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Hydrocephalus status in spina bifida: an evaluation of variations in neuropsychological outcomes

Lyla E Hampton1, Jack M Fletcher, Paul T Cirino

  • 1Department of Psychology, University of Houston, Texas 77204-5053, USA. lelmessi@gmail.com

Journal of Neurosurgery. Pediatrics
|September 3, 2011
PubMed

Insights

Hydrocephalus status impacts neuropsychological outcomes in children with spina bifida (SB). Performance declines with shunt-treated hydrocephalus, arrested hydrocephalus, and no hydrocephalus, all below controls.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Developmental Psychology

Background:

  • Hydrocephalus is common in children with spina bifida (SB).
  • The impact of hydrocephalus status on neuropsychological outcomes in SB is not well understood.
  • Previous research has not clearly defined the relationship between hydrocephalus severity and cognitive function in SB.

Purpose of the Study:

  • To evaluate the effect of hydrocephalus status on neuropsychological outcomes in children with spina bifida (SB).
  • To test the hypothesis of a stepwise progression of outcomes based on hydrocephalus status (shunt-treated, arrested, or no hydrocephalus).
  • To determine if motor, spatial, and executive function tasks are more sensitive to hydrocephalus status than vocabulary and reading tasks.

Main Methods:

  • Two hundred eight children with SB were categorized by hydrocephalus status: shunt-treated (166), arrested (18), and no hydrocephalus (24).
  • Sixty-one typically developing children served as a control group.
  • Neuropsychological assessments included verbal/nonverbal IQ, academic achievement, memory, visuospatial function, executive function, and motor skills.

Main Results:

  • A stepwise decline in performance was observed with increasing hydrocephalus severity.
  • Children with SB and no hydrocephalus scored higher than those with arrested hydrocephalus, who in turn scored higher than those with shunt-treated hydrocephalus.
  • All SB groups performed below the control group; fine motor skills differentiated shunt-treated and arrested groups, while verbal and executive functions differentiated the no-hydrocephalus SB group from controls.

Conclusions:

  • Children with SB and arrested or shunt-treated hydrocephalus share similar neuropsychological profiles, with minor differences in fine motor, memory, and spatial domains.
  • All SB groups demonstrated lower performance than controls, potentially influenced by socioeconomic status.
  • Hydrocephalus status is a significant factor influencing cognitive and motor outcomes in children with spina bifida.
Abstract

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