O Laporta-Hoyos1,2, J Ballester-Plané1,2, P Póo3, A Macaya4, M Meléndez-Plumed5, E Vázquez6, I Delgado6, L Zubiaurre-Elorza7, V L Botellero8, A Narberhaus1, E Toro-Tamargo5, D Segarra1,2, R Pueyo9,10. 1. Department of Clinical Psychology and Psychobiology, University of Barcelona, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain. 2. Institute of Neurosciences, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain. 3. Neuropaediatric Service, Hospital Universitario Sant Joan de Déu, Santa Rosa St., Esplugues de Llobregat, 08950, Barcelona, Spain. 4. Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. 5. Traumatology and Rehabilitation Service, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. 6. Pediatric Radiology Service, Hospital Universitari Vall d'Hebron, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. 7. Department of Methods and Experimental Psychology, Faculty of Psychology and Education, University of Deusto, Unibertsitateen Etorbidea 24, 48007, Bilbo-Bizkaia, Spain. 8. Department of Laboratory Medicine, Children's and Women's Health, Medical Technology Research Center, Faculty of Medicine, Norwegian University of Science and Technology, P.O. Box 8905, 7491, Trondheim, Norway. 9. Department of Clinical Psychology and Psychobiology, University of Barcelona, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain. rpueyo@ub.edu. 10. Institute of Neurosciences, Faculty of Psychology, Passeig Vall d'Hebron, 171, 08035, Barcelona, Spain. rpueyo@ub.edu.
Abstract
PURPOSE: Quality of life (QOL) is a key outcome for people with cerebral palsy (CP), and executive functioning is an important predictor of QOL in other health-related conditions. Little is known about this association in CP or about its neural substrate. We aim to analyze the influence of executive functioning (including cognitive flexibility) as well as that of other psychological, motor, communication and socioeconomic variables on QOL and to identify neuroanatomical areas related to QOL in adolescents and adults with CP. METHODS: Fifty subjects diagnosed with dyskinetic CP (mean age 25.96 years) were recruited. Their caregivers completed the primary caregiver proxy report version of the CP QOL-Teen questionnaire. Motor status, communication, IQ, four executive function domains, anxiety/depression and socioeconomic status were evaluated. Correlations and multiple linear regression models were used to relate CP QOL domains and total score to these variables. Thirty-six participants underwent an MRI assessment. Correlations were examined between cortical thickness and CP QOL total score and between cortical thickness and variables that might predict the CP QOL total score. RESULTS: Executive functions predict scores in four domains of CP QOL (General well-being and participation, Communication and physical health, Family health and Feelings about functioning) in the regression model. Among the cognitive domains that comprise executive function, only cognitive flexibility measured in terms of performance on the Wisconsin card sorting test (WCST) predicts the CP QOL total score. Monthly income, fine motor functioning and communication ability predict scores on the domains Access to services and Family Health, Feelings about functioning and School well-being, respectively. The clusters resulting from the correlation between cortical thickness and both CP QOL total score and WCST performance overlapped in the posterior cingulate and precuneus cortices. CONCLUSIONS: Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.
PURPOSE: Quality of life (QOL) is a key outcome for people with cerebral palsy (CP), and executive functioning is an important predictor of QOL in other health-related conditions. Little is known about this association in CP or about its neural substrate. We aim to analyze the influence of executive functioning (including cognitive flexibility) as well as that of other psychological, motor, communication and socioeconomic variables on QOL and to identify neuroanatomical areas related to QOL in adolescents and adults with CP. METHODS: Fifty subjects diagnosed with dyskinetic CP (mean age 25.96 years) were recruited. Their caregivers completed the primary caregiver proxy report version of the CP QOL-Teen questionnaire. Motor status, communication, IQ, four executive function domains, anxiety/depression and socioeconomic status were evaluated. Correlations and multiple linear regression models were used to relate CP QOL domains and total score to these variables. Thirty-six participants underwent an MRI assessment. Correlations were examined between cortical thickness and CP QOL total score and between cortical thickness and variables that might predict the CP QOL total score. RESULTS: Executive functions predict scores in four domains of CP QOL (General well-being and participation, Communication and physical health, Family health and Feelings about functioning) in the regression model. Among the cognitive domains that comprise executive function, only cognitive flexibility measured in terms of performance on the Wisconsin card sorting test (WCST) predicts the CP QOL total score. Monthly income, fine motor functioning and communication ability predict scores on the domains Access to services and Family Health, Feelings about functioning and School well-being, respectively. The clusters resulting from the correlation between cortical thickness and both CP QOL total score and WCST performance overlapped in the posterior cingulate and precuneus cortices. CONCLUSIONS: Cognitive flexibility predicts proxy report CP QOL-Teen total score in dyskinetic CP. This relationship has its anatomical correlate in the posterior cingulate and precuneus cortices.
Entities:
Keywords:
Cerebral palsy; Cortical thickness; Executive functions; Magnetic resonance imaging; Quality of life
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