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1.
Dev Med Child Neurol ; 65(8): 1081-1092, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36628521

RESUMO

AIM: To describe the development and initial psychometric evaluation of a new, freely available measure, the Autism Symptom Dimensions Questionnaire (ASDQ). METHOD: After development and revision of an initial 33-item version, informants completed a revised 39-item version of the ASDQ on 1467 children and adolescents (aged 2-17 years), including 104 with autism spectrum disorder (ASD). RESULTS: The initial 33-item version of the ASDQ had good reliability and construct validity. However, only four specific symptom factors were identified, potentially due to an insufficient number of items. Factor analyses of the expanded instrument identified a general ASD factor and nine specific symptom factors with good measurement invariance across demographic groups. Scales showed good-to-excellent overall and conditional reliability. Exploratory analyses of predictive validity for ASD versus neurotypical and other developmental disability diagnoses indicated good accuracy for population and at-risk contexts. INTERPRETATION: The ASDQ is a free and psychometrically sound informant report instrument with good reliability of measurement across a continuous range of scores and preliminary evidence of predictive validity. The measure may be a useful alternative to existing autism symptom measures but further studies with comparison of clinical diagnoses using criterion-standard instruments are needed. WHAT THIS PAPER ADDS: The Autism Symptom Dimensions Questionnaire (ASDQ) is a new, freely available measure of autism symptoms. The ASDQ showed reliable and accurate measurement of autism symptoms. The measure had good screening efficiency for autism spectrum disorder relative to other developmental conditions.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Criança , Adolescente , Humanos , Transtorno Autístico/diagnóstico , Transtorno do Espectro Autista/diagnóstico , Psicometria/métodos , Reprodutibilidade dos Testes , Inquéritos e Questionários
2.
Am J Med Genet A ; 182(7): 1655-1663, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32343043

RESUMO

This study examined sensitivity of eye tracking measures to hyperphagia severity in Prader-Willi syndrome (PWS). Gaze data were collected in 57 children with PWS, age 3-11 years, and 47 typically developing peers at two study sites during free visual exploration of complex stimulus arrays that included images of food, animals, and household objects. Analysis of the number and duration of fixations as well as gaze perseverations revealed that food items are not exceptionally salient for children with PWS. Instead, increased attention to food in the context of other high-interest items (e.g., animals) was associated with caregiver reports of more severe hyperphagia and more advanced nutritional phase. The study also provided preliminary evidence of possible genetic subtype and sex differences as well as demonstrated that multiple investigators in a wide range of settings can effectively implement the eye tracking protocol. The results indicate that gaze characteristics derived from eye tracking may be a promising objective marker of hyperphagia in PWS for use in research and clinical trials.


Assuntos
Tecnologia de Rastreamento Ocular , Hiperfagia/psicologia , Síndrome de Prader-Willi/etiologia , Animais , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Alimentos , Humanos , Masculino , Estimulação Luminosa , Síndrome de Prader-Willi/genética
3.
Support Care Cancer ; 28(5): 2311-2319, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31478164

RESUMO

PURPOSE: Incidence and mortality rates of uterine cancer are increasing and, obesity, which is also rising, has been associated with uterine cancer development and mortality. A recent study found that poor sleep quality is common among endometrial cancer survivors and those with obesity had more sleep disturbances than those having normal weight. However, it is unclear if higher levels of obesity (Class III, BMI ≥ 40 kg/m2), which are rising rapidly, are differentially associated with sleep as well as depression and quality of life in endometrial cancer survivors. METHODS: We evaluated sleep, depression, and quality of life in 100 Stage I endometrial cancer survivors with obesity seeking weight loss enrolled in a lifestyle intervention (NCT01870947) at baseline. RESULTS: The average age was 60 years and mean BMI was 42.1 kg/m2 with 58% having a BMI ≥ 40 kg/m2. Most survivors (72.3%) had poor sleep quality and most (71.2%) reported sleeping < 7 h/night. Survivors with class III compared with class I obesity had significantly more sleep disturbances and daytime dysfunction; and, those with poor sleep had higher depression and lower quality of life. Survivors with a BMI ≥ 50 kg/m2 (~ 25%) had the highest levels of depression and lowest physical and emotional well-being. CONCLUSIONS: Our results reveal that endometrial cancer survivors with class III compared with class I obesity have poorer sleep quality, higher depression, and lower quality of life. Given the rising rates of obesity and uterine cancer mortality, interventions to combat both obesity and poor sleep are needed.


