Caroline Nadebaum
Royal Children's Hospital
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Publication
Featured researches published by Caroline Nadebaum.
Developmental Neuropsychology | 2007
Caroline Nadebaum; Vicki Anderson; Cathy Catroppa
Little is known about the long-term effects of traumatic brain injury (TBI) in very young children. This study used a prospective, cross-sectional design to investigate the impact of TBI on executive function (EF) outcomes in children who sustained a TBI before the age of seven. The study aimed to identify specific or global EF deficits five years post-TBI, and to explore factors that predicted outcomes. Fifty-four children with a TBI and 17 uninjured comparison children participated. Their performance on several cognitive and behavioral EF measures was examined. Results suggested that executive difficulties were present following severe TBI, however children with mild and moderate injuries were relatively unaffected. Skills that develop early appeared to be relatively robust. Injury severity was found to be most predictive of long-term EF, however other injury, child and family-related variables also contributed to outcomes.
Neurology | 2011
Caroline Nadebaum; Vicki Anderson; F. J. E. Vajda; David C. Reutens; Sarah Barton; Amanda G. Wood
Objectives: Fetal exposure to some antiepileptic drugs (AEDs) carries increased risk of major birth defects, and may be associated with reduced intellectual abilities. The impact on language remains unclear. This study aimed to investigate the impact of fetal AED exposure on language skills. Methods: Women with epilepsy and their children were recruited to this observational study through the Australian Pregnancy Register for Women with Epilepsy and Allied Disorders. Language skills of 102 AED-exposed children were assessed using the Clinical Evaluation of Language Fundamentals, fourth edition (CELF-4). Assessments were conducted blind to drug. Maternal epilepsy, pregnancy, and medical histories were obtained from prospectively collected records. Results: Mean CELF-4 Core Language scores of children exposed to sodium valproate in monotherapy (mean 91.5, SD 17.5) or polytherapy (mean 73.4, SD = 22.3) were significantly below the standardized test mean of 100 (p < 0.05). Mean language scores of children exposed to carbamazepine or lamotrigine monotherapy, or polytherapy without sodium valproate, were not significantly different from normal. First-trimester sodium valproate dose was negatively correlated with language scores, and significantly predicted language scores after controlling for other group differences. Conclusions: Fetal exposure to sodium valproate increases the risk of language impairment. This should be taken into account when making treatment decisions for women with epilepsy of childbearing age.
Diabetes Care | 2014
Fergus J. Cameron; Shannon E. Scratch; Caroline Nadebaum; Elisabeth Northam; Ildiko Koves; Juliet Jennings; Kristina Finney; Jeffrey J. Neil; R. Mark Wellard; Mark T. Mackay; Terrie E. Inder
OBJECTIVE To investigate the impact of new-onset diabetic ketoacidosis (DKA) during childhood on brain morphology and function. RESEARCH DESIGN AND METHODS Patients aged 6–18 years with and without DKA at diagnosis were studied at four time points: <48 h, 5 days, 28 days, and 6 months postdiagnosis. Patients underwent magnetic resonance imaging (MRI) and spectroscopy with cognitive assessment at each time point. Relationships between clinical characteristics at presentation and MRI and neurologic outcomes were examined using multiple linear regression, repeated-measures, and ANCOVA analyses. RESULTS Thirty-six DKA and 59 non-DKA patients were recruited between 2004 and 2009. With DKA, cerebral white matter showed the greatest alterations with increased total white matter volume and higher mean diffusivity in the frontal, temporal, and parietal white matter. Total white matter volume decreased over the first 6 months. For gray matter in DKA patients, total volume was lower at baseline and increased over 6 months. Lower levels of N-acetylaspartate were noted at baseline in the frontal gray matter and basal ganglia. Mental state scores were lower at baseline and at 5 days. Of note, although changes in total and regional brain volumes over the first 5 days resolved, they were associated with poorer delayed memory recall and poorer sustained and divided attention at 6 months. Age at time of presentation and pH level were predictors of neuroimaging and functional outcomes. CONCLUSIONS DKA at type 1 diabetes diagnosis results in morphologic and functional brain changes. These changes are associated with adverse neurocognitive outcomes in the medium term.
Journal of The International Neuropsychological Society | 2011
Caroline Nadebaum; Vicki Anderson; F. J. E. Vajda; David C. Reutens; Sarah Barton; Amanda G. Wood
Prenatal exposure to sodium valproate (VPA) and polytherapy has been linked with increased risk of birth defects and cognitive impairment in young children. We evaluated the cognitive impact of prenatal exposure to VPA and polytherapy in school-aged children. Fifty-seven children exposed to VPA (n = 23), polytherapy with VPA (n = 15), or polytherapy without VPA (n = 19) were assessed using the Wechsler Intelligence Scale for Children--Fourth Edition. Information on maternal epilepsy, pregnancy, and medical history was obtained prospectively through the Australian Pregnancy Register for Women with Epilepsy and Allied Disorders. All groups had elevated frequencies of Extremely Low (<70) or Borderline (70-79) Full-Scale IQ (15.8-40.0%). Verbal Comprehension and Working Memory scores in all groups fell significantly below the standardized test mean, while Perceptual Reasoning and Processing Speed scores were relatively intact. Multivariate analysis of covariance analysis revealed significant main effects of VPA on Verbal Comprehension and Working Memory, and of polytherapy on Verbal Comprehension and Processing Speed. Our results suggest that VPA has a dose-dependent negative impact on verbal intellectual abilities, and may also affect working memory. The possibility that inclusion of VPA in many polytherapy regimens may underlie reduced mean scores of polytherapy-exposed children is discussed.
