Obsessive–compulsive symptoms in children and adolescents: symptomatology,impairment and quality of life

Although the “presence of obsessive–compulsive (OC) symptoms” and “OC-related impairment” are the main criteria to diagnose obsessive–compulsive disorder, the significance of symptomatology versus impairment in explaining quality of life remains unclear. The present study relies on two samples including 462 children (8–11 years old) and 265 children and adolescents (10–17 years old) and explores how self-ratings of specific OC symptoms and OC impairment are associated with father ratings of childhood quality of life. Hierarchical regression analysis was used to investigate the additive effect of OC impairment beyond OC symptomatology (and vice versa) in predicting quality of life. The results demonstrated that specific OC symptoms and OC impairment are differentially related to quality of life, underscoring the additive value of OC impairment beyond OC symptomatology, whereas the reverse was not the case. This finding highlights the importance of measuring impairment besides symptomatology to identify those OC features in childhood that are most significantly related to decreased quality of life.     

Do autistic symptoms persist across time? Evidence of substantial change in symptomatology over a 3-year period in cognitively able children with autism

This study investigated the extent and nature of changes in symptomatology in cognitively able children with autism over a 3-year period. Thirty-seven children diagnosed with an autism spectrum condition involved in an earlier study (M age = 5 years, 7 months) were followed and reassessed 3 years later (M age = 8 years, 4 months). Scores on the Social Communication Questionnaire (SCQ; M. Rutter, A. Bailey, & C. Lord, 2003 ) decreased significantly over time in all symptom domains but especially in the social domain, and correlational findings suggested the presence of 2 distinct developmental trajectories-social communication and repetitive behaviors-that interact across time. Furthermore, 7 children (19% of sample) made substantial changes to the extent that they failed to meet criteria on diagnostic instruments (the Autism Diagnostic Observation Schedule-Generic [ADOS-G; C. Lord, M. Rutter, P. C. DiLavore, & S. Risi, 1999 ] and the SCQ) 3 years later. Children showing diagnostic discontinuity were distinguishable from those who fulfilled ADOS-G criteria only in terms of the age at which they began receiving intervention. The presence of a significant proportion of children showing considerable progress over the 3-year period challenges assumptions of diagnostic continuity and highlights the potential long-term benefits of early intervention.     

Prevalence of hypopigmented maculae and café-au-lait spots in idiopathic epileptic and healthy children

The cutaneous lesions and findings related to the central nervous system are frequently seen concomitantly in many patients. Neurocutaneous syndromes are the most typical examples supporting this observation. The prevalences of hypopigmented maculae and café-au-lait spots were investigated in 210 idiopathic epileptic children between the ages of 2 and 17 years and 2754 healthy children between the ages of 5 and 15 years. In the group of epileptic children, hypopigmented maculae and café-au-lait spots were observed in 30 (14.3%) and 63 (30%) children, respectively. In the group of healthy children, the prevalence of hypopigmented maculae was 1.6% (44 children) and of café-au-lait spots was 2.83% (78 children). The difference between the two groups was very significant statistically (P < .0001).     

Neural correlates of auditory distraction revealed in θ-band EEG

Selective attention involves the exclusion of irrelevant information in order to optimize perception of a single source of sensory input; failure to do so often results in the familiar phenomenon of distraction. The term 'distraction' broadly refers to a perceptual phenomenon. In the present study we attempted to find the electrophysiological correlates of distraction using an auditory discrimination task. EEG and event-related potential responses to identical stimuli were compared under two levels of distraction (continuous broad-band noise or continuous speech). Relative to broad-band noise, the presence of a continuous speech signal in the unattended ear impaired task performance and also attenuated the N1 peak evoked by nontarget stimuli in the attended ear. As the magnitude of a peak in the event-related potential waveform can be modulated by differences in intertrial power but also by differences in the stability of EEG phase across trials, we sought to characterize the effect of distraction on intertrial power and intertrial phase locking around the latency of the N1. The presence of continuous speech resulted in a prominent reduction of theta EEG band intertrial phase locking around the latency of the N1. This suggests that distraction may act not only to disrupt a sensory gain mechanism but also to disrupt the temporal fidelity with which the brain responds to stimulus events.     

