Memory performances and personality traits in mothers of children with obstructive sleep apnea syndrome

Background: Chronic diseases in pediatric age have been identified as stressful risk factors for parents. Studies on caregivers have documented the impact of chronic parenting stress on emotion and cognition. Aim: To investigate the differences between a group of mothers of children affected by obstructive sleep apnea syndrome (OSAS) for at least 4 years and a group of mothers of typically developing children (TDC) in relation to parental stress, self-esteem, locus of control, and memory performances. Methods: A group of 86 mothers (mean age 35.6±4.9, ranged between 32 and 41 years) of children with OSAS diagnosis, and a group of 52 mothers of TDC (mean age 35.9±4.2, ranged between 32 and 41 years) participated in the study. All participants were administered stress level, global self-esteem, internal/external locus of control scales, and memory assessment. Results: Mothers of OSAS children, compared to mothers of TDC, had a significantly higher level of stress, lower self-esteem, more external locus of control and poorer memory performance. Conclusions: The child respiratory disease, with its sudden and unpredictable features, appeared as a significant source of stress for the mother. Such stress condition may have an impact on mothers’ personality traits (self-esteem, locus of control) and on their memory performances. The data have suggested a need for psychological support programs for mothers to better manage stress associated with children’s respiratory disease

Evaluation of neurocognitive abilities in children affected by obstructive sleep apnea syndrome before and after adenotonsillectomy

Obstructive sleep apnoea syndrome (OSAS) is the most severe form of sleep-related disordered breathing (SRDB) and is characterised by snoring, apnoeas, and/or hypopnoeas associated to hypoxia, hypercarbia, or repeated arousals from sleep. OSAS has three major categories of morbidities: neurobehavioural, cardiovascular and somatic growth failure. The gold standard for objective diagnosis of obstructive-SRDB severity is polysomnography (PSG). The indication for surgical treatment in children is moderate-severe OSAS (AHI, apnoea hypopnoea index > 5/h) and in mild OSAS (AHI 2-5/h) with complications or morbidity. The entire spectrum of PSG-defined SRDB (ranging from Primary Snoring to severe OSAS) may correlate with behavioural, attentional and executive function deficits relating to hypoxia and sleep disruption: in some cases, these alterations may mimic attention deficit hyperactivity disorder (ADHD). The aim of this research was to evaluate visuoperceptual and constructional abilities, paediatric sleep questionnaire and polysomnographic scores before and 6 months after adenotonsillectomy with objective and subjective information. We included 59 children who underwent neuropsychiatric and otolaryngologist clinical evaluation and the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI); children parents were asked to fill in the Paediatric Sleep Questionnaire (PSQ); each child underwent PSG. At 6 months after adenotonsillectomy, all patients were evaluated again. There is a significant difference in PSQ parameters, VMI standard, visual tests scores and PSG parameters before and after adenotonsillectomy in children affected by OSAS. These results showed the achievement of therapeutic benefits with improvement of the quality of life for both children and their parents

The Social Brain and Emotional Contagion: COVID-19 Effects

Background and objectives: Coronavirus disease 2019 (COVID-19) is a highly contagious infectious disease, responsible for a global pandemic that began in January 2020. Human/COVID-19 interactions cause dierent outcomes ranging from minor health consequences to death. Since social interaction is the default mode by which individuals communicate with their surroundings, dierent modes of contagion can play a role in determining the long-term consequences for mental health and emotional well-being. We examined some basic aspects of human social interaction, emphasizing some particular features of the emotional contagion. Moreover, we analyzed the main report that described brain damage related to the COVID-19 infection. Indeed, the goal of this review is to suggest a possible explanation for the relationships among emotionally impaired people, brain damage, and COVID-19 infection. Results: COVID-19 can cause several significant neurological disorders and the pandemic has been linked to a rise in people reporting mental health problems, such as depression and anxiety. Neurocognitive symptoms associated with COVID-19 include delirium, both acute and chronic attention and memory impairment related to hippocampal and cortical damage, as well as learning deficits in both adults and children. Conclusions: Although our knowledge on the biology and long-term clinical outcomes of the COVID-19 infection is largely limited, approaching the pandemic based on lessons learnt from previous outbreaks of infectious diseases and the biology of other coronaviruses will provide a suitable pathway for developing public mental health strategies, which could be positively translated into therapeutic approaches, attempting to improve stress coping responses, thus contributing to alleviate the burden driven by the pandemic

