Susan E Caudle1, Jennifer M Katzenstein2, Saul J Karpen3, Valérie A McLin4. 1. Psychology Service, Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX. Electronic address: secaudle@texaschildrens.org. 2. Psychology Service, Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX. 3. Texas Children's Liver Center, Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX. 4. Texas Children's Liver Center, Texas Children's Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX; Unité de Gastroentérologie pédiatrique, Hôpital des Enfants, Geneva, Switzerland.
Abstract
OBJECTIVE: To test the hypothesis that in very young patients with biliary atresia, cognitive deficits are apparent before transplantation. STUDY DESIGN: With the Mullen Scales of Early Learning (Mullen), we examined 15 infants (mean age, 7.8 months) with biliary atresia, correlating Mullen scores with standard clinical and biochemical parameters. RESULTS: Overall, participants displayed significant delays in gross motor and language skills, and fine motor and visual reasoning skills were relatively preserved. The international normalized ratio correlated inversely with gross (P < .01) and fine (P < .05) motor skills. Growth parameters correlated positively with expressive language ability, but length of hospitalization and mode of feeding did not. Age at performance of the Kasai procedure was found to correlate with receptive language performance (P < .05). CONCLUSIONS: Very young children with biliary atresia display a characteristic profile of early developmental deficits before transplantation. These findings suggest that early intervention and aggressive nutritional management should be the standard of care to minimize neurocognitive effects. Copyright 2010 Mosby, Inc. All rights reserved.
OBJECTIVE: To test the hypothesis that in very young patients with biliary atresia, cognitive deficits are apparent before transplantation. STUDY DESIGN: With the Mullen Scales of Early Learning (Mullen), we examined 15 infants (mean age, 7.8 months) with biliary atresia, correlating Mullen scores with standard clinical and biochemical parameters. RESULTS: Overall, participants displayed significant delays in gross motor and language skills, and fine motor and visual reasoning skills were relatively preserved. The international normalized ratio correlated inversely with gross (P < .01) and fine (P < .05) motor skills. Growth parameters correlated positively with expressive language ability, but length of hospitalization and mode of feeding did not. Age at performance of the Kasai procedure was found to correlate with receptive language performance (P < .05). CONCLUSIONS: Very young children with biliary atresia display a characteristic profile of early developmental deficits before transplantation. These findings suggest that early intervention and aggressive nutritional management should be the standard of care to minimize neurocognitive effects. Copyright 2010 Mosby, Inc. All rights reserved.
Authors: Vicky L Ng; Lisa G Sorensen; Estella M Alonso; Emily M Fredericks; Wen Ye; Jeff Moore; Saul J Karpen; Benjamin L Shneider; Jean P Molleston; Jorge A Bezerra; Karen F Murray; Kathleen M Loomes; Philip Rosenthal; Robert H Squires; Kasper Wang; Ronen Arnon; Kathleen B Schwarz; Yumirle P Turmelle; Barbara H Haber; Averell H Sherker; John C Magee; Ronald J Sokol Journal: J Pediatr Date: 2018-03-05 Impact factor: 4.406
Authors: Shikha S Sundaram; Estella M Alonso; Barbara Haber; John C Magee; Emily Fredericks; Binita Kamath; Nanda Kerkar; Philip Rosenthal; Ross Shepherd; Christine Limbers; James W Varni; Patricia Robuck; Ronald J Sokol Journal: J Pediatr Date: 2013-06-06 Impact factor: 4.406