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Seizure May 2024People with Intellectual Disabilities (PwID) are twenty times more likely than general population to have epilepsy. Guidance for prescribing antiseizure medication (ASM)...
INTRODUCTION
People with Intellectual Disabilities (PwID) are twenty times more likely than general population to have epilepsy. Guidance for prescribing antiseizure medication (ASM) to PwID is driven by trials excluding them. Levetiracetam (LEV) is a first-line ASM in the UK. Concerns exist regarding LEV's behavioural and psychological adverse effects, particularly in PwID. There is no high-quality evidence comparing effectiveness and adverse effects in PwID to those without, prescribed LEV.
METHODS
Pooled casenote data for patients prescribed LEV (2000-2020) at 18 UK NHS Trusts were analysed. Demographics, starting and maximum dose, adverse effects, dropouts and seizure frequency between ID (mild vs. moderate-profound (M/P)) and general population for a 12-month period were compared. Descriptive analysis, Mann-Whitney, Fisher's exact and logistic regression methods were employed.
RESULTS
173 PwID (mild 53 M/P 120) were compared to 200 without ID. Mean start and maximum dose were similar across all groups. PwID (Mild & M/P) were less likely to withdraw from treatment (P = 0.036). No difference was found between ID and non-ID or between ID groups (Mild vs M/P) in LEV's efficacy i.e. >50 % seizure reduction. Significant association emerged between ID severity and psychiatric adverse effects (P = 0.035). More irritability (14.2 %) and aggression (10.8 %) were reported in M/P PwID.
CONCLUSION
PwID and epilepsy have high rates of premature mortality, comorbidities, treatment resistance and polypharmacy but remain poorly researched for ASM use. This is the largest studied cohort of PwID trialled on LEV compared to general population controls. Findings support prescribing of LEV for PwID as a first-line ASM.
PubMed: 38897161
DOI: 10.1016/j.seizure.2024.05.010 -
Journal of Developmental and Behavioral... Jun 2024Early treatment of autism spectrum disorder (ASD) can improve developmental outcomes. Children with ASD from minority families often receive services later. We explored...
OBJECTIVE
Early treatment of autism spectrum disorder (ASD) can improve developmental outcomes. Children with ASD from minority families often receive services later. We explored factors related to child's age at time of mother's first concerns about child's development and subsequent time to service initiation among children with ASD.
METHODS
Analysis included 759 preschool-age children classified with ASD based on comprehensive evaluations. Factors associated with retrospectively reported child age at time of first maternal concern and subsequent time to service initiation were investigated using multiple linear regression and Cox proportional hazards.
RESULTS
Earlier maternal concern was associated with multiparity, ≥1 child chronic condition, externalizing behaviors, and younger gestational age, but not race/ethnicity. Time to service initiation was longer for children of non-Latino Black or other than Black or White race and higher developmental level and shorter for children with ≥1 chronic condition and older child age at first maternal concern.
CONCLUSION
Parity, gestational age, and child health and behavior were associated with child age at first maternal concern. Knowledge of child development in multiparous mothers may allow them to recognize potential concerns earlier, suggesting that first time parents may benefit from enhanced education about normal development. Race/ethnicity was not associated with child's age when mothers recognized potential developmental problems; hence, it is unlikely that awareness of ASD symptoms causes racial/ethnic disparities in initiation of services. Delays in time to service initiation among children from racial/ethnic minority groups highlight the need to improve their access to services as soon as developmental concerns are recognized.
PubMed: 38896561
DOI: 10.1097/DBP.0000000000001283 -
Autism Research : Official Journal of... Jun 2024Younger siblings (SIBS) of children with autism exhibit a wide range of clinical and subclinical symptoms including social, cognitive, language, and adaptive functioning...
Younger siblings (SIBS) of children with autism exhibit a wide range of clinical and subclinical symptoms including social, cognitive, language, and adaptive functioning delays. Identifying factors linked with this phenotypic heterogeneity is essential for improving understanding of the underlying biology of the heterogenous outcomes and for early identification of the most vulnerable SIBS. Prevalence of neurodevelopmental (NDD) and neuropsychiatric disorders (NPD) is significantly elevated in families of children with autism. It remains unknown, however, if the family history associates with the developmental outcomes among the SIBS. We quantified history of the NDDs and NPDs commonly reported in families of children with autism using a parent interview and assessed autism symptoms, verbal, nonverbal, and adaptive skills in a sample of 229 SIBS. Multiple regression analyses were used to examine links between family history and phenotypic outcomes, whereas controlling for birth year, age, sex, demographics, and parental education. Results suggest that family history of schizophrenia, depression, anxiety, bipolar disorder, and intellectual disability associate robustly with dimensional measures of social affect, verbal and nonverbal IQ, and adaptive functioning in the SIBS. Considering family history of these disorders may improve efforts to predict long-term outcomes in younger siblings of children with autism and inform about familial factors contributing to high phenotypic heterogenetity in this cohort.