Parental Stress and Parental Ratings of Behavioral Problems of Enuretic Children

Background: Primary monosymptomatic nocturnal enuresis (PMNE) may have a stressful impact on the everyday life of children and parents, and it may represent a cumulative stress factor increasing feelings of “learned helplessness.” Methods: The current study investigated parental stress in a group of parents (n = 330) of children affected by PMNE, compared to a group of parents (n = 330) of typical developing children (TDC). In addition, the study evaluated whether parents of PMNE children experience more emotional, social, and behavioral problems in their children, compared to parents of TDC. Finally, the study correlated frequency of enuresis with stress values and Child Behavior Checklist (CBCL) subscales and total stress with CBCL. Both groups were given The Parental Stress Inventory-Short Form (PSI-SF) and the Child Behavior Checklist (CBCL). Results: Parents of PMNE children showed significantly higher stress level than parents of TDC. Nocturnal enuresis, as a demanding clinical condition difficult to control, represents a relevant stress factor. Mothers appeared as more vulnerable to stress than fathers. Parents of PMNE children reported higher behavioral and emotional problems, compared to reports of parents of TDC. PMNE children appeared to their parents as having lower competency in social activities, school performance, and social relationships than TDC. Moreover, they were rated as more withdrawn, anxious-depressed,more aggressive, inattentive, and withmore somatic complaints than healthy children. It was always the mother who rated a significantly higher number of emotional, social, and behavioral problems compared to fathers. Correlational analysis showed that the higher the frequency of enuresis, the greater the parental stress level, the lower the social activities, school performance and relational competencies and the higher the emotional, social and behavioral problems in children, according to the parents’ evaluations. The greater the parental stress level, the lower the competencies rated and the higher the behavioral problems detected by parents

Neuropsychological Profile, Emotional/Behavioral Problems, and Parental Stress in Children with Neurodevelopmental Disorders

Background: The aim of our study was to trace a specific neuropsychological profile, to investigate emotional-behavioral problems and parental stress in children with Autism Spectrum Disorder Level 1/High functioning (ASD-HF), Specific Learning Disorders (SLD) and Attention Deficit/Hyperactivity Disorder (ADHD) disorders and to highlight similarities and differences among the three groups. Methods: We retrospectively collected the data from a total of 62 subjects with ASD-HF (n = 19) ADHD (n = 21), SLD (n = 22) and 20 typical development. All the participants underwent neuropsychological standardized test for the evaluation of cognitive profile (Wechsler Intelligence Scale for Children Fourth Edition—WISC-IV), behavioral and emotional problems (Child Behavior CheckList CBCL), and parental stress (Parental Stress Index Short Form—PSI-SF). The scores of the ASD-HF, ADHD, and SLD groups were compared using non-parametric statistic methods (Kruskall–Wallis H test and U Mann–Whitney for post-hoc analysis). Results: The ASD-HF group were significantly higher in all areas of the WISC-IV than the other two clinical groups. The SLD group performed significantly lower than ASD-HF in Working Memory Index. The SLD group showed lower scores on the somatic problems subscale than the other two groups. In the Difficult Child subscale of the PSI-SF, parents of ADHD children scored lower than the mothers of SLD subjects and higher than the fathers of SLD subjects. In all three groups there are specific deficiencies compared to the control group in the cognitive profile, behavioral and emotional problems, and parental stress. Conclusions: Our comparative analysis highlighted similarities and differences in three groups of children with different neurodevelopmental disorders, helping to better define cognitive, behavioral, and emotional characteristics of these children and parental stress of their parents

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

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

Inhibition, set-shifting and working memory in Global Developmental Delay preschool children

Executive functions (EFs) allow to planning and voluntarily and autonomously produce targeted behaviors, in unusual or complex conditions in which the automated response schemes are not appropriate or sufficient to achieve behavior goal. The aim of this study was to evaluate EFs in preschool children presenting with Global Developmental Delay (GDD). Fifty-two preschool children participated in this study: 20 GDD childrenand 32 typical developing children (TDC) as control group, enrolled in the schools of Campania and Sicily Regions. All subjects underwent evaluation of the executive functioning through the administration of the Battery for the Assessment of Preschool Executive Functions (BAFE) and the Behavior Rating of Executive Function-Preschool Version (BRIEF-P). The two groups were comparable for age and gender. GDD children showed significantly lower scores in all BAFE subscales and significantly higher in all BRIEF-P subscales compared to TDC controls. EFs are integrated with each other and as many functions are the essential basis for the other basic skills as well as basis for more complex cognitive skills. During childhood, EFs’ difficulties tend to influence not just a single area/expertise but have a global impact that extends to management, development, planning and daily living

Trattamento profilattico della Cefalea Tensiva Episodica Frequente in età evolutiva: efficacia del complesso nutraceutico Griffonia simplicifolia/Magnesio

