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意大利 NF1 患儿的神经心理学特征及其与神经影像学数据的关系:初步研究结果。

Neuropsychological profile in Italian children with neurofibromatosis type 1 (NF1) and their relationships with neuroradiological data: Preliminary results.

机构信息

Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Italy.

Child Neurology and Psychiatry Unit, Azienda Ospedaliero Universitaria, Policlinico S. Orsola-Malpighi, Bologna, Italy.

出版信息

Eur J Paediatr Neurol. 2018 Sep;22(5):822-830. doi: 10.1016/j.ejpn.2018.04.016. Epub 2018 May 4.

Abstract

BACKGROUND

Neurofibromatosis type 1 is a genetic disorder associated with cognitive deficits, learning disabilities and behavioral problems. These domains appear to have a still controversial debated association with local areas of T2-hyperintensities on MRI images, called unidentified bright objects (UBOs).

METHODS

A cohort of 36 children (aged 7-11 years) included consecutively, underwent neuropsychological and behavioral assessment to determine their cognitive and neuropsychological profile, and the frequency of specific learning disabilities. MRI examination was used to determine the impact of UBOs' presence, number, and location on the cognitive, neuropsychological and behavioral profile, and also the presence of optic glioma.

RESULTS

The mean full intelligence quotient was 104.6; only one child had mild intellectual disability. Forty one percent of children had a diagnosis of specific learning disabilities and reading was mainly involved. Twenty per cent had attention problems. All children had normal scores in visuo-motor and visuo-perceptual tests. UBOs were present in 94.0% of the MRI examinations. Two children had optic glioma. Children with UBOs in a specific location and children with UBOs elsewhere were statistically compared, no one of the location seemed to have an impact on general cognition measured with full intelligence quotient. The thalamus was associated with problems in calculation and striatum with behavioral problems. An inverse relationship between the number of UBOs and the full intelligence quotient was present, but without a statistical significance.

CONCLUSIONS

In this study, the specific location of UBOs did not seem to influence the general cognitive profile and also the relationship between their number and the full intelligence quotient was not significant; these results are still controversial in literature. Finally, the presence of UBOs in the thalamus and striatum may represent a neuroradiological pattern that influences performances in calculation and behavior respectively in children with Neurofibromatosis type 1.

摘要

背景

神经纤维瘤病 1 型是一种与认知缺陷、学习障碍和行为问题相关的遗传疾病。这些领域似乎与 MRI 图像上称为未识别的明亮物体(UBO)的局部 T2 高信号区域有仍有争议的关联。

方法

本研究纳入了一组 36 名年龄在 7-11 岁的儿童,他们接受了神经心理学和行为评估,以确定他们的认知和神经心理学特征,以及特定学习障碍的频率。MRI 检查用于确定 UBO 的存在、数量和位置对认知、神经心理学和行为特征的影响,以及视神经胶质瘤的存在。

结果

平均总智商为 104.6;只有一名儿童有轻度智力障碍。41%的儿童有特定学习障碍的诊断,主要涉及阅读障碍。20%的儿童有注意力问题。所有儿童在视动和视知觉测试中均有正常分数。94.0%的 MRI 检查中存在 UBO。两名儿童患有视神经胶质瘤。对存在特定位置 UBO 的儿童和存在其他位置 UBO 的儿童进行统计学比较,没有一个位置似乎对全智商测量的总体认知有影响。丘脑与计算问题有关,纹状体与行为问题有关。UBO 数量与全智商呈负相关,但无统计学意义。

结论

在本研究中,UBO 的特定位置似乎不会影响总体认知特征,其数量与全智商之间的关系也不显著;这些结果在文献中仍存在争议。最后,丘脑和纹状体 UBO 的存在可能代表一种神经影像学模式,分别影响神经纤维瘤病 1 型儿童的计算和行为表现。

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