PubMed: 38896553
DOI: 10.1002/aur.3175 -
Frontiers in Public Health 2024Internet addiction and depressive symptoms are common mental health problems in adolescents. Due to the comorbidity of Internet addiction and depressive symptoms, their...
OBJECTIVE
Internet addiction and depressive symptoms are common mental health problems in adolescents. Due to the comorbidity of Internet addiction and depressive symptoms, their mutual relationship influences their developmental trajectories over time. Thus, this study aimed to identify the joint trajectories of Internet addiction and depressive symptoms, and examined the individual, family, and school antecedents of these trajectories among Chinese adolescents.
METHODS
Using a battery of self-report scales, three waves of data collection were conducted in a Chinese adolescent sample ( = 1,301). The co-developmental trajectories of Internet addiction and depressive symptoms were extracted by adopting parallel-process latent class growth modeling (PPLCGM). Multinomial logistic regression was performed to assess predictive factors.
RESULTS
Four unique joint trajectory classes were detected: the Health Group ( = 912, 70.1%), Comorbidity-Worsening Group ( = 85, 6.5%), Asymptomatic-Comorbid Risk Group ( = 148, 11.4%), and Prominent Depressive Symptoms-Remission Group ( = 156, 12.0%). Individual, family, and school factors (e.g., gender, positive youth development, family function, academic performance) significantly predicted the membership in these distinct co-developmental trajectories.
CONCLUSION
Our findings illustrate that the joint development of Internet addiction and depressive symptoms among adolescents presents a heterogeneous distribution, which could better inform prevention and intervention strategies since each co-developmental trajectory may represent unique experience for adolescents who need targeted treatment. Various individual, family, and school factors are important predictors that play different roles in distinguishing the joint trajectories of Internet addiction and depressive symptoms during this critical developmental transition period.
Topics: Humans; Adolescent; Female; Male; Depression; Internet Addiction Disorder; China; Comorbidity; Risk Factors; Self Report; Internet
PubMed: 38894983
DOI: 10.3389/fpubh.2024.1374762 -
BMC Women's Health Jun 2024The aim of this study was to describe the longitudinal developmental trajectories and its influencing factors of sexual activity in patients with breast cancer during...
PURPOSE
The aim of this study was to describe the longitudinal developmental trajectories and its influencing factors of sexual activity in patients with breast cancer during treatment.
METHODS
A prospective longitudinal study was conducted, including 225 newly diagnosed breast cancer patients in A tumor specialty three-class hospital in Southwest China. We measured sexual activity at the time of admission and diagnosis (T) and one month (T), three months (T), six months (T), and nine months (T) after diagnosis. A trajectory analysis model (GBTM) was used to explore the changes in sexual activity in breast cancer patients. Multivariate binary logistic regression analysis was used to analyse the factors that affected the classification of sexual activity trajectories.
RESULTS
The ratio of sexual activity abruptly declined from 100% at baseline to 39.1% at T. The percentage of sexual activity was improved, from 51.4% at T to 63.1% at T. The optimal model was a 2-group trajectory of sexual activity in breast cancer patients,36.6% in the "low activity group" and 63.4% in the "high activity group." The multivariate binary logistic regression analysis revealed statistically significant and positive correlations between sexual activity and age (β = 0.085, OR = 1.089, 95%CI 1.035 ∼ 1.145, P = 0.001),libido(β = 0.774, OR = 2.168, 95%CI 1.337 ∼ 3.515, P = 0.002), vaginal lubrication(β = 1.254, OR = 33.503, 95%CI 2.000 ∼ 6.137, P<0.001).
CONCLUSIONS
Breast cancer patients exhibited varying levels of sexual activity during treatment; higher age was associated with increased sexual activity, which can contribute to the recovery of sexual function. Therefore, it is crucial to provide appropriate guidance on sexual health for younger patients.
Topics: Humans; Female; Breast Neoplasms; Longitudinal Studies; China; Middle Aged; Sexual Behavior; Adult; Prospective Studies; Aged; Age Factors
PubMed: 38890676
DOI: 10.1186/s12905-024-03150-8 -
Birth Defects Research Jun 2024Associations between maternal periconceptional exposure to disinfection by-products (DBPs) in drinking water and neural tube defects (NTDs) in offspring are...
