Neuropsychological Alterations in Children Affected by Obstructive Sleep Apnea Syndrome

Sleep-related breathing disorders are a group of clinical conditions ranging from habitual snoring to obstructive sleep apnea syndrome (OSAS) during the lifespan. In children, other risk factors are represented by adenotonsillar hypertrophy, rhinitis, nasal structure alteration, cleft palate, velopharyngeal flap surgery, pharyngeal masses, craniofacial malformations, genetic syndrome (i.e. Down syndrome, Crouzon syndrome, and Apert syndrome), genetic hypoplasia mandibular (i.e. Pierre Robin syndrome, Treacher Collins syndrome, Shy-Drager syndrome, and Cornelia De Lange syndrome), craniofacial traumas, chronic or seasonal rhinitis, asthma, neuromuscular syndromes, brainstem pathologies (i.e. Arnold-Chiari malformation and Joubert syndrome), achondroplasia, and mucopolysaccharidosis. OSAS may affect the executive functioning such as motivational ability, planning, behavior modulation, ability to complete an action program, identification of functional strategies to achieve the goal, problem solving, flexibility, monitoring and self-assessment of behavior in relation to results, change of task, or behavior in the light of emerging information, which may be all impaired by nocturnal intermittent hypoxia also during the developmental age. The clinical presentation of OSAS can mimic other neurobehavioral symptoms, such as ADHD syndrome, learning problems, or can exacerbate the Fragile X syndrome, and generalized nonconvulsive epilepsy symptoms

Neuropsychological Alterations in Children Affected by Obstructive Sleep Apnea Syndrome

Sleep-related breathing disorders are a group of clinical conditions ranging from habitual snoring to obstructive sleep apnea syndrome (OSAS) during the lifespan. In children, other risk factors are represented by adenotonsillar hypertrophy, rhinitis, nasal structure alteration, cleft palate, velopharyngeal flap surgery, pharyngeal masses, craniofacial malformations, genetic syndrome (i.e. Down syndrome, Crouzon syndrome, and Apert syndrome), genetic hypoplasia mandibular (i.e. Pierre Robin syndrome, Treacher Collins syndrome, Shy-Drager syndrome, and Cornelia De Lange syndrome), craniofacial traumas, chronic or seasonal rhinitis, asthma, neuromuscular syndromes, brainstem pathologies (i.e. Arnold-Chiari malformation and Joubert syndrome), achondroplasia, and mucopolysaccharidosis. OSAS may affect the executive functioning such as motivational ability, planning, behavior modulation, ability to complete an action program, identification of functional strategies to achieve the goal, problem solving, flexibility, monitoring and self-assessment of behavior in relation to results, change of task, or behavior in the light of emerging information, which may be all impaired by nocturnal intermittent hypoxia also during the developmental age. The clinical presentation of OSAS can mimic other neurobehavioral symptoms, such as ADHD syndrome, learning problems, or can exacerbate the Fragile X syndrome, and generalized non-convulsive epilepsy symptoms

ADDICTIONS SUBSTANCE FREE DURING LIFESPAN

The addictions substance free is an umbrella definition comprises internet addiction, sexual addiction, gambling pathological, workholism, videogames and computer addiction. Actually, the technological addictions is frequent in young adolescents. The term Digital Natives indicates the children born in an information system of learning and communication different from that of the generations previous. This temporal range was strongly characterized by growing presence of technological communication toolsin daily life. The effects of hyper-exposition to technological tools tend to create a relational virtuality without a body is born,therefore, already within the family ties and during adolescence he moved to the digital socialization network. The technological object it interacts between the adolescent and the world of peers and adults, becoming the facilitator object that as the psychotropic substance, it conveys new modes of communicatio

The transcranial stimulation with direct currents (tdcs): An historical and conceptual minireview

Transcranial Stimulation with Direct Currents (tDCS) is a method for non invasive brain stimulation created to induce functional changes in cerebral cortex. tDCS consists of application on the scalp of electrodes providing a low intensity direct current influencing neuronal functions. tDCS is not the only neurostimulation method for neuroscience clinical practice and research and can be used for treat many different clinical conditions such as migraine prevention, autism spectrum disorders (ASD), cerebral palsy rehabilitation, post-traumatic brain injury neuropsychological disorders

Rehabilitative treatment proposals in pediatric non-verbal syndrome

Nonverbal learning disability (NVLD) can be defined as a specific learning disorder peculiar for deficits in non-verbal area, such as visuospatial and visuo-constructive difficulties, fine motor coordination impairments, and poor mathematics achievement, associated with well-developed language skills. aim of the present work is suggesting rehabilitative proposal for management treatment of NVLD in pediatric age tailored on children and based on EBM