RIASSUNTO Background. La cefalea tensiva è un’algia di tipo gravativo-costrittivo, di intensità medio moderata, frequentemente bilaterale, di durata variabile da pochi minuti a diversi giorni, talvolta associata a fotofobia o fonofobia, osmofobia la cefalea tensiva episodica è stata ulteriormente suddivisa in due sottotipi: infrequente e frequente. Non esistono terapie codificate per tale forma di cefalea pediatrica. Scopo dello studio è verificare l’efficacia e sicurezza di un composto nutraceutico a base di griffonia simplicifolia/magnesio nella terapia preventiva in una popolazione pediatrica di soggetti affetti da cefalea tensiva episodica di tipo frequente (FETTH). Metodi. 79 bambini (38 M, età media 9,24 ± 2,07 anni) affetti da FETTH sono stati sottoposti a un trattamento profilattico con il complesso nutraceutico griffonia simplicifolia/magnesio per via orale due volte al giorno per 3 mesi, l’efficacia del trattamento è stata stimata con il confronto della frequenza e intensità degli attacchi prima e dopo tale trattamento. Risultati. A T0, la frequenza media al mese era pari a 6,81 attacchi (SD ± 1,98) e al T1 era 1,25 (SD ± 0,93) (F = 510,35, p < 0,001), con una media frequenza percentuale delta era 86,04 (SD ± 15.73) a T1. Conclusioni. Pertanto il presente studio si propone come studio preliminare sulla efficacia di tale complesso nella forma di cefalea tensiva definita come episodica frequente.Summary Background. Tension-type headache (TTH) is common primary headache typically bilateral, pressing or tightening in quality and of mild to moderate intensity, lasting minutes to days. The pain does not worsen with routine physical activity and is not associated with nausea, but photophobia or phonophobia may be present. TTH can be distinguished into two subtypes: infrequent and frequent. There is no specific coded treatment in pediatric TTH. Aim of study is evaluating efficacy and safety of Griffonia simplicifolia/Magnesium nutraceutical complex as prophylactic therapy in a pediatric sample with frequent episodic tension type headache (FETTH). Methods. A prophylactic treatment with the complex nutraceutical Griffonia simplicifolia/ Magnesium orally twice a day for 3 months was administered to 79 children (38 M, mean age 9,24 ± 2,07 years) affecting by FETTH, efficacy of the treatment was estimated by comparison of the frequency and intensity of attacks before and after such treatment. Results. At T0, the mean frequency per month was equal to 6,81 attacks (SD ± 1,98) and the T1 was 1,25 (SD ± 0,93) (F = 510,35, p < 0,001), with an average rate Delta percentage was 86,04 (SD ± 15,73) to T1. Conclusions. Therefore, the present study aims as a preliminary study on the effectiveness of this complex in the form of tension headache defined as frequent episodic

Visuomotor integration skills in children affected by obstructive sleep apnea syndrome: A case-control study

Introduction: Sleep related breathing disorders (SRBD) consist of frequent and repetitive episodes of pharyngeal obstruction during sleep, with consequent intermittent hypoxia, sleep architecture fragmentation, daytime sleepiness and/or behavioural problems and executive impairment in children. When untreated, SRBD and obstructive sleep apnea syndrome (OSA) mainly, may impact school performance, cognition, metabolism, and cardiovascular function. Aim of the present study is assessing the visuomotor integration skills in children affected by OSA. Materials and methods: 57 subjects affected by mild-to severe OSA, PSG diagnosed according to international diagnostic criteria, (31 males and 26 females) (mean age 10.8; SD ± 2.49) and 83 healthy children (45 males and 38 females) (mean age 9.95; SD ± 1.87; p = 0.725). All subjects underwent assessment of motor coordination skills with Movement-ABC tests and visual-motor integration ability with Visual Motor Integration (VMI) test. Results: The subjects with OSA show a worse average performances in all items of Movement ABC (p < 0.001) respect of controls. Specifically, children with OSAS show significantly higher values of total points (p < 0.001), manual dexterity (p < 0.001), ball skills (p < 0.001) and balance (p < 0.001). Accordingly, the average centile in OSA children at the MABC-test is significantly reduced compared with controls (p < 0.001). (Table 1) On the other hand, the VMI test evaluation among children with OSAS shows worst result in total Visuo-Motor Integration (p < 0.001), and in Motor Coordination sub-item (p < 0.001) than controls. (Table 1). Conclusion: Our results also support for children and adolescents the hypothesis that executive functioning deficits might be linked primarily to the degree of severity nocturnal hypoxemia rather than daytime sleepiness, although several other studies are needed