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生酮饮食疗法(KDT)开始的时机及其对葡萄糖转运蛋白1缺陷综合征(Glut1-DS)患儿认知特征的影响——一项初步研究

Timing of Ketogenic Dietary Therapy (KDT) Introduction and Its Impact on Cognitive Profiles in Children with Glut1-DS-A Preliminary Study.

作者信息

Barthold Martina, Jurkutat Anne, Goetz Regina, Schubring Lucia, Spiegler Juliane, Fries Ann-Sophie, Kiesel Lucia, Klepper Joerg

机构信息

Department of Special Education and Therapy in Language and Communication Disorders, Julius Maximilians University, 97074 Wuerzburg, Germany.

Department of Neuropediatrics, Children's Hospital Aschaffenburg-Alzenau, 63739 Aschaffenburg, Germany.

出版信息

Children (Basel). 2023 Apr 3;10(4):681. doi: 10.3390/children10040681.

Abstract

UNLABELLED

The aim of this research was to characterize cognitive abilities in patients with Glut1-Deficiency syndrome (Glut1DS) following ketogenic diet therapy (KDT).

METHODS

The cognitive profiles of eight children were assessed using the Wechsler Intelligence Scale (WISC-IV). The effect of ketogenic diet therapy (KDT) on individual subareas of intelligence was analyzed considering the potential influence of speech motor impairments.

RESULTS

Patients with Glut1DS showed a wide range of cognitive performance levels. Some participants showed statistically and clinically significant discrepancies between individual subdomains of intelligence. Both variables, KDT initiation as well as duration, had a positive effect on the overall IQ score. Significant correlations were partially found between the time of KDT initiation and the level of IQ scores, depending on the presence of expressive language test demands of the respective subtests of the WISC-IV. Accordingly, the participants benefited les in the linguistic cognitive domain. The discrepancies in cognitive performance profiles of patients with Glut1DS can be attributed to the possibility of a negative distortion of the results due to the influence of speech motor impairments.

CONCLUSIONS

The individual access skills of test persons should be more strongly considered in test procedures for the assessment of intelligence to reduce the negative influence of motor deficits on test performance. Specific characterization and systematization of the speech disorder are indispensable for determining the severity of speech motor impairment in Glut1DS. Therefore, a stronger focus on dysarthria during diagnosis and therapy is necessary.

摘要

未标注

本研究的目的是对生酮饮食疗法(KDT)后的葡萄糖转运蛋白1缺乏综合征(Glut1DS)患者的认知能力进行特征描述。

方法

使用韦氏智力量表(WISC-IV)对8名儿童的认知概况进行评估。考虑到言语运动障碍的潜在影响,分析了生酮饮食疗法(KDT)对智力各个子领域的影响。

结果

Glut1DS患者表现出广泛的认知表现水平。一些参与者在智力的各个子领域之间表现出统计学和临床上的显著差异。KDT开始时间和持续时间这两个变量对总体智商得分都有积极影响。根据WISC-IV各个子测试的表达性语言测试要求,在KDT开始时间和智商得分水平之间部分发现了显著相关性。因此,参与者在语言认知领域受益较少。Glut1DS患者认知表现概况的差异可归因于言语运动障碍影响导致结果出现负面偏差的可能性。

结论

在智力评估的测试程序中应更加强烈地考虑测试对象的个体获取技能,以减少运动缺陷对测试表现的负面影响。言语障碍的具体特征描述和系统化对于确定Glut1DS中言语运动障碍的严重程度是必不可少的。因此,在诊断和治疗期间有必要更加强调构音障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b82/10136870/3351bfb330a6/children-10-00681-g001.jpg

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