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65 Examining Neuropsychological Outcomes Among Youth Concussion Patients With and Without Neurodevelopmental Learning Disorders
- Christopher Anzalone, Scott L Decker
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 170-171
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Objective:
The increasing incidence rates of concussive injuries, specifically among the youth age demographic, has led to the Center for Disease Control and Prevention to classify these injuries as a “silent epidemic.” While symptoms from concussion typically remit within four weeks, many experience symptoms that persist beyond what is typically expected. For children, the persistence of symptoms can have damaging side-effects that impact daily functioning and the progression through developmental and educational milestones. Recent research highlights factors that modify the nature of outcomes after a concussive injury. For youth-aged individuals, one such factor is the presence of premorbid conditions. A growing body of research suggests children with learning disorders (LDs) may be more susceptible to negative symptom outcomes across neuropsychological domains. Therefore, the purpose of this study is to further examine the influence of developmental learning disorders on concussion outcomes among youths.
Participants and Methods:Youths between 7 and 19 years of age that sought care at a concussion specialty clinic were screened for inclusion in the current study. The final sample of included 54 patients who reported having a neurodevelopmental LD between the ages of 8 and 17 and 54 patients without LDs matched on age, race/ethnicity, and gender to serve as paired case-controls. Measures of post-concussive physical symptoms (Modified Balance Error Scoring System; Quality of Life in Neurological Disorders: Neuro-QoL-SD, Neuro-QoL-F), emotional state (BAI, BDI), parent report measure of behavioral manifestations of cognitive functioning (Behavioral Rating Inventory of Executive Function), and select measures from the CogState automated test battery (i.e., One-Back, Two-Back, Groton Maze Learning, and Groton Maze Recall) were administered during the patient’s first examination at the clinic. Patients were instructed by the provider to follow-up at the clinic between two-three weeks for a repeat examination. The current study examined concussion outcome variables via two (group: LD, control) by two (time: initial examination, follow-up examination) repeated measures ANCOVAs where time between injury and the first examination was included as a covariate to control for the duration of elapsed days since injury.
Results:Regarding cognitive symptoms, parent reported behaviors associated with executive functioning symptoms increased over time to reach clinically significant levels for the LD group, while symptoms decreased and remained within normal limits for the control group. Performance-based measures of cognition revealed no significant interactions or group/time differences. Additionally, the LD group showed more intense balance problems compared to the control group and symptom trends suggest LD participants may be more susceptible to prolonged, clinically significant, balance problems. With respect to sleep disturbances and fatigue, symptoms remained within normal limits across groups and time. Depression and anxiety symptoms remained within normal limits across groups and time as well.
Conclusions:Results highlight more intense balance problems and parent-reported executive dysfunction following concussion for youths with LDs compared to those without LDs. Additionally, though not significantly different
than the control group, results reveal several symptom domains in which the level of dysfunction meets clinical significance for the LD group participants only. As such, this study highlights the continued need for the scientific study of risk factors for vulnerable populations to aid in assessment and prevention efforts, especially for youths with LD.
Arrhythmias in children with ventricular assist devices
- W. Buck Kyle, Jamie Decker, Scott L. Macicek, Santiago O. Valdes, David Morales, Borah Hong, Jack F. Price, William J. Dreyer, Susan W. Denfield, Jeffrey J. Kim
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- Journal:
- Cardiology in the Young / Volume 25 / Issue 2 / February 2015
- Published online by Cambridge University Press:
- 26 November 2013, pp. 255-260
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Background: Children with decompensated heart failure are at high risk for arrhythmias, and ventricular assist device placement is becoming a more common treatment strategy. The impact of ventricular assist devices on arrhythmias and how arrhythmias affect the clinical course of this population are not well described. Methods and results: A single-centre retrospective analysis of children receiving a ventricular assist device between 1998 and 2011 was performed. In all, 45 patients received 56 ventricular assist devices. The median age at initial placement was 13 years (interquartile range 6–15). The median duration of support was 10 days (range 2–260). The aetiology of heart failure included cardiomyopathy, transplant rejection, myocarditis, and congenital heart disease. In all, 32 patients (71%) had an arrhythmia; 19 patients (42%) had an arrhythmia before ventricular assist device and eight patients (18%) developed new arrhythmias on ventricular assist device. Ventricular tachycardia was most common (25/32, 78%). There was no correlation between arrhythmia and risk of death or transplantation (p=0.14). Of the 15 patients who weaned from ventricular assist device, post-ventricular assist device arrhythmias occurred in nine (60%), with five (33%) having their first arrhythmia after weaning. Patients with ventricular dysfunction after ventricular assist device were more likely to have arrhythmias (p<0.02). Conclusions: Arrhythmias, especially ventricular, are common in children requiring ventricular assist device. They frequently persist for those able to wean from ventricular assist device.
