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Neurocognitive functioning in children with mild and moderate asthma in the childhood asthma management program. The
R D Annett1, E H Aylward, J Lapidus
1University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Insights
Childhood asthma severity did not impact neurocognitive function in children participating in the CAMP trial. Asthma symptoms and lung function measures showed differences between mild and moderate cases, but neurocognitive outcomes remained consistent across groups.
Area of Science:
- Pediatric Pulmonology
- Neuropsychology
- Clinical Trials
Background:
- The Childhood Asthma Management Program (CAMP) is a major clinical trial investigating anti-inflammatory treatments for mild to moderate childhood asthma.
- Asthma's potential impact on cognitive development is a growing area of research.
Purpose of the Study:
- To examine the relationship between asthma severity and neurocognitive functioning in children enrolled in the CAMP trial.
- To determine if asthma symptoms or lung function predict neurocognitive outcomes.
Main Methods:
- Asthma severity was assessed using clinical history, spirometry, and methacholine challenge tests.
- Symptom severity, nighttime awakenings, and rescue inhaler use were recorded daily.
- Neurocognitive function was evaluated using comprehensive assessments of intelligence, attention, memory, and academic achievement.
Main Results:
- Children with moderate asthma exhibited significantly poorer lung function and more severe symptoms compared to those with mild asthma.
- No significant differences in neurocognitive variables were observed between children with mild and moderate asthma.
- Neurocognitive variables did not predict asthma outcomes, even after controlling for socioeconomic status.
Conclusions:
- Asthma severity, as defined by symptoms and lung function, is not associated with neurocognitive functioning in children with mild to moderate asthma.
- Neurocognitive performance in this cohort aligns with national averages, suggesting asthma does not impair cognitive development in these cases.
Background:
The Childhood Asthma Management Program (CAMP) is a multicenter double-blind, randomized, placebo-controlled, clinical trial of two anti-inflammatory agents and placebo in children with mild and moderate asthma.
Objective:
The interrelationship between asthma severity and neurocognitive functioning among 1041 children (age range, 5-12 years) enrolled in the CAMP trial was examined.
Methods:
Asthma severity was established at baseline with a clinical history of asthma symptomatology and measures of lung function (spirometry and methacholine challenge). Diary cards were used in a screening to record nighttime awakenings and doctor contacts caused by asthma symptoms, symptom severity, and number of puffs from a rescue inhaler. All children received a comprehensive neurocognitive assessment at the end of the 28-day screening period (before randomization), including measures of intelligence, attention, memory, and academic achievement.
Results:
Significant differences were found between children with mild and moderate asthma on lung function and symptom outcome variables (log(e)FEV(1)PC(20), DeltaFEV(1) percent predicted, change in peak flow percent predicted, nighttime awakenings caused by asthma, average symptom severity score, and average daily number of puffs from a rescue inhaler) but not on neurocognitive variables. Multiple regression analyses revealed that asthma outcomes could not be predicted by neurocognitive variables despite controlling for socioeconomic status. The prevalence of neurocognitive dysfunction, as indicated by the use of psychostimulant medication, was found to be consistent with that found in the existing literature.
Conclusion:
Mild and moderate asthma symptoms are not related to neurocognitive functioning in the children enrolled in CAMP. Mean performance on neurocognitive variables was found to be similar to that of national normative data.
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