Executive Function in Children and Adolescents with Critical Cyanotic Congenital Heart Disease.
Executive Function in Children and Adolescents with Critical Cyanotic Congenital Heart Disease.
复制标题
DOI：
10.1017/s1355617714001027
复制
发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Bellinger DC
中科院分区：
文献类型：
--
作者：
Cassidy AR;White MT;DeMaso DR;Newburger JW;Bellinger DC
患有严重紫绀型先天性心脏病（CHD）的儿童和青少年存在执行功能（EF）方面缺陷的风险。本研究的主要目的是比较3组儿童/青少年重度CHD患者和对照组（年龄10-19岁）的EF结局。参与者包括463名患有CHD的儿童/青少年[先天性大动脉转位（TGA），n = 139;法洛四联症（TOF），n = 68;以及需要Fontan手术的单心室解剖结构（SVF），n = 145]和111名对照组，他们接受了实验室和基于信息的EF技能评估。CHD组（75-81%）的D-KEFS测量的EF受损率几乎是对照组（43%）的两倍。在D-KEFS任务中，CHD组之间记录了不同的EF曲线。在所有三个CHD组中记录了灵活性/解决问题和言语介导的EF技能的缺陷; TOF和SVF组中视觉空间介导的EF能力受损，但在TGA中保留。家长，教师和自我报告的评分的简要强调了独特的模式的元认知和自我监管的关注整个线人。CHD对EF的发展构成严重威胁。CHD严重程度越高，EF结果越差。随着对CHD儿童和青少年所经历的认知和自我调节脆弱性的了解的增加，有可能早期识别风险并提供个性化的支持以促进最佳的神经发育。
Children and adolescents with critical cyanotic congenital heart disease (CHD) are at risk for deficits in aspects of executive function (EF). The primary aim of this investigation was to compare EF outcomes in three groups of children/adolescents with severe CHD and controls (ages 10–19 years). Participants included 463 children/adolescents with CHD [dextro-transposition of the great arteries (TGA), n = 139; tetralogy of Fallot (TOF), n = 68; and, single-ventricle anatomy requiring Fontan procedure (SVF), n = 145] and 111 controls, who underwent laboratory and informant-based evaluation of EF skills. Rates of EF impairment on D-KEFS measures were nearly twice as high for CHD groups (75–81%) than controls (43%). Distinct EF profiles were documented between CHD groups on D-KEFS tasks. Deficits in flexibility/problem-solving and verbally-mediated EF skills were documented in all three CHD groups; visuo-spatially-mediated EF abilities were impaired in TOF and SVF groups, but preserved in TGA. Parent, teacher, and self-report ratings on the BRIEF highlighted unique patterns of metacognitive and self-regulatory concerns across informants. CHD poses a serious threat to EF development. Greater severity of CHD is associated with worse EF outcomes. With increased understanding of the cognitive and self-regulatory vulnerabilities experienced by children and adolescents with CHD, it may be possible to identify risks early and provide individualized supports to promote optimal neurodevelopment.