Contributors
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- By Aakash Agarwala, Linda S. Aglio, Rae M. Allain, Paul D. Allen, Houman Amirfarzan, Yasodananda Kumar Areti, Amit Asopa, Edwin G. Avery, Patricia R. Bachiller, Angela M. Bader, Rana Badr, Sibinka Bajic, David J. Baker, Sheila R. Barnett, Rena Beckerly, Lorenzo Berra, Walter Bethune, Sascha S. Beutler, Tarun Bhalla, Edward A. Bittner, Jonathan D. Bloom, Alina V. Bodas, Lina M. Bolanos-Diaz, Ruma R. Bose, Jan Boublik, John P. Broadnax, Jason C. Brookman, Meredith R. Brooks, Roland Brusseau, Ethan O. Bryson, Linda A. Bulich, Kenji Butterfield, William R. Camann, Denise M. Chan, Theresa S. Chang, Jonathan E. Charnin, Mark Chrostowski, Fred Cobey, Adam B. Collins, Mercedes A. Concepcion, Christopher W. Connor, Bronwyn Cooper, Jeffrey B. Cooper, Martha Cordoba-Amorocho, Stephen B. Corn, Darin J. Correll, Gregory J. Crosby, Lisa J. Crossley, Deborah J. Culley, Tomas Cvrk, Michael N. D'Ambra, Michael Decker, Daniel F. Dedrick, Mark Dershwitz, Francis X. Dillon, Pradeep Dinakar, Alimorad G. Djalali, D. John Doyle, Lambertus Drop, Ian F. Dunn, Theodore E. Dushane, Sunil Eappen, Thomas Edrich, Jesse M. Ehrenfeld, Jason M. Erlich, Lucinda L. Everett, Elliott S. Farber, Khaldoun Faris, Eddy M. Feliz, Massimo Ferrigno, Richard S. Field, Michael G. Fitzsimons, Hugh L. Flanagan Jr., Vladimir Formanek, Amanda A. Fox, John A. Fox, Gyorgy Frendl, Tanja S. Frey, Samuel M. Galvagno Jr., Edward R. Garcia, Jonathan D. Gates, Cosmin Gauran, Brian J. Gelfand, Simon Gelman, Alexander C. Gerhart, Peter Gerner, Omid Ghalambor, Christopher J. Gilligan, Christian D. Gonzalez, Noah E. Gordon, William B. Gormley, Thomas J. Graetz, Wendy L. Gross, Amit Gupta, James P. Hardy, Seetharaman Hariharan, Miriam Harnett, Philip M. Hartigan, Joaquim M. Havens, Bishr Haydar, Stephen O. Heard, James L. Helstrom, David L. Hepner, McCallum R. Hoyt, Robert N. Jamison, Karinne Jervis, Stephanie B. Jones, Swaminathan Karthik, Richard M. Kaufman, Shubjeet Kaur, Lee A. Kearse Jr., John C. Keel, Scott D. Kelley, Albert H. Kim, Amy L. Kim, Grace Y. Kim, Robert J. Klickovich, Robert M. Knapp, Bhavani S. Kodali, Rahul Koka, Alina Lazar, Laura H. Leduc, Stanley Leeson, Lisa R. Leffert, Scott A. LeGrand, Patricio Leyton, J. Lance Lichtor, John Lin, Alvaro A. Macias, Karan Madan, Sohail K. Mahboobi, Devi Mahendran, Christine Mai, Sayeed Malek, S. Rao Mallampati, Thomas J. Mancuso, Ramon Martin, Matthew C. Martinez, J. A. Jeevendra Martyn, Kai Matthes, Tommaso Mauri, Mary Ellen McCann, Shannon S. McKenna, Dennis J. McNicholl, Abdel-Kader Mehio, Thor C. Milland, Tonya L. K. Miller, John D. Mitchell, K. Annette Mizuguchi, Naila Moghul, David R. Moss, Ross J. Musumeci, Naveen Nathan, Ju-Mei Ng, Liem C. Nguyen, Ervant Nishanian, Martina Nowak, Ala Nozari, Michael Nurok, Arti Ori, Rafael A. Ortega, Amy J. Ortman, David Oxman, Arvind Palanisamy, Carlo Pancaro, Lisbeth Lopez Pappas, Benjamin Parish, Samuel Park, Deborah S. Pederson, Beverly K. Philip, James H. Philip, Silvia Pivi, Stephen D. Pratt, Douglas E. Raines, Stephen L. Ratcliff, James P. Rathmell, J. Taylor Reed, Elizabeth M. Rickerson, Selwyn O. Rogers Jr., Thomas M. Romanelli, William