Neural correlates of delayed visual–motor performance in children treated for brain tumours

Both structural and functional neural integrity is critical for healthy cognitive function and performance. Across studies, it is evident that children who are affected by neurological insult commonly demonstrate impaired cognitive abilities. Children treated with cranial radiation for brain tumours suffer substantial structural damage and exhibit a particularly high correlation between the degree of neural injury and cognitive deficits. However the pathophysiology underlying impaired cognitive performance in this population, and many other paediatric populations affected by neurological injury or disease, is unknown. We wished to investigate the characteristics of neuronal function during visual–motor task performance in a group of children who were treated with cranial radiation for brain tumours. We used Magnetoencephalography to investigate neural function during visual–motor reaction time (RT) task performance in 15 children treated with cranial radiation for Posterior Fossa malignant brain tumours and 17 healthy controls. We found that, relative to controls, the patient group showed: 1) delayed latencies for neural activation in both visual and motor cortices; 2) muted motor responses in the alpha (8–12 Hz) and beta (13–29 Hz) bandwidths, and 3) potentiated visual and motor responses in the gamma (30–100 Hz) bandwidth.Collectively these observations indicate impaired neural processing during visual–motor RT performance in this population and that delays in the speed of visual and motor neuronal processing both contribute to the delays in the behavioural response. As increases in gamma activity are often observed with increases in attention and effort, increased gamma activities in the patient group may reflect compensatory neural activity during task performance. This is the first study to investigate neural function in real-time during cognitive performance in paediatric brain tumour patients.     

Description of Neural Regeneration Research

Neural Regeneration Research （NRR, ISSN 1675-5374,CN11-5422/R） is an international-level first class academic journal, charged by the Ministry of Health, sponsored by the Chinese Association of Rehabilitation Medicine, edited and published by the Editorial Board of Neural Regeneration Research. Its open issue has come out in April 2006, which is published monthly all over the world.     

Wide spectrum of clinical manifestations in children with tuberous sclerosis complex – Follow-up of 20 children

TSC is a multisystem genetic disorder predisposing to multiple organ manifestations and developmental problems. Clinical follow-up of patients remains a challenge for the caring paediatrician. Methods: We performed a retrospective analysis of clinical manifestations, diagnostic and therapeutic data in 20 children with the diagnosis of tuberous sclerosis complex (TSC) to answer the following questions: are the clinical guidelines and imaging strategies appropriate to discover complications, are there significant early predictors of long-term prognosis, what is the age range for signs and symptoms to occur. Results: Cardiac rhabdomyoma were present in 18 children and occurred as earliest manifestation. 8 of these exhibited associated arrhythmia or congenital cardiac anomalies. Seizures combined with cortical tubers and subependymal nodules occurred in 18 patients and were most likely to start in infancy, which was associated with later cognitive impairment. Cutaneous manifestations (15 children) occurred in late childhood and school age, whilst renal angiomyolipomas (11) developed in puberty. Discussion: The clinical course and imaging strategies are compared with data from previous studies. A review of TSC in regard to the multiple manifestations is provided.     

Maternal perception of children’s fear: A fMRI study in mothers of preschool children

ABSTRACT

A secure attachment relationship is facilitated by a mother´s ability to perceive her child´s emotions, especially her child´s fear. Prior studies showed that maternal perception of an own child activated a neural network including amygdala, insula and nucleus accumbens (NAcc). Results for different emotions were inconsistent and there are no reports on children´s fear. The goal of this study was to investigate neural responses of 17 mothers to photos of their own and an unknown preschool child with happy and fearful expressions by functional magnetic resonance imaging (fMRI). Whole brain analyses showed that a fearful (vs. happy) own child elicited larger activity in the visual cortex. Region of interest (ROI) analyses (amygdala, insula, NAcc) revealed stronger responses to a happy (vs. fearful) unknown child, but equally strong responses to one´s own child´s expressions. Moreover, an own (vs. unknown) fearful child elicited larger activity in the insula and NAcc. This suggests that mothers allocated more visual attention towards their own child´s fear, but showed consistent emotional involvement with their own child across expressions. Mothers might respond with stronger empathy and approach motivation towards an own (vs. unknown) fearful child, in line with a key role of fear in the attachment relationship.     