Epilepsia | 2015
Amanda G. Wood; Caroline Nadebaum; Vicki Anderson; David C. Reutens; Sarah Barton; Terence J. O'Brien; F. J. E. Vajda
The association between autism spectrum disorders (ASDs) and prenatal anticonvulsant exposure is increasingly investigated, but comprehensive, blinded assessment using a validated instrument for autism within a well‐characterized prospective cohort has not been conducted. Thus, existing studies may represent an underestimate of the true risk. Herein we present a prospective cohort study in children exposed to anticonvulsants during pregnancy, with all assessments conducted by examiners who were blinded to drug‐exposure status.
Pediatric Diabetes | 2012
Caroline Nadebaum; Shannon E. Scratch; Elisabeth Northam; Fergus J. Cameron
Screening tests of basic cognitive status or ‘mental state’ have been shown to predict mortality and functional outcomes in adults. This study examined the relationship between mental state and outcomes in children with type 1 diabetes.
Developmental Neuropsychology | 2012
Caroline Nadebaum; Vicki Anderson; F. J. E. Vajda; David C. Reutens; Amanda G. Wood
Despite elevated rates of birth defects associated with prenatal antiepileptic drug exposure, pharmacotherapy is typically continued throughout pregnancy because of the risks posed to mother and child by recurrent seizures. Emerging data suggest that prenatal exposure to valproate or polytherapy may also be associated with increased risk of cognitive impairment. However, our understanding of the longer-term sequelae of prenatal antiepileptic drug exposure remains incomplete. Improved understanding of the neurobehavioral consequences of prenatal antiepileptic drug exposure is essential to ensure accurate information is available for women with epilepsy planning a pregnancy, and to achieve optimal outcomes for mothers and children.
Annals of clinical and translational neurology | 2014
Amanda G. Wood; Jian Chen; Sarah Barton; Caroline Nadebaum; Vicki Anderson; Cathy Catroppa; David C. Reutens; Terence J. O'Brien; F. J. E. Vajda
Prenatal exposure to sodium valproate (VPA) is associated with neurodevelopmental impairments. Cortical thickness was measured in 16 children exposed prenatally to VPA and 16 controls. We found increased left inferior frontal gyrus (IFG; BA45) and left pericalcarine sulcus (BA18) thickness, an association between VPA dose and right IFG thickness, and a close relationship between verbal skills and left IFG thickness. A significant interaction between group and hemispheric IFG thickness showed absence of the normal asymmetry in the IFG region of VPA‐exposed children. These data provide preliminary insights into the putative neural basis of difficulties experienced by some VPA‐exposed children.
Epilepsia | 2011
Caroline Nadebaum; Vicki Anderson; F. J. E. Vajda; David C. Reutens; Sarah Barton; Amanda G. Wood
Purpose: Patients with localized refractory temporal lobe epilepsy (TLE) enrolled in the presurgical workout protocol at Ghent University Hospital undergo, among many investigations, extensive neuropsychological assessment including auditory and visual naming tests. We developed dutch adaptations of these tests to presurgically asses visual object naming and auditory description naming in surgical candidates with lateralized refractory TLE. Both tests will eventually be adapted to be incorporated in the presurgical neurostimulation mapping protocol. Method: Auditory and visual naming target words were matched controlling for word frequency and word length, resulting in two equally difficult naming tasks. Stimuli were based on Snodgrass and Vanderwart pictures and dictionary definitions. Both naming tasks were administered to left and right lateralized TLE patients and the performance of both groups in both tasks was compared. Results: Patients with left lateralized focal TLE performed significantly worse on the auditory version of the naming task compared to the visual alternative. This pattern was also seen in the right lateralized group, but less pronounced. Also, the left lateralized group performed worse on the auditory naming test compared to the right lateralized group, while their results on the visual naming task were less differentiated. Conclusion: The inclusion of auditory and visual naming tasks in presurgical neuropsychological assessment of refractory epilepsy patients is a valuable tool in the prediction of possible naming decline after surgical intervention. Particularly, the inclusion of an auditory naming task proves to be a valuable addition because of its unique capability to capture subtle naming deficits in patients with left TLE. Auditory naming characterizes and lateralizes left TLE-associated language dysfunction better, compared to the visual alternative.
Epilepsia | 2011
Amanda G. Wood; Caroline Nadebaum; Vicki Anderson; David C. Reutens; Sarah Barton; Terence J. O'Brien; F. V. Vajda
Purpose: Patients with localized refractory temporal lobe epilepsy (TLE) enrolled in the presurgical workout protocol at Ghent University Hospital undergo, among many investigations, extensive neuropsychological assessment including auditory and visual naming tests. We developed dutch adaptations of these tests to presurgically asses visual object naming and auditory description naming in surgical candidates with lateralized refractory TLE. Both tests will eventually be adapted to be incorporated in the presurgical neurostimulation mapping protocol. Method: Auditory and visual naming target words were matched controlling for word frequency and word length, resulting in two equally difficult naming tasks. Stimuli were based on Snodgrass and Vanderwart pictures and dictionary definitions. Both naming tasks were administered to left and right lateralized TLE patients and the performance of both groups in both tasks was compared. Results: Patients with left lateralized focal TLE performed significantly worse on the auditory version of the naming task compared to the visual alternative. This pattern was also seen in the right lateralized group, but less pronounced. Also, the left lateralized group performed worse on the auditory naming test compared to the right lateralized group, while their results on the visual naming task were less differentiated. Conclusion: The inclusion of auditory and visual naming tasks in presurgical neuropsychological assessment of refractory epilepsy patients is a valuable tool in the prediction of possible naming decline after surgical intervention. Particularly, the inclusion of an auditory naming task proves to be a valuable addition because of its unique capability to capture subtle naming deficits in patients with left TLE. Auditory naming characterizes and lateralizes left TLE-associated language dysfunction better, compared to the visual alternative.