BACKGROUND
Associations between maternal periconceptional exposure to disinfection by-products (DBPs) in drinking water and neural tube defects (NTDs) in offspring are inconclusive, limited in part by exposure misclassification.
METHODS
Maternal interview reports of drinking water sources and consumption from the National Birth Defects Prevention Study were linked with DBP concentrations in public water system monitoring data for case children with an NTD and control children delivered during 2000-2005. DBPs analyzed were total trihalomethanes, the five most common haloacetic acids combined, and individual species. Associations were estimated for all NTDs combined and selected subtypes (spina bifida, anencephaly) with maternal periconceptional exposure to DBPs in public water systems and with average daily periconceptional ingestion of DBPs accounting for individual-level consumption and filtration information. Mixed effects logistic regression models with maternal race/ethnicity and educational attainment at delivery as fixed effects and study site as a random intercept were applied.
RESULTS
Overall, 111 case and 649 control children were eligible for analyses. Adjusted odds ratios for maternal exposure to DBPs in public water systems ranged from 0.8-1.5 for all NTDs combined, 0.6-2.0 for spina bifida, and 0.7-1.9 for anencephaly; respective ranges for average daily maternal ingestion of DBPs were 0.7-1.1, 0.5-1.5, and 0.6-1.8. Several positive estimates (≥1.2) were observed, but all confidence intervals included the null.
CONCLUSIONS
Using community- and individual-level data from a large, US, population-based, case-control study, we observed statistically nonsignificant associations between maternal periconceptional exposure to total and individual DBP species in drinking water and NTDs and subtypes.
Topics: Humans; Female; Drinking Water; Neural Tube Defects; Pregnancy; Maternal Exposure; Disinfection; Adult; Case-Control Studies; Disinfectants; Water Purification; Trihalomethanes; Male; Water Pollutants, Chemical; Prenatal Exposure Delayed Effects; Spinal Dysraphism
PubMed: 38888449
DOI: 10.1002/bdr2.2370 -
Epileptic Disorders : International... Jun 2024Although epilepsy is the most common comorbidity of brain tumors, epileptic spasms rarely occur. Brain tumors associated with epileptic spasms are mostly low-grade...
Although epilepsy is the most common comorbidity of brain tumors, epileptic spasms rarely occur. Brain tumors associated with epileptic spasms are mostly low-grade gliomas. To date, few studies in the literature have reported on malignant (Grades 3-4) brain tumors associated with epileptic spasms. Thus, we aimed to investigate the characteristics of malignant brain tumor-associated epileptic spasms. We retrospectively reviewed patients with malignant brain tumors and epileptic spasms in our institution. Data on demographics, tumor histology, magnetic resonance imaging, epileptic spasm characteristics, electroencephalography, and treatment responsiveness were also collected. Six patients were included. In all cases, the brain tumors occurred in infancy in the supratentorial region and epileptic spasm onset occurred after the completion of brain tumor treatment. Anti-seizure medication did not control epileptic spasms; two patients were seizure-free after epileptic surgery. Although all patients had developmental delays caused by malignant brain tumors and their treatment, developmental regression proceeded after epileptic spasm onset. Two patients who achieved seizure-free status showed improved developmental outcomes after cessation of epileptic spasms. This is the first report of the characteristics of malignant brain tumor-associated epileptic spasms. Our report highlights a difficulties of seizure control and possibillity of efficacy of epileptic surgery in this condition. In malignant brain tumor-associated epileptic spasms, it is important to proceed with presurgical evaluation from an early stage, bearing in mind that epileptic spasms may become drug-resistant.
PubMed: 38888438
DOI: 10.1002/epd2.20240 -
Frontiers in Aging Neuroscience 2024This study aims to utilize latent growth model (LGM) to explore the developmental trajectory of motor dysfunction in Parkinson's disease (PD) patients and investigate...
OBJECTIVE
This study aims to utilize latent growth model (LGM) to explore the developmental trajectory of motor dysfunction in Parkinson's disease (PD) patients and investigate the relationship between depression and motor dysfunction.
METHODS
Four-year follow-up data from 389 PD patients were collected through the Parkinson's Progression Marker Initiative (PPMI). Firstly, a univariate LGM was employed to examine the developmental trajectory of motor dysfunction in PD patients. Subsequently, depression levels were introduced as covariates into the model, and depression was further treated as a parallel growth latent variable to study the longitudinal relationship between motor dysfunction and depression.
