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Neurocognitive function in children with obstructive sleep apnoea syndrome due to adenotonsillar hypertrophy

Neurocognitive function in children with obstructive sleep apnoea syndrome due to adenotonsillar hypertrophy
Neurocognitive function in children with obstructive sleep apnoea syndrome due to adenotonsillar hypertrophy
OBJECTIVE: It is clear from epidemiological studies that there are increased rates of behavioural cognitive and educational disturbance amongst sleep disturbed children in general. However these problems are particularly common in the context of upper airways obstruction due to adenotonsillar hypertrophy. In the worst cases this may result in obstructive sleep apnoea syndrome (OSAS) characterised by prolonged partial upper airways obstruction (hypopnea) and/or intermittent complete obstruction (apnoea) that disrupts both gas exchange (hypercarbia and hypoxia) and normal sleep (arousals). The causal pathway for neurocognitive deficits is unclear. Beebe and Gozal proposed that frontal lobe function may be adversely affected by the hypoxia and sleep arousals characteristic of OSAS. Animal models have also suggested that hypoxia leads to long-term changes in frontal dopaminergic pathways . However without evidence of functional brain abnormality the implications for a similar pathophysiology in children with OSAS remain implied but not confirmed.
METHOD: In order to address this limitation of the literature we used a combination of neuropsychological non-invasive transcranial Doppler and event-related potential techniques. Here we present preliminary analyses obtained from 17 children (3-7 years) with OSAS (apnoea-hypopnoea index > 1) confirmed by attended polysomonography and 14 healthy controls of similar age.
RESULTS: These data reveal significantly increased levels of abnormal behaviour assessed by the Behaviour Rating Inventory of Executive Function (BRIEF(P)) in OSAS children (p<.05) but mean IQ scores (WPPSI-III) are in the average range in both groups. Importantly velocity of blood flow in the middle cerebral artery was significantly increased in OSAS children (p<.001) and correlated positively with BRIEF(P) scores.
CONCLUSION: The finding of significant group differences on behavioural measures supports previous studies. We now extend the literature by providing novel evidence of abnormal brain function.
28-29
Hogan, A.M.
42ccf5b5-98d7-4ce7-b09a-ea482dfe8447
Onugha, N.N.
b6daf62d-82c3-4983-9b75-6b96819b5bf9
Harrison, D.
fd368c13-f185-41de-a326-e507b4366535
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Datta, A.
6de2211f-524f-443b-9a09-ee64820f7b7f
McGrigor, V.
368269fa-269c-4672-8b7c-60a837e74e52
Stevenson, J.
3d9ea18b-ebfe-4947-9e9e-aaf1b7ab09d4
Hill, C.M.
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d
Hogan, A.M.
42ccf5b5-98d7-4ce7-b09a-ea482dfe8447
Onugha, N.N.
b6daf62d-82c3-4983-9b75-6b96819b5bf9
Harrison, D.
fd368c13-f185-41de-a326-e507b4366535
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Datta, A.
6de2211f-524f-443b-9a09-ee64820f7b7f
McGrigor, V.
368269fa-269c-4672-8b7c-60a837e74e52
Stevenson, J.
3d9ea18b-ebfe-4947-9e9e-aaf1b7ab09d4
Hill, C.M.
867cd0a0-dabc-4152-b4bf-8e9fbc0edf8d

Hogan, A.M., Onugha, N.N., Harrison, D., Kirkham, F.J., Datta, A., McGrigor, V., Stevenson, J. and Hill, C.M. (2005) Neurocognitive function in children with obstructive sleep apnoea syndrome due to adenotonsillar hypertrophy. Congress of the European Academy of Childhood Disability [EACD], Monaco. 19 - 22 Nov 2005. pp. 28-29 .

Record type: Conference or Workshop Item (Other)

Abstract

OBJECTIVE: It is clear from epidemiological studies that there are increased rates of behavioural cognitive and educational disturbance amongst sleep disturbed children in general. However these problems are particularly common in the context of upper airways obstruction due to adenotonsillar hypertrophy. In the worst cases this may result in obstructive sleep apnoea syndrome (OSAS) characterised by prolonged partial upper airways obstruction (hypopnea) and/or intermittent complete obstruction (apnoea) that disrupts both gas exchange (hypercarbia and hypoxia) and normal sleep (arousals). The causal pathway for neurocognitive deficits is unclear. Beebe and Gozal proposed that frontal lobe function may be adversely affected by the hypoxia and sleep arousals characteristic of OSAS. Animal models have also suggested that hypoxia leads to long-term changes in frontal dopaminergic pathways . However without evidence of functional brain abnormality the implications for a similar pathophysiology in children with OSAS remain implied but not confirmed.
METHOD: In order to address this limitation of the literature we used a combination of neuropsychological non-invasive transcranial Doppler and event-related potential techniques. Here we present preliminary analyses obtained from 17 children (3-7 years) with OSAS (apnoea-hypopnoea index > 1) confirmed by attended polysomonography and 14 healthy controls of similar age.
RESULTS: These data reveal significantly increased levels of abnormal behaviour assessed by the Behaviour Rating Inventory of Executive Function (BRIEF(P)) in OSAS children (p<.05) but mean IQ scores (WPPSI-III) are in the average range in both groups. Importantly velocity of blood flow in the middle cerebral artery was significantly increased in OSAS children (p<.001) and correlated positively with BRIEF(P) scores.
CONCLUSION: The finding of significant group differences on behavioural measures supports previous studies. We now extend the literature by providing novel evidence of abnormal brain function.

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More information

Published date: 2005
Venue - Dates: Congress of the European Academy of Childhood Disability [EACD], Monaco, 2005-11-19 - 2005-11-22

Identifiers

Local EPrints ID: 27591
URI: http://eprints.soton.ac.uk/id/eprint/27591
PURE UUID: 704e4cf0-e7b1-4c26-9978-79791a9b8662
ORCID for F.J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958
ORCID for C.M. Hill: ORCID iD orcid.org/0000-0003-2372-5904

Catalogue record

Date deposited: 24 May 2006
Last modified: 12 Dec 2021 03:16

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Contributors

Author: A.M. Hogan
Author: N.N. Onugha
Author: D. Harrison
Author: F.J. Kirkham ORCID iD
Author: A. Datta
Author: V. McGrigor
Author: J. Stevenson
Author: C.M. Hill ORCID iD

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