Neural change following different memory training approaches in very preterm born children – A pilot study

Objective: There is mixed evidence regarding neural change following cognitive training. Brain activation increase, decrease, or a combination of both may occur. We investigated training-induced neural change using two different memory training approaches. Methods: Very preterm born children (aged 7–12 years) were randomly allocated to a memory strategy training, an intensive working memory practice or a waiting control group. Before and immediately after the trainings and the waiting period, brain activation during a visual working memory task was measured using fMRI and cognitive performance was assessed. Results: Following both memory trainings, there was a significant decrease of fronto-parietal brain activation and a significant increase of memory performance. In the control group, no neural or performance change occurred after the waiting period. Conclusion: These pilot data point towards a training-related decrease of brain activation, independent of the training approach. Our data highlight the high training-induced plasticity of the child’s brain during development.     

Neural correlates of early deliberate emotion regulation: Young children’s responses to interpersonal scaffolding

Deliberate emotion regulation, the ability to willfully modulate emotional experiences, is shaped through interpersonal scaffolding and forecasts later functioning in multiple domains. However, nascent deliberate emotion regulation in early childhood is poorly understood due to a paucity of studies that simulate interpersonal scaffolding of this skill and measure its occurrence in multiple modalities. Our goal was to identify neural and behavioral components of early deliberate emotion regulation to identify patterns of competent and deficient responses. A novel probe was developed to assess deliberate emotion regulation in young children. Sixty children (age 4–6 years) were randomly assigned to deliberate emotion regulation or control conditions. Children completed a frustration task while lateral prefrontal cortex (LPFC) activation was recorded via functional near-infrared spectroscopy (fNIRS). Facial expressions were video recorded and children self-rated their emotions. Parents rated their child’s temperamental emotion regulation. Deliberate emotion regulation interpersonal scaffolding predicted a significant increase in frustration-related LPFC activation not seen in controls. Better temperamental emotion regulation predicted larger LPFC activation increases post- scaffolding among children who engaged in deliberate emotion regulation interpersonal scaffolding. A capacity to increase LPFC activation in response to interpersonal scaffolding may be a crucial neural correlate of early deliberate emotion regulation.     

Integrin β4 in Neural Cells

Integrin β4, one of the heterodimeric receptors, is expressed predominantly on epithelial cells. It is concentrated at the basement membrane zone, where it localizes to specialized adhesion structures called hemidesmosomes. In addition to its adhesive functions, novel insights have emerged regarding the specific roles of integrin β4 in their attachment to extracellular matrix and in their signal transduction pathways within the central nervous system (CNS) and peripheral nervous system in the past few years. It has been reported that integrin β4 is expressed in several kinds of neural cells including astrocyte, Schwann cells, neurons, and neural stem cells. In the mean while, it is expressed by some Schwann cells in the peripheral nervous system and mediated the Mycobacterium leprae invade the peripheral nervous system to reach the Schwann cells. This review highlights recent progress in the function and regulation of integrin β4 in neural cells.     

What motivates repayment? Neural correlates of reciprocity in the Trust Game

Reciprocity of trust is important for social interaction and depends on individual differences in social value orientation (SVO). Here, we examined the neural correlates of reciprocity by manipulating two factors that influence reciprocal behavior: (1) the risk that the trustor took when trusting and (2) the benefit for the trustee when being trusted. FMRI results showed that anterior Medial Prefrontal Frontal Cortex (aMPFC) was more active when participants defected relative to when participants reciprocated, but was not sensitive to manipulations of risk and benefit or individual differences in SVO. However, activation in the temporal-parietal-junction (rTPJ), bilateral anterior insula and anterior cingulate cortex (ACC) was modulated by individual differences in SVO. In addition, these regions were differentially sensitive to manipulations of risk for the trustor when reciprocating. In contrast, the ACC and the right dorsolateral prefrontal cortex were sensitive to the benefit for the trustee when reciprocating. Together, the results of this study provide more insight in how several brain regions work together when individuals reciprocate trust, by showing how these regions are differentially sensitive to reciprocity motives and perspective-taking.     

