Charlotte Pinabiaux

Use of Early Remedial Services in Children with Transposition of the Great Arteries

OBJECTIVES To characterize the prevalence of use of early remedial services and its associated demographic, medical, and cognitive factors in children aged 4-6 years with corrected transposition of the great arteries (TGA). STUDY DESIGN This was a prospective study of neurocognitive outcomes after TGA. Children underwent formal neuropsychological testing including general intelligence and a comprehensive battery of executive functions (EF) including motor and interference control, short-term memory, and working memory as well as cognitive flexibility. Parental reports on the childrens behavior and EF were also evaluated. Demographic factors and preoperative, intraoperative, and postoperative factors as well as cognitive factors were examined according to the current use of remediation. RESULTS Forty-five patients (67% male) and their parents participated in this study. Twenty-four (53%) patients were receiving remedial services. Male sex, a postnatal diagnosis of TGA, and a longer postoperative intensive care unit stay were significantly associated with use of remediation. Children receiving remediation had lower EF scores, had more severe EF deficits as observed by formal testing, and were rated as having more behavioral daily life difficulties. However, in the group without remediation, 13 children (43%) also displayed EF deficits rated as moderate to severe. CONCLUSIONS Demographic and medical factors could help identify children at higher risk for neurocognitive delays. Evaluation of executive functioning from an early age may influence referral for remediation.

Impaired emotional memory recognition after early temporal lobe epilepsy surgery: the fearful face exception?

INTRODUCTION Recognition memory may be enhanced for emotional stimuli compared to neutral ones. Neuropsychological studies in adults with temporal lobe epilepsy (TLE) have reported disorders in this emotional memory enhancement but few studies have focused on children and adolescents with TLE. However these young patients are at particular risk for memory impairments. METHODS We included 25 patients aged 8-18 years with temporal lobe resection (TLR) for refractory TLE and compared them with 50 age-matched healthy controls for emotional memory recognition tasks involving faces and words. Recollection and familiarity memory processes were explored using the R/K/G paradigm and identification of emotional facial expressions was evaluated. RESULTS In the control group, recognition was enhanced for emotional faces and words compared to neutral ones. In patients, no memory enhancement effect was found, except for fearful faces. Memory enhancement for fearful faces relied on familiarity-based judgments in patients whereas it was supported by recollection in controls. In left-TLR patients, memory recognition of emotional material was correlated with identification of emotional facial expressions whereas this was not the case for right-TLR patients. CONCLUSION Together, these findings indicate that temporal lobe integrity is crucial for children to develop normal interactions between emotions and memory. In the case of early lesions, fearful expressions might possibly increase memory for faces but through familiarity rather than through recollection as in healthy individuals.

Facial Expression Recognition and Emotion Understanding in Children after Neonatal Open-Heart Surgery for Transposition of the Great Arteries

Theory of mind impairments are part of the cognitive morbidities associated with transposition of the great arteries (TGA). We sought to assess core components of social cognition in school‐aged children with TGA.

Cognitive disorders in pediatric epilepsy

Childhood epilepsy may cause cognitive disorders and the intellectual quotient is indeed not normally distributed in epileptic children, a fair proportion of whom show an IQ in the deficient range. Some epileptic syndromes happen during vulnerability periods of brain maturation and interfere with the development of specific cognitive functions. This is the case for the Landau-Kleffner syndrome, which generally appears during speech development and affects language. Similarly, West syndrome - or infantile spasms - is an epileptogenic encephalopathy appearing during the first years of life and induces a major delay in social and oculo-motor development. Specific impairments can also be identified in partial childhood epilepsies in relation with seizure focus localization. For instance, left temporal and frontal epilepsies are frequently associated with verbal impairments. Moreover, episodic memory disorders have been described in children suffering from temporal lobe epilepsy whereas executive deficits (planning, self-control, problem solving) have been reported in frontal lobe epilepsy. In most cases, including its mildest forms, childhood epilepsy induces attention deficits, which may affect academic achievement. These observations militate in favor of individual neuropsychological assessments as well as early interventions in order to provide the child with an optimal individualized treatment program.

