Inattention, Hyperactivity, and School Performance in a Population of School-Age Children With Complex Congenital Heart Disease

Shillingford, Amanda J.; Glanzman, Marianne; Ittenbach, Richard F.; Clancy, Robert R.; Gaynor, J. William; Wernovsky, Gil

doi:10.1542/peds.2007-1066

Cited by 301 publications

(250 citation statements)

References 53 publications

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“…Our results are also in agreement with Shillingford et al. (2008) who demonstrated higher prevalence of ADHD in school‐aged (5–10 years old) children with CHD. Interestingly, as was the case in our study, this higher prevalence was more pronounced using the parent‐report scores as compared with the teacher‐report scores.…”

Section: Discussionmentioning

confidence: 96%

“…Since children with CHD have greater likelihood of ADHD (Shillingford et al. 2008), we hypothesized that differences in brain structural topology may underlie this diagnosis as well. The risk for ADHD children with complex CHD may, in fact, be 3–4 times higher as in the general population (Shillingford et al.…”

Section: Introductionmentioning

confidence: 99%

“…The risk for ADHD children with complex CHD may, in fact, be 3–4 times higher as in the general population (Shillingford et al. 2008), making it important to understand the neurophysiological etiology.…”

Section: Introductionmentioning

confidence: 99%

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Organizational topology of brain and its relationship to ADHD in adolescents with d‐transposition of the great arteries

et al. 2016

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ObjectiveLittle is currently known about the impact of congenital heart disease (CHD) on the organization of large‐scale brain networks in relation to neurobehavioral outcome. We investigated whether CHD might impact ADHD symptoms via changes in brain structural network topology in a cohort of adolescents with d‐transposition of the great arteries (d‐TGA) repaired with the arterial switch operation in early infancy and referent subjects. We also explored whether these effects might be modified by apolipoprotein E (APOE) genotype, as the APOE ε2 allele has been associated with worse neurodevelopmental outcomes after repair of d‐TGA in infancy.MethodsWe applied graph analysis techniques to diffusion tensor imaging (DTI) data obtained from 47 d‐TGA adolescents and 29 healthy referents to construct measures of structural topology at the global and regional levels. We developed statistical mediation models revealing the respective contributions of d‐TGA, APOE genotype, and structural network topology on ADHD outcome as measured by the Connors ADHD/DSM‐IV Scales (CADS).ResultsChanges in overall network connectivity, integration, and segregation mediated worse ADHD outcomes in d‐TGA patients compared to healthy referents; these changes were predominantly in the left and right intrahemispheric regional subnetworks. Exploratory analysis revealed that network topology also mediated detrimental effects of the APOE ε4 allele but improved neurobehavioral outcomes for the APOE ε2 allele.ConclusionOur results suggest that disruption of organization of large‐scale networks may contribute to neurobehavioral dysfunction in adolescents with CHD and that this effect may interact with APOE genotype.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Organizational topology of brain and its relationship to ADHD in adolescents with d‐transposition of the great arteries

et al. 2016

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“…It is not clear whether the association is due to structural anomalies being physiologically related to neurological deficits [32], enhanced medical surveillance, intervention procedures and/or hospitalizations [33]. Learning disabilities in our study population were indicated by a specific set of FCCs which usually meant that the subject also had a mild neurological deficit such as an incoordination which has also been suggested by other authors [34].…”

Section: Discussionmentioning

confidence: 56%

Cardiac anomalies and associated comorbidities in a large adolescent population

Fink

Machluf

Farkash

et al. 2017

International Journal of Adolescent Medicine and Health

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Abstract:Objective: To determine the prevalence, secular trends and associations of heart disease in a large unscreened, otherwise basically healthy, adolescent population. Subjects and methods: Cross-sectional study of the cardiac status of 113,694 adolescents from the northern district of Israel, who completed the profiling process between the ages of 16 and 19, including all essential measures over a 22-year period. Results of imaging were categorized as either isolated valvar or structural abnormalities, and their clinically significant subgroups defined prospectively. The findings were correlated with the socio-demographic and anthropometric data and non-cardiac health conditions. Results: Of those sent for echocardiography, 1257 (0.93% of the total population) had isolated valvar disease and 216 (0.19%) had structural abnormalities, with 20% of both groups considered significant. Females had lower prevalence of heart disease. There was peak prevalence in the second 5-year period. Tall subjects or a past history of rheumatic fever had more valvar abnormalities. Thin subjects or those with skeletal anomalies had more structural abnormalities. Significant valvar and structural anomalies were more common in subjects with learning disorders, endocrine disorders and diabetes mellitus. Fewer valvar abnormalities were diagnosed in obese subjects. Heart disease was more common in those with non-solid tumors. Conclusion: Appreciable numbers of potentially healthy adolescents were found to have heart disease. There appeared to be an association with body size, skeletal abnormalities and relatively common medical disorders, the cause of which remains to be determined in prospective studies that could change the way common adolescent disease should be followed.

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“…Yet these infants remain subject to considerable perioperative morbidity; including bleeding, organ dysfunction, prolonged mechanical ventilation, and long hospitalizations. These events increase the risk of adverse long-term outcomes (neurodevelopmental dysfunction) of the repair of such defects and result in significant resource utilization and increased health care costs [1,2]. Unfortunately, the currently recognized factors associated with an increased risk of these morbid events, such as prematurity, low birth weight, complexity of the congenital heart defect, genetic syndromes, and extracardiac congenital anomalies, can often not be modified [3].…”

Section: Invited Commentarymentioning

confidence: 99%