Neural substrates of spatial and temporal disorientation in Alzheimer’s disease

To examine the neuroanatomical correlates of spatial and temporal disorientation in Alzheimer’s disease (AD), we performed an anterograde clinicopathological study of 29 patients with clinically and neuropathologically confirmed AD. Spatial and temporal disorientation was assessed using the locational orientation subtests of the Mini Mental State Examination and the Benton’s test for temporal orientation. Quantitative analysis of neurofibrillary tangles and senile plaques were performed in the CA1 field of the hippocampus, layers II and V of the entorhinal cortex, and layers II–III and V–VI of areas 9, 7, 39, 19, 37, 20 and 23 in the right hemisphere. Forward stepwise logistic regression was used to assess the relationship between lesion densities and the presence of either spatial or temporal disorientation; severity scores and brain weight were included as covariants. A statistically significant relationship was found between neurofibrillary tangle densities in Brodmann’s areas 7, 23 and the CA1 field of hippocampus and both spatial and temporal disorientation. Senile plaque counts did not correlate with any of the neuropsychological parameters. Both temporal and spatial disorientation in AD are related to the degeneration of the same pathways linking the hippocampus with the superior parietal and posterior cingulate cortex in the right hemisphere. These observations are discussed with respect to the notion of global corticocortical disconnection in AD. Received: 30 August 1999 / Revised, accepted: 3 November 1999     

Neural correlates of impaired emotion processing in manifest Huntington’s disease

The complex phenotype of Huntington’s disease (HD) encompasses motor, psychiatric and cognitive dysfunctions, including early impairments in emotion recognition. In this first functional magnetic resonance imaging study, we investigated emotion-processing deficits in 14 manifest HD patients and matched controls. An emotion recognition task comprised short video clips displaying one of six basic facial expressions (sadness, happiness, disgust, fear, anger and neutral). Structural changes between patients and controls were assessed by means of voxel-based morphometry. Along with deficient recognition of negative emotions, patients exhibited predominantly lower neural response to stimuli of negative valences in the amygdala, hippocampus, striatum, insula, cingulate and prefrontal cortices, as well as in sensorimotor, temporal and visual areas. Most of the observed reduced activity patterns could not be explained merely by regional volume loss. Reduced activity in the thalamus during fear correlated with lower thalamic volumes. During the processing of sadness, patients exhibited enhanced amygdala and hippocampal activity along with reduced recruitment of the medial prefrontal cortex. Higher amygdala activity was related to more pronounced amygdala atrophy and disease burden. Overall, the observed emotion-related dysfunctions in the context of structural neurodegeneration suggest both disruptions of striatal-thalamo-cortical loops and potential compensation mechanism with greater disease severity in manifest HD.     

Neural signatures of chronic accessibility in parent – adult child attachment bonds

Some of the closest reciprocal relationships are between parents and their children. As part of the attachment characterizing many parent-child bonds, individuals form mental representations that are chronically accessible and calibrate expectations for future relationships. We predict that there exist unique neural signatures of this chronic accessibility. Young (N = 29, 16 females) and older adults (N = 27, 12 females) made trait judgments for parent or child, respectively, during fMRI scanning. Multivariate analysis identified whole-brain patterns of activation that covaried with the magnitude of parent-child attachment when thinking about that individual. Higher levels of parent and child attachment were associated with lower neural recruitment in anterior cingulate cortex, amygdala, posterior cingulate cortex, medial temporal lobe, and occipital face area. Results provide novel evidence for neural signatures of chronic accessibility, as bringing to mind one’s attached parent or child requires less engagement of brain regions involved in distress relief, memory, and facial processing.