Assuntos
Sobreviventes de Câncer/psicologia , Neoplasias do Endométrio/psicologia , Obesidade/psicologia , Obesidade/terapia , Sono/fisiologia , Índice de Massa Corporal , Depressão , Neoplasias do Endométrio/complicações , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/fisiopatologia , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Obesidade/complicações , Obesidade/fisiopatologia , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Redução de Peso , Programas de Redução de Peso
4.
Dev Med Child Neurol ; 57(7): 639-644, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25614932

RESUMO

AIM: To determine the role of preoperative cranial ultrasound (cUS) in predicting neurodevelopmental outcome in infants undergoing bypass surgery for congenital heart disease (CHD). METHOD: Prospective cohort study on 77 infants (44 males, 33 females) operated before 3 months of age (median age at surgery 10d [range 3-88d]) who received at least one preoperative cUS. Outcome at 1 year was assessed with a standardized neurological examination and the Bayley Scales of Infant Development II (mental developmental index [MDI]; psychomotor developmental index [PDI]). RESULTS: Abnormalities on cUS were detected in 22 (29%) infants and consisted of diffuse brain oedema (n=12, 16%), periventricular white matter injury (n=5, 6%), ventricular dilatation (n=3, 4%), and intraventricular haemorrhage (IVH) (n=2, 3%). Infants undergoing balloon-atrial septostomy (BAS) had a higher rate of subsequent brain oedema than those without BAS (p=0.006). cUS abnormalities were not related to neurodevelopmental outcome. INTERPRETATION: Preoperative cUS findings in infants undergoing bypass surgery for CHD occur rather frequently, consisting of mild lesions such as brain oedema or white matter changes. These findings, however, do not correlate with early neurodevelopmental outcome.

5.
Appetite ; 75: 103-9, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24380884

RESUMO

Obesity is a complex disorder associated with serious health risks. Examining differences in brain activity between normal weight and obese populations in response to food cues may help researchers and clinicians understand the underlying causes of overeating and obesity and help prevent them. Multiple neuroimaging studies have investigated weight differences in functional activity to food cues but have found varying results. We performed six meta-analyses of functional neuroimaging studies of weight differences in response to food images and isolated differences in processing between normal weight and obese participants. Within this study, 7 papers and 3 sets of unpublished data on functional activation to food images were analyzed using an Activation Likelihood Estimation meta-analytic approach. These analyses also addressed how feeding state impacts functional activity between weight groups. Feeding state affected weight related differences in neurofunctional activity triggered by visual food cues. In the premeal state, greater activation in the amygdala/hippocampus was found in obese participants compared to normal weight participants and, in the postmeal state, obese individuals had greater activation in the caudate and medial prefrontal cortex (MPFC) as compared to normal weight individuals. Regions of the brain associated with caloric evaluation, arousal, and memory were more active in the obese before eating, while less activity was found in an area linked to interoceptive processing. In the postmeal state, greater activity was found in the obese in areas related to risk vs. reward evaluation and reward processing. These findings may help researchers and clinicians understand and treat obesity related behaviors by identifying the altered functional regions that lead to obesity, providing a guide for future research on which neural regions need to be the target of further investigation.


Assuntos
Peso Corporal/fisiologia , Neuroimagem , Neurônios/metabolismo , Obesidade/metabolismo , Tonsila do Cerebelo/metabolismo , Sinais (Psicologia) , Ingestão de Alimentos , Hipocampo/metabolismo , Humanos , Hiperfagia/metabolismo , Funções Verossimilhança , Período Pós-Prandial/fisiologia , Córtex Pré-Frontal/metabolismo
6.
Am J Intellect Dev Disabil ; 129(4): 279-293, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38917995

RESUMO

The current study examines the efficacy of an 8-week pretend play intervention targeting social-cognitive abilities in children with Prader-Willi syndrome (PWS), ages 6-9. PWS is a rare disorder associated with various social, emotional, and cognitive challenges linked to pretend play impairments, and for which interventions are sparse. Nineteen children were quasi-randomized to receive the intervention or be part of a waitlist control group. Participants who received the intervention (n = 10) demonstrated significant improvements in various components of pretend play, most notably in organization of play, which may generalize to broader social-cognitive gains. These findings provide evidence of the intervention's efficacy in enhancing pretend play skills and related social-cognitive abilities during this critical period of development for children with PWS.


