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Neuropsychological profiles in children and young adults with spina bifida
Insights
Children with spina bifida and hydrocephalus show cognitive and autonomy deficits. Tailored therapeutic and prevention protocols are recommended, especially for those with hydrocephalus, to address their specific needs.
Area of Science:
- Neuroscience
- Pediatrics
- Developmental Psychology
Background:
- Spina bifida and myelomeningocele are congenital conditions affecting neural development.
- Shunted hydrocephalus often co-occurs, posing additional challenges to cognitive and motor function in children.
Purpose of the Study:
- To evaluate the cognitive, personality, and behavior profiles of Italian children diagnosed with spina bifida, myelomeningocele, and shunted hydrocephalus.
- To identify specific neurocognitive and functional differences among these pediatric patients.
Main Methods:
- A cohort of 43 Italian children (6-16 years) underwent comprehensive neuropsychological assessments.
- Cognitive function was assessed using the Weschler Intelligence Scale for Children-IV (WISC-IV) and the LEITER test for sustained attention.
- Parental questionnaires, including the Child Behavior Checklist (CBCL) and Barthel Index, provided data on personality, behavior, and autonomy.
Main Results:
- Significant differences were observed in WISC-IV subscales, including Perceptual Reasoning, Working Memory, and Processing Speed Index, between patient groups (p < 0.0005 to p = 0.001).
- Patients with hydrocephalus demonstrated significantly poorer cognition and autonomy (Barthel Index) compared to those without (p < 0.001).
- Lower Processing Speed Index scores were associated with wheelchair use, and lower WISC-IV QI scores were noted in patients with lipoma compared to those with LMMC and MMC.
Conclusions:
- Cognitive and autonomy deficits are significant in children with spina bifida and shunted hydrocephalus.
- Hydrocephalic children exhibit more pronounced deficiencies, necessitating targeted interventions.
- Findings support the development of specialized therapeutic and prevention protocols, including rehabilitation, speech therapy, and cognitive enhancement.
Purpose:
A total of 43 Italian children, aged between 6 and 16 years, diagnosed with spina bifida, myelomeningocele, and shunted hydrocephalus have been described clinically and completed a neuropsychological battery in order to evaluate their cognitive, personality, and behavior profile.
Methods:
Enrolled children underwent cognitive assessment by means of the Weschler WISC-IV cognitive test and assessment of the attention sustained through the LEITER test. In addition, parents were asked, in order to obtain a personality and behavior profile of the children, to fill in a "CBCL 6-18 years" questionnaire and to fill in a Barthel Index questionnaire.
Results:
Processing Speed Index of the WISC-IV QI scale was statistically significant (p = 0.027), with the highest value presented by autonomous patients (95.8 ± 12.8) and the lowest by patients using a wheelchair (75.5 ± 19). WISC-IV QI mean value is 98 (±15.7) for lipoma patients and 78.7 (±17.6) for LMMC and MMC patients (p = 0.001). In more detail, Perceptual Reasoning (p < 0.0005), Working Memory (p = 0.01), and Processing Speed Index (p = 0.001) highlighted a significant difference between the groups. The attention sustained subscale of the LEITER presented a mean of 6.9 (±3.1) for lipoma patients and a men value of 4.6 (±3.1) for LMMC and MMC patients (p = 0.024). Patients with hydrocephalus had statistically significant worse cognition and autonomy (Barthel Index) score (p < 0.001) compared with those without hydrocephalus, and normal scores regarding attention and depression scales.
Conclusion:
These results can be useful in planning dedicated therapeutic protocols such as suitable rehabilitation treatments, speech therapy, psychomotor skills, and cognitive enhancement and to develop prevention protocols particularly tailored for children with hydrocephalus who appear to have the more deficient skills.
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