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Inattention and Hyperactivity in Children with Symptomatic and Asymptomatic Congenital Cytomegalovirus
Jonathan D Topham1,2, Jerry A Miller2,3, Garry W Wright4
1Meyer Center for Developmental Pediatrics.
Insights
Symptomatic congenital cytomegalovirus (CMV) is linked to increased inattention and hyperactivity in children. Asymptomatic congenital CMV does not pose this risk, and IQ differences were found to be a confounding factor.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Infectious Diseases
Background:
- Congenital cytomegalovirus (CMV) is a common viral infection in newborns.
- While some infants with congenital CMV remain asymptomatic, others develop symptoms that can have long-term consequences.
- The potential neurodevelopmental impact of congenital CMV, particularly on attention and hyperactivity, requires further investigation.
Purpose of the Study:
- To investigate the association between symptomatic congenital CMV (ScCMV) and asymptomatic congenital CMV (AcCMV) and the prevalence of inattention and hyperactivity in school-aged children.
- To compare these outcomes between children with ScCMV, AcCMV, and a control group.
Main Methods:
- A longitudinal cohort study involving 141 children (36 ScCMV, 76 AcCMV, 29 controls).
- Behavioral assessments using the Behavior Assessment System for Children, Second Edition (BASC-2) parent and self-reports.
- Comparison of Attention Problems and Hyperactivity T-scores (≥ 65) and mean T-scores, with adjustment for IQ.
Main Results:
- Children with AcCMV showed no significant differences in attention or hyperactivity compared to controls.
- Children with ScCMV exhibited a higher proportion of elevated Attention Problems T-scores than the AcCMV group, but not controls.
- While ScCMV was associated with higher mean Attention Problems and Hyperactivity T-scores, these differences were no longer significant after adjusting for IQ.
Conclusions:
- Asymptomatic congenital CMV does not increase the risk of inattention or hyperactivity.
- Symptomatic congenital CMV may be associated with a higher prevalence of inattention and hyperactivity, though IQ is a confounding factor.
- Attention-deficit/hyperactivity disorder (ADHD) evaluation may be warranted for children with symptomatic congenital CMV.
Objectives:
To explore the relationship between congenital cytomegalovirus (CMV) and inattention and hyperactivity among school-aged children.
Methods:
The Behavior Assessment System for Children, Second Edition, parent- and self-report, was completed among children with symptomatic congenital CMV (ScCMV) (n = 36), asymptomatic congenital CMV (AcCMV) (n = 76), and controls (n = 29) enrolled in a longitudinal cohort. The proportions of children with ScCMV, AcCMV, and controls with Attention Problems or Hyperactivity T-scores ever ≥ 65 were compared. Mean T-scores in these domains were also compared and adjusted for IQ.
Results:
Children with AcCMV did not differ from controls in the proportion of children with elevated Attention Problems or Hyperactivity T-scores or in mean Attention Problems or Hyperactivity T-scores. Children with ScCMV had a higher proportion of elevated Attention Problems T-scores compared with the AcCMV group but not controls. There were no differences in the proportions of children with elevated Hyperactivity T-scores between ScCMV and AcCMV or control groups. Children with ScCMV had higher mean Attention Problems T-scores versus those with AcCMV and controls and higher mean Hyperactivity T-scores versus those with AcCMV but not controls. After adjustment for IQ, differences in mean Attention Problems or Hyperactivity T-scores were no longer significant.
Conclusion:
Children with AcCMV are not at increased risk of inattention or hyperactivity compared with controls. However, our study suggests an increased prevalence of inattention and hyperactivity among children with ScCMV. Differences in IQ were confirmed to have a confounding effect. Evaluation for attention-deficit/hyperactivity disorder may be warranted in this population.
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