Attention and Executive Functioning Deficits in Liver-Transplanted Children

Abstract

Results provide evidence suggesting that liver-transplanted children are at risk of developmental deficits regarding attention and executive functioning. Especially intrinsic alertness and working memory performance seem to be insufficient. This might result in deficient initiating, sustaining, and controlling of action. In summary, results demonstrate the need for an early and comprehensive developmental screening after pediatric liver transplantation.

Cognitive Performance in Pediatric Liver Transplant Recipients

“…Combined with guidelines for interpretation, this may serve as a basis for individually tailored interventions (18). Moreover, the newly added Index Working Memory allows for comparisons with our previous studies on attention and executive functioning (16).…”

“…Therefore, this finding confirms our earlier reports. We have previously demonstrated substantial impairment in a Working Memory task of a computerbased assessment tool in 59 liver transplanted children (16 (30) who demonstrated significant mental deficits in a group of 33 pediatric liver transplant recipients with metabolic disorders. As children with a genetic-metabolic disease also suffered from the longest duration of disease preoperatively, our results may argue for early transplantation in these children.…”

“…Simultaneous multiple regression analyses were performed with the four index scores and the Total IQ as dependent variables and disease-related variables such as type of donation, age at Ltx, duration of disease, height percentile at Ltx and time since Ltx as independent variables. Independent variables were selected based on our previous findings (15,16). Furthermore, explorative regression analyses (''stepwise'' method) were performed with all described diseaserelated variables and laboratory parameters as independent variables in order to detect further predictors.…”

“…However, our understanding of the association between cognitive deficits and certain disease-related variables is still limited. Infantile onset of liver disease (12)(13)(14), longer pretransplant duration of disease, postmortem donation (15,16), elevated serum calcineurin inhibitor level, lower pretransplant growth percentile and elevated serum ammonia (11) have all been suggested as potential risk factors for cognitive deficits in liver transplanted children. However, these findings are based on only a few studies with small samples or date back to the 1980s.…”

Health Promotion in Primary Schools- Evaluation of Side-Effects on Cognitive and Academic Performance in a Randomized Trial

“…The KiTAP consists of a broad range of non-verbal subtests measuring different attentional components and executive functions validated for children aged 6 to 10 years. The KiTAP had been widely used in neuropsychological and cross-cultural research [39][40][41][42][43] and significant associations with intellectual abilities, school outcomes and behavioral questionnaires had been reported [41,43,44], validity and reliability were satisfying [38,39]. In our study, we administered three tests: a Go-No-go task (inhibitory control), a cognitive flexibility task and a sustained attention task.…”