Executive function and theory of mind in school-aged children after neonatal corrective cardiac surgery for transposition of the great arteries
Executive function and theory of mind in school-aged children after neonatal corrective cardiac surgery for transposition of the great arteries
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DOI：
10.1111/j.1469-8749.2010.03735.x
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发表时间：
2010-12-01
影响因子：
3.8
通讯作者：
Angeard, Nathalie
中科院分区：
文献类型：
--
作者：
Calderon, Johanna;Bonnet, Damien;Angeard, Nathalie
目的：心脏畸形导致的紫绀，如大动脉转位（TGA），与神经发育障碍有关。本研究的目的是首次评估心理理论（ToM），这是TGA学龄儿童社会认知和执行功能的关键组成部分。方法采用不同的神经心理学测量方法评估执行功能（认知和反应抑制、言语和空间工作记忆以及计划），将21名接受全流量体外循环新生儿心内直视手术治疗TGA的儿童（14名男性，7名女性，平均年龄7y - 4mo， SD为3mo）与21名正常发育的年龄匹配儿童（12名男性，9名女性，平均年龄7y - 6mo， SD为3.8mo）进行比较。他们还被分配了两个ToM任务（一阶和二阶错误信念理解）。结果TGA组和对照组的一般智商均在正常范围内（平均智商分别为113 [SD 9.3]和118 [SD 10.1]），但TGA组的所有执行功能和ToM（一级和二级）的表现均显著低于对照组（p值分别为0.02、0.01和0.004）。一项判别性的多变量分析证明，认知和行为抑制以及在错误信念任务中的表现是导致两组差异的最重要因素（p=0.03）。解释：TGA患儿在认知和行为抑制方面表现出很大的困难。他们在错误信念理解方面也有特定的缺陷，这与不成熟的执行能力有关。
AIM Cardiac malformations resulting in cyanosis, such as transposition of the great arteries (TGA), have been associated with neurodevelopmental dysfunction. The purpose of this study was to assess, for the first time, theory of mind (ToM), which is a key component of social cognition and executive functions in school-aged children with TGA.METHOD Twenty-one children (14 males, seven females; mean age 7y 4mo; SD 3mo) who underwent neonatal open-heart surgery for TGA using full-flow cardiopulmonary bypass were compared with 21 typically developing age-matched children (12 males, nine females; mean age 7y 6mo; SD 3.8mo) using different neuropsychological measures specifically designed to assess executive function (cognitive and response inhibition, verbal and spatial working memory, and planning). They were also given two ToM tasks (first-and second-order false belief understanding).RESULTS General IQ was within the normal range in both the TGA group and the comparison group (mean IQ 113 [SD 9.3] and 118 [SD 10.1] respectively), but performance on all executive functions and on ToM(first and second level) was significantly lower in the TGA group (p values of 0.02, 0.01, and 0.004 respectively). A discriminant multivariate analysis provided evidence for cognitive and behavioural inhibition as well as performance on false belief tasks as being the most important contributors to the differentiation between the groups (p=0.03).INTERPRETATION Children with TGA demonstrate great difficulties in exerting cognitive and behavioural inhibition. They also present specific deficits in false belief understanding, which were related to immature executive abilities.