Assuntos
Síndrome de Prader-Willi , Humanos , Síndrome de Prader-Willi/terapia , Masculino , Feminino , Criança , Jogos e Brinquedos , Ludoterapia/métodos , Cognição Social , Habilidades Sociais
7.
Pediatr Res ; 73(5): 661-7, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23407116

RESUMO

BACKGROUND: Term newborns with congenital heart disease (CHD) show delayed brain development as early as the third trimester, especially in single-ventricle physiology (SVP). Mechanisms causing delayed brain development in CHD are uncertain but may include impaired fetal brain blood flow. Our objective was to determine if cardiac anatomy associated with obstruction to antegrade flow in the ascending aorta is predictive of delayed brain development as measured by diffusion tensor imaging and magnetic resonance spectroscopic (MRS) imaging. METHODS: Echocardiograms from 36 term newborns with SVP were reviewed for the presence of aortic atresia and the diameter of the ascending aorta. Quantitative magnetic resonance imaging parameters measuring brain microstructural (fractional anisotropy (FA) and average diffusivity (Dav)) or metabolic development (N-acetylaspartate (NAA) and lactate/choline (Lac/Cho)) were recorded. RESULTS: Increasing NAA/Cho and white matter (WM) FA, and decreasing Dav and Lac/Cho characterize normal brain development. Consistent with the hypothesis that delayed brain development is related to impaired brain perfusion, smaller ascending aortic diameter and aortic atresia were associated with higher Dav and lower WM FA. Echocardiogram variables were not associated with brain metabolic measures. CONCLUSIONS: These observations support the hypothesis that obstruction to fetal cerebral blood flow impairs brain microstructural development.


Assuntos
Encéfalo/ultraestrutura , Ventrículos Cerebrais/anatomia & histologia , Encéfalo/crescimento & desenvolvimento , Ecocardiografia , Feminino , Humanos , Recém-Nascido , Masculino
8.
Obesity (Silver Spring) ; 31(6): 1558-1568, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37157057

RESUMO

OBJECTIVE: No prior studies have evaluated inhibitory control in people with severe class III compared with class I/II obesity. Thus, the study aim was to evaluate inhibitory control and neural correlates of response inhibition by obesity class using a sample of endometrial cancer (EC) survivors with obesity, who have a higher risk of overall but not cancer-specific mortality. METHODS: Forty-eight stage I EC survivors with obesity (class I/II: n = 21; class III: n = 27) seeking weight loss in a lifestyle intervention at baseline completed a stop signal task during functional magnetic resonance imaging. RESULTS: It was found that participants with class III obesity had a longer stop signal reaction time (mean [SD], 278.8 [51.3] vs. 251.5 [34.0] milliseconds, p < 0.01) compared with those with class I/II obesity, indicating that patients with EC with severe obesity had greater impulsivity and poorer inhibitory control. Results also showed increased activation in the thalamus and superior frontal gyrus for the incorrect versus correct inhibition contrast in class III but not class I/II obesity (whole brain cluster corrected, p < 0.05). CONCLUSIONS: These results provide novel insights into inhibitory control and corresponding neural correlates in severe versus less severe classes of obesity and highlight the importance of targeting inhibitory control processes in weight-loss interventions, particularly for people with severe obesity and greater impulsivity.


Assuntos
Neoplasias do Endométrio , Obesidade Mórbida , Feminino , Humanos , Obesidade/terapia , Redução de Peso , Sobreviventes
9.
Appetite ; 58(1): 303-12, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22063094

RESUMO

The goal of this research is to identify the neural response to rewarding food cues before and after eating in overweight/obese (OB) and normal-weight (NW) adults. Based on the previous literature, we expected greater differential activation to food cues vs. objects for OB compared to NW participants both prior to eating and after consumption of a typical lunch. Twenty-two overweight/obese (11 male) and 16 normal-weight (6 male) individuals participated in a functional magnetic resonance imaging task examining neural response to visual cues of high- and low-calorie foods before and after eating. The OB group demonstrated increased neural response to high- and low-calorie foods after eating in comparison to the NW participants in frontal, temporal, and limbic regions. In addition, greater activation in corticolimbic regions (lateral OFC, caudate, anterior cingulate) to high-calorie food cues was evident in OB vs. NW participants after eating. These findings suggest that for OB individuals, high-calorie food cues show sustained response in brain regions implicated in reward and addiction even after eating. Moreover, food cues did not elicit similar brain response after eating in the NW group suggesting that neural activity in response to food cues diminishes with reduced hunger for these individuals.