RESULTS
In the trajectory analysis of motor dysfunction, the fit indices for the quadratic growth LGM model were χ2 = 7.419, df = 6, CFI = 0.998, TLI = 0.997, SRMR = 0.019, and RMSEA = 0.025, indicating that the growth trend of motor dysfunction follows a quadratic curve rather than a simple linear pattern. Introducing depression symptoms as time-varying covariates to explore their effect on motor dysfunction revealed significant positive correlations (β = 0.383, = 0.026; β = 0.675, < 0.001; β = 0.385, = 0.019; β = 0.415, = 0.014; β = 0.614, = 0.003), suggesting that as depression levels increase, motor dysfunction scores also increase. Treating depression as a parallel developmental process in the LGM, the regression coefficients for depression intercept on motor dysfunction intercept, depression slope on motor dysfunction slope, and depression quadratic factor on motor dysfunction quadratic factor were 0.448 ( = 0.046), 1.316 ( = 0.003), and 1.496 ( = 0.038), respectively. These significant regression coefficients indicate a complex relationship between depression and motor dysfunction, involving not only initial level associations but also growth trends over time and possible quadratic effects.
CONCLUSION
This study indicates a quadratic growth trajectory for motor dysfunction in PD, suggesting a continuous increase in severity with a gradual deceleration in growth rate. The relationship between depression and motor dysfunction is complex, involving initial associations, evolving trends over time, and potential quadratic effects. Exacerbation of depressive symptoms may coincide with motor function deterioration.
PubMed: 38887609
DOI: 10.3389/fnagi.2024.1393887 -
Maternal & Child Nutrition Jun 2024Iodine, an essential trace element for the human body, plays a pivotal role in sustaining health. Malnutrition has emerged as a pressing public health concern, posing a...
Iodine, an essential trace element for the human body, plays a pivotal role in sustaining health. Malnutrition has emerged as a pressing public health concern, posing a significant threat to human well-being. Iodine deficiency poses a substantial threat to the development of children, potentially leading to neurological developmental disorders and mental retardation. Conversely, excessive iodine intake can result in structural and functional abnormalities in the thyroid gland. In this study, we selected children aged 3-6 years through a stratified cluster sampling approach in six regions across China to explore the correlation between iodine nutrition and their physical growth. A total of 5920 preschool children participated in this study, with a median urinary iodine concentration (UIC) of 177.33 [107.06, 269.92] μg/L. Among these children, 250 (4.2%) exhibited stunting, 180 (3.0%) were underweight, 198 (3.3%) experienced wasting, 787 (3.3%) were overweight and 414 (7.0%) were classified as obese. The multivariate linear regression revealed that UIC exhibited a positive correlation with body mass index z-Score (BMIZ) in overweight children (β = 0.038; 95% CI: 0.001, 0.075). In normally growing children, the associations between UIC and height-for-age z-score, weight-for-age z-score and BMIZ displayed nonlinear patterns. Our findings suggest that iodine nutrition is adequate for Chinese children aged 3-6 years. Furthermore, iodine nutrition is intricately linked to the growth and development of these children. Consequently, it is imperative to implement decisive measures to prevent both iodine deficiency and excess.
PubMed: 38886166
DOI: 10.1111/mcn.13685 -
Journal of Affective Disorders Jun 2024Appraisal theory posits that emotions result from cognitive appraisals of events and situations. Experimental work suggests that sleep influences cognitive processes and...
BACKGROUND
Appraisal theory posits that emotions result from cognitive appraisals of events and situations. Experimental work suggests that sleep influences cognitive processes and event appraisal, which the present study examines in real life. Poor sleep influences brain regions involved in the appraisal-to-emotion process, and tired participants showed more conservative appraisal and reported less positive and more negative affect. In the present study, we tested whether sleep duration and/or quality predicted more pleasant event appraisal and whether sleep moderated the association between event appraisal and affect.
METHODS
Participants (N = 892) from the general Dutch population reported thrice daily on event appraisal and various emotions for 30 days and once daily on sleep duration and quality. We constructed multilevel models to account for the nested structure of our data (observations within participants).
RESULTS
Multilevel regression analyses showed that on days when participants reported having slept longer and better than their average, their event appraisal was more positive. Subjective sleep duration and quality did not influence the relationship between event appraisal and affect. Hence, poor sleep predicted changes in cognitive functioning, as people appraised situations as more unpleasant.
LIMITATIONS
We measured subjective sleep duration and quality with two single items and focused on only pleasantness dimension of event appraisal.
CONCLUSIONS
Results match perspectives on emotions as multicomponent systems involving appraisal processes. Understanding the elements of event appraisal may help unravel the detrimental effects of poor sleep on mental health and well-being.
PubMed: 38885846
DOI: 10.1016/j.jad.2024.06.034