Related Experiment Videos
Some factors relating to intelligence in treated children with spina bifida cystica
Insights
Early indicators at birth, specifically pallium thickness and lesion sensory level, predict intelligence in children with spina bifida cystica. These factors are more reliable than shunt function or revisions for assessing cognitive development.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
- Clinical Pediatrics
Background:
- Spina bifida cystica is a complex congenital condition impacting neurological development.
- Management of spina bifida cystica often involves surgical interventions like shunts.
- Long-term neurodevelopmental outcomes require further investigation.
Purpose of the Study:
- To assess intelligence and developmental outcomes in children with spina bifida cystica.
- To identify predictors of cognitive function in this population.
- To evaluate the impact of shunts and related complications on neurodevelopment.
Main Methods:
- Longitudinal assessment of 83 survivors of spina bifida cystica treated non-selectively.
- Intelligence and developmental testing administered to participants.
- Correlation analysis of clinical factors (shunt requirement, infection, pallium thickness, lesion level) with cognitive outcomes.
Main Results:
- Children without shunts showed normal intelligence distribution.
- Need for shunts correlated with craniolacunae and lesion sensory level at birth.
- Shunt infections significantly worsened intelligence outcomes.
- In shunt-treated children without infection, pallium thickness and lesion sensory level predicted intelligence.
Conclusions:
- Pallium thickness and lesion sensory level at birth are significant predictors of later intelligence in spina bifida cystica.
- Shunt complications, particularly infection, negatively impact cognitive development.
- Early clinical indicators provide valuable prognostic information for neurodevelopmental outcomes.
Abstract:
The 83 survivors of a consecutive series of children with spina bifida cystica, born between 1963 and 1971 and treated non-selectively since birth, were assessed by intelligence and developmental testing. In nine of the children who had not required shunts the distribution of intelligence was within the normal range. The need for a shunt was significantly related to the presence of craniolacunae and to the sensory level of the lesion recorded at birth. Seven of the 74 shunt-treated children had suffered ventriculitis, meningitis or septicaemia, and their intelligence was significantly worse than the others. In the 67 shunt-treated children who had not suffered infection, intelligence was significantly related to the thickness of the pallium when the shunt was inserted during the first four weeks of life, and to the sensory level of the lesion recorded at birth. Intelligence was not related to the function of the shunt at time of assessment, to the number of revisions of the shunt, or to the rate of increase in head size during the first four weeks of life. It is concluded that the best indication of later intelligence can be gained at birth from the thickness of the pallium and the sensory level of the lesion.