Assuntos
Encéfalo/fisiologia , Sinais (Psicologia) , Ingestão de Energia , Alimentos , Obesidade/metabolismo , Adolescente , Adulto , Análise por Conglomerados , Ingestão de Alimentos , Feminino , Humanos , Fome/fisiologia , Imageamento por Ressonância Magnética/métodos , Masculino , Recompensa , Adulto Jovem
10.
J Autism Dev Disord ; 52(12): 5191-5206, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35932366

RESUMO

Prader-Willi Syndrome (PWS) is a rare neurodevelopmental disorder associated with social cognitive challenges, and pretend play has been demonstrated as a tool to achieve developmental goals. Following previous report on feasibility and acceptability of a remote, play-based parent-training program (Zyga, Russ, & Dimitropoulos, 2018), we now report on preliminary efficacy of this program to enhance pretend play skills and social cognitive skills in preschoolers with PWS. Results across two studies demonstrated efficacy when live-coaching play sessions incorporated children into the intervention. Increases in play skills were observed for children with the mUPD subtype of PWS who underwent intervention, compared with children with mUPD who were waitlisted. Children with DEL subtype were less likely to respond to intervention. Implications for results are discussed.


Assuntos
Transtorno do Espectro Autista , Síndrome de Prader-Willi , Criança , Pré-Escolar , Humanos , Síndrome de Prader-Willi/psicologia , Habilidades Sociais , Instituições Acadêmicas , Pais
11.
Artigo em Inglês | MEDLINE | ID: mdl-36554817

RESUMO

At the start of the Coronavirus Disease of 2019 (COVID-19) pandemic, the risk of cases in childcare programs was unknown. Thus, a rapid-response research approach was launched in Ohio childcare settings. Passive surveillance data from a state-operated incident reporting system were evaluated to estimate the number of COVID-19 cases from 15 August 2020 to 1 January 2021. Additionally, active surveillance with self-administered reverse transcriptase-polymerase chain reaction (RT-PCR) tests were conducted among staff at 46 childcare programs. Finally, six zoom-based focus groups with program administrators were used to gain feedback. Staff and children in childcare settings contributed 0.38% and 0.15% of the COVID-19 cases in Ohio during this timeframe, respectively. RT-PCR testing identified 3 unrecognized cases (0.88% of tests), and all occurred when the statewide positivity rate was >5%. Focus groups revealed that access to affordable cleaning supplies, masks, and reliable staffing were critical. Perhaps most importantly, we conclude that expanding the incident reporting system to include a childcare census would allow for the tracking of future health problems with highly valuable incidence rate estimations.


Assuntos
COVID-19 , Criança , Humanos , COVID-19/epidemiologia , Cuidado da Criança , Ohio/epidemiologia , Teste para COVID-19 , Pandemias
12.
Pediatr Res ; 70(6): 614-8, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21857388

RESUMO

Congenital hypothyroidism (CH) can lead to intellectual deficits despite early high-dose treatment. Our study aimed to determine whether motor impairments can occur despite early high-dose treatment. Sixty-three children with CH and early (median age of onset of treatment 9 d), high-dose treatment (median starting dose of levothyroxine 14.7 µg/kg/d) were tested with the Zurich Neuromotor Assessment (ZNA) at a median age of 13.8 y (range 7.0-14.2 y). Median z-scores in the children with CH were -0.95 in the pure and -0.56 in the adaptive fine motor component, significantly lower than in the ZNA test norms (p < 0.001 and p = 0.01, respectively). The 26 children with athyreosis were more affected than the 33 children with dysgenesis, particularly in the pure motor (-1.55 versus -0.76, p = 0.03), adaptive fine motor (-1.31 versus 0.13, p < 0.01), and static balance task (-0.47 versus 0.67, p = 0.01). Boys performed worse than girls. Older age at onset of treatment was related to poorer adaptive fine motor performance. Movement quality (assessed by associated movements) was not affected. We conclude that severe CH can cause neuromotor deficits persisting into adolescence. These deficits cannot completely be reversed by postnatal treatment, but earlier age at treatment may reduce the degree of impairment.