Verbal emotional memory in children and adolescents with temporal lobe epilepsy: A first study

That emotional memory enhancement is compromised in adult patients with temporal lobe epilepsy (TLE), particularly in the case of early cerebral damage, has been suspected. We conducted a study in which we compared 20 children and adolescents aged 11-15 years with early TLE with 40 healthy control subjects. We studied the effect of emotional information on verbal memory performance using story recall and word list learning tasks. Our results highlighted the existence of emotional memory facilitation in healthy subjects, whereas there was no beneficial impact of emotional material on memory in young patients with TLE. Our study suggests that early TLE can impair the development of emotional memory processes.

Psychological Disorders and Ecological Factors Affect the Development of Executive Functions: Some Perspectives

The links between deficits in executive functions (EFs) (e.g., mental flexibility, inhibition capacities, etc.) and some psychological disorders (e.g., anxiety and depressive disorders) have been investigated in the past decades or so. Observations evidenced that some deficits in working memory, planning, and mental flexibility were highly correlated with anxiety and depressive disorders. The majority of studies focused on adults’ population, whereas it seems important to adopt a developmental perspective to fully understand the dynamic relation of these EF/psychological disorders. We suggest to focus on the following two axes in future research: (i) relations between EF and anxiety traits through development and (ii) the possible role of external factors such as parent–child relationships on the development of EF.

Memory for fearful faces across development: specialization of amygdala nuclei and medial temporal lobe structures

Enhanced memory for emotional faces is a significant component of adaptive social interactions, but little is known on its neural developmental correlates. We explored the role of amygdaloid complex (AC) and medial temporal lobe (MTL) in emotional memory recognition across development, by comparing fMRI activations of successful memory encoding of fearful and neutral faces in children (n = 12; 8–12 years) and adolescents (n = 12; 13–17 years). Memory for fearful faces was enhanced compared with neutral ones in adolescents, as opposed to children. In adolescents, activations associated with successful encoding of fearful faces were centered on baso-lateral AC nuclei, hippocampus, enthorhinal and parahippocampal cortices. In children, successful encoding of fearful faces relied on activations of centro-mesial AC nuclei, which was not accompanied by functional activation of MTL memory structures. Successful encoding of neutral faces depended on activations in anterior MTL region (hippocampal head and body) in adolescents, but more posterior ones (hippocampal tail and parahippocampal cortex) in children. In conclusion, two distinct functional specializations emerge from childhood to adolescence and result in the enhancement of memory for these particular stimuli: the specialization of baso-lateral AC nuclei, which is associated with the expertise in processing emotional facial expression, and which is intimately related to the specialization of MTL memory network. How the interplay between specialization of AC nuclei and of MTL memory structures is fundamental for the edification of social interactions remains to be elucidated.

Spontaneous response to and expressive regulation of mirth elicited by humorous cartoons in younger and older adults

ABSTRACT Many studies have examined the effect of aging on the ability to regulate negative emotions but less is known about the way the elderly people control their positive affects. Thirty-eight younger and 38 older adults were compared on their affective, expressive, physiological, and behavioral spontaneous responses to and in expressive regulation of mirth elicited by humorous cartoons. Compared to younger adults, older adults were equally amused and aroused but showed lower expressivity in their spontaneous reaction. They were similarly successful in implementing expressive regulation but they had lower physiological activation under amplification condition and more gaze avoidance from the key areas of the cartoons under suppression condition. This indicates that in older, amplification skills are disjointed from the physiological responses and suppression skills seem supplanted by a less costly strategy of attention redeployment. This also suggests that older adults’ behavior is not driven by a greater preference for positive information.

Recent advances in functional magnetic resonance imaging: Contribution to pediatric epilepsy

New non-invasive functional magnetic resonance imaging (fMRI) techniques are deeply changing the exploration of epileptic and functional networks in childhood epilepsies, as well as of the normally developing brain. In this review, we first briefly describe the fMRI methods and the specificity, advantages and limitations of fMRI protocols and studies in pediatric epi- lepsies. Current fMRI applications in pediatric epilepsies mostly refer to presurgical mapping that can be performed with motor, language or memory tasks, and allows to select patients, tailor resection and sometimes predict postoperative cognitive outcome. Functional connectivity studies are currently emerging from resting state fMRI acquisitions to assess the possible consequences of epileptic activity on the development of functional long distance networks. Future directions for research applications, espe- cially connectivity analysis, and new developments such as electroencephalography-fMRI, will lead to better comprehensive descriptions of functional brain networks in pediatric epilepsy.