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Iowa Gambling Task Performance in Overweight Children and Adolescents at Risk for Obstructive Sleep Apnea

  • Kelly A. McNally (a1), Paula K. Shear (a2), Sarah Tlustos (a3), Raouf. S. Amin (a4) (a5) and Dean W. Beebe (a5) (a6)...
Abstract
Abstract

Obstructive sleep apnea (OSA) is a nocturnal respiratory disorder associated with cognitive and behavioral sequelae, including impairments in executive functioning (EF). Previous literature has focused on “cool” EF, meaning abilities such as working memory and planning that do not involve affective control requirements. Little is known about the impact OSA may have on “hot” EF that involves regulation of affect and risk-related decision-making, and that may be particularly salient during adolescence, when these skills are rapidly developing. This study examined performance on the Iowa Gambling Task (IGT), a task believed to assess aspects of “hot” EF, in overweight adolescents at risk for OSA. Consistent with hypotheses, individuals without OSA made more beneficial decisions on the IGT over time, but participants with OSA did not benefit from feedback and continued to make choices associated with higher initial rewards, but greater long-term losses. The relationship between developmental level and IGT performance was moderated by OSA status. Individuals with OSA did not demonstrate the expected developmental gains in performance during the IGT. This finding suggests that OSA may impact the development of critical aspects of EF, or at least the expression of these skills during the developmentally important period of adolescence. (JINS, 2012, 18, 481–489)