Assuntos
Hipotireoidismo Congênito/tratamento farmacológico , Hipotireoidismo Congênito/fisiopatologia , Destreza Motora/fisiologia , Tiroxina/farmacologia , Adolescente , Análise de Variância , Criança , Feminino , Humanos , Recém-Nascido , Masculino , Destreza Motora/efeitos dos fármacos , Triagem Neonatal , Fatores Sexuais , Suíça , Tiroxina/administração & dosagem , Tiroxina/uso terapêutico , Resultado do Tratamento
13.
J Autism Dev Disord ; 51(2): 576-588, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32556834

RESUMO

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder marked by socio-emotional deficits, and difficulties with pretend play skills. Play skills are related to processes of adaptive functioning and emotion understanding. The present pilot study implemented an in-person pretend play intervention to school-aged children (ages 6 to 9 years, intervention group = 18, control group = 7) diagnosed with high-functioning ASD (HF-ASD), to increase children's cognitive and affective play skills, and emotional understanding abilities. The intervention consisted of 5 weekly sessions, 15-20 minutes each. The intervention group significantly increased in imagination and cognitive play skills, which generalized to increased skills in emotional understanding. Findings demonstrate the positive impact of a short, easily facilitated, accessible play intervention for school-aged children with HF-ASD.


Assuntos
Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Imaginação/fisiologia , Ludoterapia/métodos , Instituições Acadêmicas , Estudantes/psicologia , Criança , Emoções/fisiologia , Feminino , Humanos , Masculino , Projetos Piloto , Resultado do Tratamento
14.
Res Dev Disabil ; 108: 103820, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33307337

RESUMO

Prader-Willi Syndrome (PWS) is characterized by decreased social and emotional functioning. Due to the low base-rate of children with PWS, developing behavioral interventions for individuals with PWS is faced with the challenge of enrolling enough local participants for adequate study of behavioral intervention efficacy. However, these types of studies are greatly needed in PWS and telehealth methodology may be useful in addressing this challenge. This article is a follow-up to a previous feasibility study (Dimitropoulos et al., 2017) and reports on the preliminary efficacy of a telehealth intervention delivered to 15 children, ages 6-12, with PWS. Overall, children demonstrated significantly improved cognitive and affective processes in pretend play and general cognitive flexibility following the 6-week remote intervention. These findings are limited by the lack of control group and small sample size which should be considered when interpreting results. Overall, these preliminary findings point to the potential role pretend play can serve as a means of enacting cognitive and behavioral change via telehealth.


Assuntos
Síndrome de Prader-Willi , Telemedicina , Terapia Comportamental , Criança , Emoções , Estudos de Viabilidade , Humanos , Síndrome de Prader-Willi/terapia
15.
J Neurodev Disord ; 13(1): 25, 2021 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-34148559

RESUMO

Prader-Willi syndrome (PWS) is a rare neurodevelopmental genetic disorder associated with a characteristic behavioral phenotype that includes severe hyperphagia and a variety of other behavioral challenges such as temper outbursts and anxiety. These behaviors have a significant and dramatic impact on the daily functioning and quality of life for the person with PWS and their families. To date, effective therapies addressing these behavioral challenges have proven elusive, but several potential treatments are on the horizon. However, a limiting factor for treatment studies in PWS is the lack of consensus in the field regarding how to best define and measure the complex and interrelated behavioral features of this syndrome. The International PWS Clinical Trials Consortium (PWS-CTC, www.pwsctc.org ) includes expert PWS scientists, clinicians, and patient advocacy organization representatives focused on facilitating clinical trials in this rare disease. To address the above gap in the field, members of the PWS-CTC "Behavior Outcomes Working Group" sought to develop a unified understanding of the key behavioral features in PWS and build a consensus regarding their definition and description. The primary focus of this paper is to present consensus definitions and descriptions of key phenotypic PWS behaviors including hyperphagia, temper outbursts, anxiety, obsessive-compulsive behaviors, rigidity, and social cognition deficits. Patient vignettes are provided to illustrate the interrelatedness and impact of these behaviors. We also review some available assessment tools as well as new instruments in development which may be useful in measuring these behavioral features in PWS.