H. Rosenblatt, Carl E. Rosow, Edgar L. Ross, J. Victor Ryckman, Mônica M. Sá Rêgo, Nicholas Sadovnikoff, Warren S. Sandberg, Annette Y. Schure, B. Scott Segal, Navil F. Sethna, Swapneel K. Shah, Shaheen F. Shaikh, Fred E. Shapiro, Torin D. Shear, Prem S. Shekar, Stanton K. Shernan, Naomi Shimizu, Douglas C. Shook, Kamal K. Sikka, Pankaj K. Sikka, David A. Silver, Jeffrey H. Silverstein, Emily A. Singer, Ken Solt, Spiro G. Spanakis, Wolfgang Steudel, Matthias Stopfkuchen-Evans, Michael P. Storey, Gary R. Strichartz, Balachundhar Subramaniam, Wariya Sukhupragarn, John Summers, Shine Sun, Eswar Sundar, Sugantha Sundar, Neelakantan Sunder, Faraz Syed, Usha B. Tedrow, Nelson L. Thaemert, George P. Topulos, Lawrence C. Tsen, Richard D. Urman, Charles A. Vacanti, Francis X. Vacanti, Joshua C. Vacanti, Assia Valovska, Ivan T. Valovski, Mary Ann Vann, Susan Vassallo, Anasuya Vasudevan, Kamen V. Vlassakov, Gian Paolo Volpato, Essi M. Vulli, J. Matthias Walz, Jingping Wang, James F. Watkins, Maxwell Weinmann, Sharon L. Wetherall, Mallory Williams, Sarah H. Wiser, Zhiling Xiong, Warren M. Zapol, Jie Zhou
- Edited by Charles Vacanti, Scott Segal, Pankaj Sikka, Richard Urman
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- Book:
- Essential Clinical Anesthesia
- Published online:
- 05 January 2012
- Print publication:
- 11 July 2011, pp xv-xxviii
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Contributors
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- By Robert S. Agnew, Lara M. Belliston, Daniel M. Blonigen, Michel Boivin, Jeanne Brooks‐Gunn, Andrew Canastar, Noel A. Card, Emil F. Coccaro, Nicki R. Crick, Linda L. Dahlberg, Garth Davies, Scott H. Decker, Kenneth A. Dodge, Dorothy L. Espelage, Jeffrey Fagan, Albert D. Farrell, David P. Farrington, Daniel J. Flannery, Mark S. Fleisher, Vangie A. Foshee, Holly Foster, Richard J. Gelles, Denise C. Gottfredson, Gary D. Gottfredson, Michael R. Gottfredson, Richard E. Heyman, James C. (Buddy) Howell, Megan Q. Howell, Li Huang, L. Rowell Huesmann, Cynthia Irvin, Gary F. Jensen, Yoshito Kawabata, Lucyna Kirwil, Jeff M. Kretschmar, Robert F. Krueger, Markus J. P. Kruesi, Benjamin B. Lahey, Royce Lee, Scott O. Lilienfeld, Todd D. Little, Anne Martin, Rebecca A. Matthew, Stephen C. Maxson, Jacquelyn Mize, Terrie E. Moffitt, Daniel S. Nagin, Jamie M. Ostrov, Christopher J. Patrick, Bowen Paulle, Gregory S. Pettit, Adrian Raine, Soo Hyun Rhee, Angela Scarpa, Jean R. Séguin, Michelle R. Sherrill, Mark I. Singer, Amy M. Smith Slep, Kevin J. Strom, Patrick Sylvers, Patrick H. Tolan, Elizabeth Trejos‐Castillo, Richard E. Tremblay, Manfred van Dulmen, Johan van Wilsem, Alexander T. Vazsonyi, Edelyn Verona, Frank Vitaro, Monique Vulin‐Reynolds, Irwin D. Waldman, Mark Warr, Stanley Wasserman, Deanna L. Wilkinson
- Edited by Daniel J. Flannery, Kent State University, Ohio, Alexander T. Vazsonyi, Auburn University, Alabama, Irwin D. Waldman, Emory University, Atlanta
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- Book:
- The Cambridge Handbook of Violent Behavior and Aggression
- Published online:
- 05 June 2012
- Print publication:
- 03 September 2007, pp xi-xviii
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