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Hemophilia growth and development study: relationships between neuropsychological, neurological, and MRI findings at
P A Sirois1, D W Usner, S D Hill
1Tulane University Medical Center, Section of Hematology/Medical Oncology, New Orleans, Louisiana 70112, USA. psirois@tmcpop
Insights
Hemophilia impacts children's cognitive development, but human immunodeficiency virus (HIV) infection did not show adverse effects on neuropsychological performance in this study. Factors like academic issues and head trauma were linked to lower scores.
Area of Science:
- Pediatric Neurology
- Neuropsychology
- Infectious Diseases
Background:
- Children and adolescents with hemophilia face unique developmental challenges.
- The impact of human immunodeficiency virus (HIV) on cognitive development in this population requires further investigation.
- Understanding neurological and environmental factors is crucial for assessing cognitive outcomes.
Purpose of the Study:
- To examine the effects of HIV infection on the cognitive development of children and adolescents with hemophilia.
- To identify neurological and environmental variables associated with neuropsychological measures in HIV-seronegative (HIV-) and HIV-seropositive (HIV+) individuals.
- To compare cognitive performance between HIV- and HIV+ participants.
Main Methods:
- Utilized data from 298 male participants (ages 7-19) in the Hemophilia Growth and Development Study (HGDS).
- Employed least squares modeling to analyze baseline neuropsychological test scores.
- Adjusted for environmental and medical history variables, including HIV status, age, and neurological findings.
Main Results:
- Participants generally performed within age expectations for general intelligence.
- Lowered neuropsychological performance was associated with academic problems, coordination/gait abnormalities, parental education, and prior head trauma.
- HIV status was not significantly associated with neuropsychological dysfunction.
Conclusions:
- Hemophilia-related morbidity subtly influences cognitive performance in affected children and adolescents.
- HIV infection did not demonstrate an association with neuropsychological dysfunction in this cohort, even with MRI abnormalities.
- Further research may explore specific hemophilia-related factors impacting cognition.
Objective:
To determine the effects of human immunodeficiency virus (HIV) infection on children's development by identifying neurological and environmental variables associated with neuropsychological measures of cognitive development in HIV-seronegative (HIV-) and HIV-seropositive (HIV+)children and adolescents with hemophilia.
Methods:
Participants (N = 298; 60% HIV+) were males ages 7-19 years enrolled in the Hemophilia Growth and Development Study (HGDS). Least squares modeling was used to determine whether there was a difference at baseline in mean neuropsychological test scores by HIV status, age, and neurological baseline findings, adjusting for selected environmental and medical history variables.
Results:
The participants were within age expectations for general intelligence. Variables associated with lowered neuropsychological performance included academic problems, coordination and/or gait abnormalities, parents' education, and previous head trauma.
Conclusions:
Hemophilia-related morbidity has a subtle adverse influence on cognitive performance. HIV infection was not associated with neuropsychological dysfunction in this group even when MRI abnormalities were present.