Assuntos
Síndrome de Prader-Willi , Ansiedade , Consenso , Humanos , Síndrome de Prader-Willi/terapia , Qualidade de Vida
16.
Am J Intellect Dev Disabil ; 125(1): 76-84, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31877257

RESUMO

Early parent-child interactions (PCI) impact social cognitive development. Relatedly, children with various developmental disorders exhibit abnormal parental attachment relationships. Parental characteristics and behaviors can impact PCI and socioemotional development as well. No research has examined the parent-child dynamic in Prader-Willi syndrome (PWS), a neurodevelopmental disorder that presents with social cognitive deficits. This article provides a preliminary characterization of PCI quality and parenting stress in 17 PWS parent-child dyads, children ages 3-5 years, in comparison to 20 typically developing children and their parent. Results suggest early PCI disruption in preschoolers with PWS and their parents report increased levels of stress in various domains. These findings have important implications not only on parent well-being in PWS but its impact on child development.


Assuntos
Relações Pais-Filho , Poder Familiar/psicologia , Síndrome de Prader-Willi/psicologia , Estresse Psicológico/psicologia , Adulto , Pré-Escolar , Feminino , Humanos , Masculino
17.
Nutr Diabetes ; 10(1): 21, 2020 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-32541652

RESUMO

BACKGROUND: The rates of severe or Class III obesity (BMI ≥ 40.0 kg/m2) and endometrial cancer (EC) incidence and mortality have been increasing significantly in the United States. Adults with severe obesity are more likely to die and women with severe obesity have a higher risk of EC development and mortality than those with Class I/II obesity (BMI: 30-<40 kg/m2). However, no prior studies have evaluated the neural response to food cues by obesity severity/class in adults with or without cancer. METHODS: We conducted a functional magnetic resonance imaging visual food cue task in 85 obese Stage I EC survivors who were seeking weight loss in a lifestyle intervention at baseline. We evaluated the neural response to high-calorie vs. non-food images after an overnight fast (fasted state) and after eating a standardized meal (fed state), and grouped patients by obesity class (Class I/II: n = 38; Class III: n = 47). RESULTS: In the fasted state, we found increased activation in several regions including the dorsolateral prefrontal cortex (DLPFC) in Class III and Class I/II patients (whole brain cluster corrected (WBCC), p < 0.05), which was significantly higher in Class III vs. Class I/II (p < 0.05). We found decreased activation in the insula in the fasted state, which was significantly lower in Class I/II vs. Class III (p = 0.03). In the fed state, we found increased activation in the DLPFC in Class III and Class I/II (WBCC, p < 0.05). The increased activation in cognitive control/inhibition regions (DLPFC) is consistent with the summative literature; however, the decreased activation in taste information processing regions (insula) was unexpected. CONCLUSIONS: Our results provide novel insights on food cue response between different classes of obesity and highlight the importance of targeting the DLPFC in weight loss interventions, particularly in severely obese patients. Additional studies examining food-related neural circuitry between different classes of obesity are needed.


Assuntos
Encéfalo/metabolismo , Sobreviventes de Câncer/psicologia , Neoplasias do Endométrio/psicologia , Comportamento Alimentar , Obesidade/psicologia , Idoso , Sinais (Psicologia) , Neoplasias do Endométrio/epidemiologia , Ingestão de Energia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Refeições , Pessoa de Meia-Idade , Obesidade/classificação , Obesidade/epidemiologia , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/psicologia , Córtex Pré-Frontal/metabolismo , Recompensa , Redução de Peso
18.
Pediatr Res ; 65(2): 242-8, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18787501