PRECOCIOUS DIAGNOSTIC ELEMENTS IN AUTISM SPECTRUM DISORDERS

Introduction: Autism Spectrum Disorder (ASD) is a condition characterized mainly by the presence of disorders and alterations in some specific behavioral domains, such as social development, communication and restricted and repetitive behaviors. This retrospective study aimed to identify the early symptoms and clinical features in a group of ASD children. Materials and methods: A sample of 79 children participated in the study (68 males and 11 females; age ranged between 13 months and 8.3 years). All participants were administered the ADOS-2, a clinical and standardized assessment tool, based on behavioral observation of ASD subjects. Results: Frequency analysis of the results evidenced significant impairments in some specific areas investigated, such as eating and sleeping disorders, deficits in the language and in social communication, delay in motor development, autonomic and executive dysfunctions. Conclusion: Detecting these deficits and the knowledge of these diagnostic elements at a very early stage of development could therefore have a significant impact on clinical practice for planning of the efficient rehabilitation programs and suitable interventions for ASD children

FUNCTIONAL NONRETENTIVE FECAL SOILING AND STRESSFUL LIFE EVENTS

Introduction: Functional non-retentive fecal soiling (FNRFS), or encopresis without constipation, is a common problem in pediatric age. FNRFS is associated with high levels of distress for both children and parents and with emotional disorders in about 30%-50% of affected children. This study aimed to evaluate stressors on a sample of children with FNRFS comparing to a group of typical devolpment children (TDC). Methods:154 subjects participated in the study: 56 FNRFS children (37 males; mean age 10.87 years ± 1.68); 98 TDC (65 males; mean age 11.3 years ± 1.85). All participants were evaluated for the presence of stressful events (LCU) using the Coddington Life Events Scales (CLES). Results: Both groups were similar for age (p = 0.155), and gender (p = 0.885). Children with FNRFS do not show a significant difference in the prevalence of stressful events than the control group (35.85% vs. 30.83%; CI95% -9.9363% to 20.5490%; Chi-square = 0.402; p = 0, 0.5258). Conclusions: These data suggest that FNRFS is a condition independent of stress factors. In fact, it itself represents a stress factor that can negatively influence the correct psychological and neuropsychological development in children

Life events and primary monosymptomatic nocturnal enuresis: A pediatric pilot study

Introduction: The association between primary monosymptomatic nocturnal enuresis (PMNE) and behavioral disorders was highlighted frequently, suggesting psychiatric origin. On the other hand, there is no difference between the incidence of mental disorders in children with PMNE and controls, although the psychological genesis could provide additional secondary forms, in which the child might react to stressful events with the resumption of involuntary urination at night, with a possible alteration of bowel control due to a high vulnerability to stressors. The purpose of this study is assessing the stressful events of life in a sample of children with PMNE. Materials and methods: 56 subjects with PMNE, (37 males and 19 females) (mean 10.87 years; SD ± 1.68) were recruited consecutively. All subjects were evaluated for the presence of stressful events (ICU) with test Coddington Life Events Scales (CLES). The control group consists of 98 typically developing children (65 males, 33 females) (p = 0.855) (mean 11.3 years; SD ± 1.85; p = 0.594). Results: Individuals with enuresis do not show a significant difference in the prevalence of stressful events than the control group (42.85% vs 41.83%; Chi-square = 0.002; p = 0,963) (table 1). Conclusions: These results for the first time show that PMNE can be regarded as an independent state by stress factors, suggesting that it itself represents a stress factor that can affect the proper psychological and neuropsychological development in children

Emotional Intelligence And Obstructive Sleep Apnea Syndrome In Children: Preliminary Case-Control Study

Introduction: Obstructive sleep apnea syndrome (OSAS) affects up to 4% of pediatric population, with many co-morbidities in the medium-long term. Functional alterations in prefrontal cortex (PFC) may explain why OSAS impacts aspects such as: executive functions, memory, motor control, attention, visual-spatial skills, learning and mood regulation. Emotional intelligence (EI) is a complex neuropsychological function that could be impaired in many clinical conditions. Aim of the study is to evaluate the difference in emotional intelligence skills among children with OSAS and healthy subjects Materials and methods: 29 children (16 males) mean age 9.5 ± 1.54 years, affected by OSAS were compared with 60 typical developing children similar for gender (p = 0,871), age (p = 0,934) and socio-economic status (p = 0.714). Bar-On emotional quotient inventory, youth version (EQ-i: YV) was used in order to assess the Emotional Quotient. Results: Apnea/hypopnea index (AHI) results to be 8.76 ±3.45 with medium desaturation index (ODI) amounting to 2:52 ± 21.5, average saturation 92.7±4.8 %, average desaturation 4.9 %. OSAS children have significant differences in Interpersonal scales (84.95 ± 07.03 vs. 99.61 ± 8.96; p <0.001), Adaptability (7:36 ± 79.61 vs. 101.32 ± 9.4; p <0.001), Stress Management (72.48 ± 8.14 vs. 98.44 ± 5.19, p <0.001), QE Total (81.28 ± 11.03 vs. 102.14 ± 9.62; p <0.001). Pearson correlation analysis shows an inverse relationship between QE total and ODI (p <0.01). Conclusion: Our findings tend to highlight the role of intermittent hypoxia in OSAS effects genesis, involving also aspects different from physical impairments

Forensic considerations on violent parasomnias during lifespan

Nocturnal parasomnias are a group of sleep complex manifestation that don't alter the sleep macrostructure, but when persistent during adulthood may be assume violent aspects with relevant forensic implications about the guiltiness