Cassidy Adam R, Newburger Jane W, Bellinger David C
1Department of Psychiatry,Boston Children's Hospital,Harvard Medical School, Boston,Massachusetts.
2Department of Cardiology,Boston Children's Hospital,Harvard Medical School,Boston,Massachusetts.
J Int Neuropsychol Soc. 2017 Sep;23(8):627-639. doi: 10.1017/S1355617717000443. Epub 2017 Jun 20.
Although evidence exists of broadly defined memory impairment among adolescents with critical congenital heart disease (CHD), nuanced investigations of declarative memory in this at-risk population have not been conducted. This study had two primary aims: (1) to conduct a fine-grained analysis of a range of relevant learning and memory processes in adolescents with critical biventricular CHD, and (2) to identify risk, odds, and predictors of memory impairment.
Data were combined from two single-center studies of neurodevelopmental outcomes in critical CHD. Two-hundred seven adolescents (M age =15.61±1.0 years) with critical CHD (139 with dextro-transposition of the great arteries and 68 with tetralogy of Fallot without an identified genetic condition), as well as 61 healthy referents (M age =15.27±1.1 years) completed a neuropsychological evaluation which included the Children's Memory Scale.
Whereas visual-spatial memory deficits were found in both CHD subgroups, verbal memory abilities were relatively preserved. Adolescents with CHD demonstrated stronger memory for Stories than Word Pairs, t (203)=2.63, p=.009, and for Dot Locations than Faces, t(204)=-2.57, p=.01. CHD subgroup, socioeconomic status, sex, and seizure history were among the most frequent significant predictors of memory impairment. Seizure history, in particular, was associated with a 2 to 3 times greater odds of impaired performance on learning and memory tasks.
Adolescents with critical biventricular CHD are at risk for deficits in aspects of declarative memory. Independent risk factors for worse outcome include history of seizures. (JINS, 2017, 23, 627-639).
尽管有证据表明患有严重先天性心脏病(CHD)的青少年存在广义上的记忆障碍,但尚未对这一高危人群的陈述性记忆进行细致的研究。本研究有两个主要目的:(1)对患有严重双心室CHD的青少年的一系列相关学习和记忆过程进行细粒度分析,(2)确定记忆障碍的风险、几率和预测因素。
数据来自两项关于严重CHD神经发育结局的单中心研究。207名患有严重CHD的青少年(平均年龄=15.61±1.0岁)(139名患有大动脉右位转位,以及68名患有法洛四联症且未发现遗传疾病),以及61名健康对照者(平均年龄=15.27±1.1岁)完成了一项神经心理学评估,其中包括儿童记忆量表。
虽然在两个CHD亚组中均发现视觉空间记忆缺陷,但言语记忆能力相对保留。患有CHD的青少年对故事的记忆强于对单词对的记忆,t(203)=2.63,p=0.009;对点位置的记忆强于对面孔的记忆,t(204)=-2.57,p=0.01。CHD亚组、社会经济地位、性别和癫痫病史是记忆障碍最常见的重要预测因素。特别是癫痫病史与学习和记忆任务表现受损的几率高出2至3倍有关。
患有严重双心室CHD的青少年存在陈述性记忆方面缺陷的风险。预后较差的独立危险因素包括癫痫病史。(《神经心理学杂志》,2017年,23卷,627 - 639页)