RESUMO

We aim to determine long-term intellectual outcome of adolescents with early high-dose treated congenital hypothyroidism (CH). Sixty-three prospectively followed children with CH were assessed at age of 14 y with the Wechsler Intelligence Scale for Children-Revised and compared with 175 healthy controls. Median age at onset of treatment was 9 d (range 5-18 d) and median starting dose of levothyroxine (L-T4) was 14.7 microg/kg/d (range 9.9-23.6 microg/kg/d). Full-scale intelligence quotient (IQ) was significantly lower than in controls after adjustment for socioeconomic status (SES) and gender (101.7 versus 111.4; p < 0.0001). Children with athyreosis had a lower performance IQ than those with dysgenesis (adjusted difference 7.6 IQ scores, p < 0.05). Lower initial thyroxine (T4) levels correlated with poorer IQ (r = 0.27, p = 0.04). Lower SES was associated with poorer IQ, in particular in children with CH (interaction, p = 0.03). Treatment during childhood was not related to IQ at age 14 y. Adolescents with CH manifest IQ deficits when compared with their peers despite early high-dose treatment and optimal substitution therapy throughout childhood. Those adolescents with athyreosis and lower SES are at particular risk for adverse outcome. Therefore, early detection of intellectual deficits is mandatory in children with CH.


Assuntos
Desenvolvimento do Adolescente/efeitos dos fármacos , Hipotireoidismo Congênito/tratamento farmacológico , Inteligência/efeitos dos fármacos , Disgenesia da Tireoide/tratamento farmacológico , Glândula Tireoide/anormalidades , Tiroxina/administração & dosagem , Adolescente , Estudos de Casos e Controles , Hipotireoidismo Congênito/sangue , Hipotireoidismo Congênito/diagnóstico , Hipotireoidismo Congênito/psicologia , Feminino , Humanos , Recém-Nascido , Testes de Inteligência , Masculino , Triagem Neonatal , Estudos Prospectivos , Suíça , Disgenesia da Tireoide/sangue , Disgenesia da Tireoide/diagnóstico , Disgenesia da Tireoide/psicologia , Glândula Tireoide/metabolismo , Tireotropina/sangue , Tiroxina/sangue , Fatores de Tempo , Resultado do Tratamento
19.
J Autism Dev Disord ; 49(11): 4441-4454, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31388797

RESUMO

Children with Prader-Willi syndrome (PWS) and autism spectrum disorder (ASD) present with challenges in social cognitive ability, Research comparing PWS to ASD is important given the implication of 15q11-q13 region in the biology of autism. However, recent findings question the accuracy of relying solely on parent report in behavioral characterization. Thus, this study examined social cognition in an observable pretend play task and by parent report in 50 preschool children (ages 3-5) with PWS, by subtype, compared to ASD. Behaviorally, the paternal deletion subtype expressed overall higher functioning, whereas the maternal uniparental disomy subtype performed more similarly to the ASD group. Results are the first to show deficits in social cognitive ability early in development. The severity and differences in deficits between PWS subtypes are important in informing early intervention efforts.


Assuntos
Transtorno do Espectro Autista/psicologia , Cognição , Síndrome de Prader-Willi/psicologia , Habilidades Sociais , Transtorno do Espectro Autista/genética , Pré-Escolar , Feminino , Humanos , Masculino , Síndrome de Prader-Willi/genética , Comportamento Social , Dissomia Uniparental
20.
J Autism Dev Disord ; 38(9): 1642-53, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18311513

RESUMO

Prader-Willi syndrome (PWS) is a neurodevelopmental disorder characterized by hyperphagia and food preoccupations. Although dysfunction of the hypothalamus likely has a critical role in hyperphagia, it is only one of several regions involved in the regulation of eating. The purpose of this research was to examine food-related neural circuitry using functional magnetic resonance imaging in individuals with PWS and matched controls. Individuals with PWS showed increased activation in neural circuitry known to mediate hunger and motivation (hypothalamus, OFC) in response to high- versus low-calorie foods and in comparison to controls. This suggests neural circuitry for PWS is abnormally activated during hunger, particularly for high-calorie foods, and may mediate abnormally strong hunger states, therefore playing a significant role in PWS-induced hyperphagia.


Assuntos
Ingestão de Energia , Alimentos , Rede Nervosa/fisiopatologia , Obesidade/epidemiologia , Síndrome de Prader-Willi/epidemiologia , Síndrome de Prader-Willi/fisiopatologia , Adolescente , Adulto , Criança , Humanos , Hipotálamo/fisiopatologia , Cariotipagem , Imageamento por Ressonância Magnética , Masculino , Córtex Pré-Frontal/fisiopatologia
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