Copyright
Corresponding author
Correspondence and reprint requests to: Kelly McNally, Department of Psychology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205. E-mail: kelly.mcnally@nationwidechildrens.org
References
Hide All
Ali N.J., Stradling J.R. (2000). Epidemiology and natural history of snoring and sleep-disordered breathing. In G.M. Loughlin, J.L. Carroll, and C.L. Marcus (Eds.), Sleep and breathing in children: A developmental approach (pp. 555574). New York: Marcel Dekker.
American Thoracic Society. (1996). Standards and indications for cardiopulmonary sleep studies in children. American Journal of Respiratory and Critical Care Medicine, 153, 866878.
Amin R.S., Kimball T.R., Bean J.A., Jeffries J.L., Willging J.P., Cotton R.T., Daniels S.R. (2002). Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. American Journal of Respiratory and Critical Care Medicine, 165, 13951399.
Anderson S.W., Bechara A., Damasio H., Tranel D., Damasio A.R. (1999). Impairment of social and moral behavior related to early damage in human prefrontal cortex. Nature Neuroscience, 2, 10321037.
Arens R. (2000). Obstructive sleep apnea in childhood. In G.M. Loughlin, J.L. Carroll, and C.L. Marcus (Eds.), Sleep and breathing in children: A developmental approach (pp. 575600). New York: Marcel Dekker.
Bechara A., Damaisio A., Damasio H., Anderson S. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50, 715.
Bechara A., Dolan S., Denburg N., Hindes A., Anderson S., Nathan P. (2001). Decision-making deficits linked to a dysfunctional ventromedial prefrontal cortex revealed in alcohol and stimulant abusers. Neuropsychologia, 39, 376389.
Bechara A., Tranel D., Damasio H. (2000). Characterization of the decision-making deficit of patients with ventromedial prefrontal cortex lesions. Brain, 123, 21892202.
Beebe D.W. (2006). Neurobehavioral morbidity associated with disordered breathing during sleep in children: A comprehensive review. Sleep, 29, 11151134.
Beebe D.W., Gozal D. (2002). Obstructive sleep apnea and the prefrontal cortex: Towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. Journal of Sleep Research, 11, 116.
Beebe D.W., Lewin D., Zeller M., McCabe M., MacLeod K., Daniels S.R., Amin R. (2007). Sleep in overweight adolescents: Shorter sleep, poorer sleep quality, sleepiness, and sleep-disordered breathing. Journal of Pediatric Psychology, 32, 6979.
Beebe D.W., Ris M.D., Kramer M.E., Long E., Amin R. (2010). The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood. Sleep, 33, 144714456.
Beebe D.W., Wells C.T., Jeffries J., Chini B., Kalra M., Amin R. (2004). Neuropsychological effects of pediatric obstructive sleep apnea. Journal of the International Neuropsychological Society, 10, 962975.
Blair R.J., Colledge E., Mitchell D.G. (2001). Somatic markers and response reversal: Is there orbitofrontal cortex dysfunction in boys with psychopathic tendencies? Journal of Abnormal Child Psychology, 29, 499511.
Blakemore S.J., Choudhury S. (2006). Developments of the adolescent brain: Implications for executive function and social cognition. Journal of Child Psychology and Psychiatry, 47, 296312.
Brown H., Prescott R. (2006). Applied mixed models in medicine (pp. 311395). New York: John Wiley & Sons.
Budhiraja R., Parthasarathy S., Drake C.L., Roth T., Sharief I., Budhiraja P., Hudgel D. (2007). Early CPAP use identifies subsequent adherence to CPAP therapy. Sleep, 30(3), 320324.
Carskadon M.A., Acebo C. (1993). A self-administered rating scale for pubertal development. Journal of Adolescent Health, 14, 190195.
Cavedini P., Riboldi G., Keller R., D'Annucci A., Bellodi L. (2002). Frontal lobe dysfunction in pathological gambling patients. Biological Psychiatry, 51, 334341.
Crone E., van der Molen M. (2007). Development of decision making in school-aged children and adolescents: evidence from heart rate and skin conductance analysis. Child Development, 78(4), 12881301.
Crone E.A., Vendel I., van der Molen M.W. (2003). Decision-making in disinhibited adolescents and adults: Insensitivity to future consequences or driven by immediate reward? Personality and Individual Differences, 35, 16251641.
Dahl R. (2004). Adolescent brain development: A period of vulnerabilities and opportunities. Keynote address. Annals of the New York Academy of Sciences, 1021, 122.
Gottfried A.W., Gottfried A.E., Bathurst K., Guerin D.W., Parramore M. (2003). Socioeconomic status in children's development and family environment: Infancy through adolescence. In M. Bornstein & R. Bradley (Eds.), Socioeconomic status, parenting, and child development. Mahway, NJ: Lawrence Erlbaum.
Hooper C.J., Luciana M., Conklin H.M., Yarger R.S. (2004). Adolescents’ performance on the Iowa Gambling Task: Implications for the development of decision making and ventromedial prefrontal cortex. Developmental Psychology, 40, 11481158.
Horne J.A. (1993). Human sleep, sleep loss, and behaviour. British Journal of Psychiatry, 162, 413419.
Julien J.Y., Martin J.G., Ernst P., Olivenstein R., Hamid Q., Lemiere C., Kimoff R.J. (2009). Prevalence of obstruction sleep apnea-hypopnea in severe versus moderate asthma. Journal of Allergy and Clinical Immunology, 124, 371374.
Kheirandish L., Gozal D., Pequignot J.M., Pequignot J., Row B.W. (2005). Intermittent hypoxia during development induces long-term alterations in spatial working memory, monamines, and dendritic branching in rat frontal cortex. Pediatric Research, 58, 594599.
Killgore W.D., Balkin T.J., Wesensten N.J. (2006). Impaired decision making following 49 h of sleep deprivation. Journal of Sleep Research, 15, 713.
Killgore W.D., Killgore D.B., Day L.M., Li C., Kamimori G.H., Balkin T.J. (2007). The effects of 53 hours of sleep deprivation on moral judgment. Sleep, 30(3), 345352.
Lenroot R.K., Giedd J.N. (2006). Brain development in children and adolescents: Insights from anatomical magnetic resonance imaging. Neuroscience and Biobehavioral Reviews, 30, 718729.
Marcus C.L., Omlin K.J., Basinki D.J., Bailey S.L., Rachal A.B., Von Pechmann W.S., Ward S.L. (1992). Normal polysomnographic values for children and adolescents. American Review of Respiratory Disease, 146, 12351239.
McNally K., Rohan J., Pendley J.S., Delameter A., Drotar D. (2010). Executive functioning, treatment adherence and glycemic control in children with type-1 diabetes. Diabetes Care, 33, 11591162.
Mitchell R.B., Kelly J. (2004). Adenotonsillectomy for obstructive sleep apnea in obese children. Otolaryngology Head and Neck Surgery, 131, 104108.
Moffitt T.E., Caspi A., Harrington H., Milne B.J. (2002). Males on the life-course-persistent and adolescence-limited antisocial pathways: Follow-up at age 26 years. Development and Psychopathology, 14(1), 179207.
Owens J., Spirito A., Marcotte A.C., McGuinn M., Berkelhammer L. (2000). Neuropsychological and behavioral correlates of obstructive sleep apnea syndrome in children: A preliminary study. Sleep and Breathing, 4, 6778.
Reavis R., Overman H. (2001). Adult sex differences on a decision-making task previously shown to depend on the orbital prefrontal cortex. Behavioral Neuroscience, 115(1), 196206.
Rechtschaffen A., Kales A. (1968). A manual of standardized terminology: Techniques and scoring system for sleep stages of human subjects. Los Angeles, CA: UCLA Brain Information Service Brain Research Institute.
Row B.W., Kheirandish L., Neville J.J., Gozal D. (2003). Impaired spatial learning and hyperactivity in developing rats exposed to intermittent hypoxia. Pediatric Research, 52, 449453.
Row B.W., Liu R., Xu W., Kheirandish L., Gozal D. (2002). Intermittent hypoxia is associated with oxidative stress and spatial learning deficits in the rat. American Journal of Respiratory and Critical Care Medicine, 167, 15481553.
Uliel S., Tauman R., Greenfield M., Sivan Y. (2004). Normal polysomnographic respiratory values in children and adolescents. Chest, 125, 872878.
Wang L.Y., Chyen D., Lee S., Lowry R. (2008). The association between body mass index in adolescence and obesity in adulthood. Journal of Adolescent Health, 42(5), 512518.
Wechsler D. (2003). WISC-IV technical manual. San Antonio, TX: The Psychological Corporation.
Zelazo P.D., Mueller U. (2002). Executive function in typical and atypical development. In U. Goswami (Ed.), Handbook of childhood cognitive development (pp. 445469). Oxford: Blackwell.
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Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
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