关。

结论

SDS 患儿的神经认知缺陷在很大程度上独立于家庭环境和慢性疾病,可能是 Shwachman-Bodian-Diamond 综合征基因功能障碍的结果。需要采用一种广泛的方法来评估认知功能,并对 SDS 患儿进行适当的矫正。

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