Makiko Kaga

Self-face recognition in children with autism spectrum disorders : A near-infrared spectroscopy study

It is assumed that children with autism spectrum disorders (ASD) have specificities for self-face recognition, which is known to be a basic cognitive ability for social development. In the present study, we investigated neurological substrates and potentially influential factors for self-face recognition of ASD patients using near-infrared spectroscopy (NIRS). The subjects were 11 healthy adult men, 13 normally developing boys, and 10 boys with ASD. Their hemodynamic activities in the frontal area and their scanning strategies (eye-movement) were examined during self-face recognition. Other factors such as ASD severities and self-consciousness were also evaluated by parents and patients, respectively. Oxygenated hemoglobin levels were higher in the regions corresponding to the right inferior frontal gyrus than in those corresponding to the left inferior frontal gyrus. In two groups of children these activities reflected ASD severities, such that the more serious ASD characteristics corresponded with lower activity levels. Moreover, higher levels of public self-consciousness intensified the activities, which were not influenced by the scanning strategies. These findings suggest that dysfunction in the right inferior frontal gyrus areas responsible for self-face recognition is one of the crucial neural substrates underlying ASD characteristics, which could potentially be used to evaluate psychological aspects such as public self-consciousness.

Event-related potentials of self-face recognition in children with pervasive developmental disorders

Patients with pervasive developmental disorders (PDD) often have difficulty reading facial expressions and deciphering their implied meaning. We focused on semantic encoding related to face cognition to investigate event-related potentials (ERPs) to the subjects own face and familiar faces in children with and without PDD. Eight children with PDD (seven boys and one girl; aged 10.8+/-2.9 years; one left-handed) and nine age-matched typically developing children (four boys and five girls; aged 11.3+/-2.3 years; one left-handed) participated in this study. The stimuli consisted of three face images (self, familiar, and unfamiliar faces), one scrambled face image, and one object image (e.g., cup) with gray scale. We confirmed three major components: N170 and early posterior negativity (EPN) in the occipito-temporal regions (T5 and T6) and P300 in the parietal region (Pz). An enhanced N170 was observed as a face-specific response in all subjects. However, semantic encoding of each face might be unrelated to N170 because the amplitude and latency were not significantly different among the face conditions. On the other hand, an additional component after N170, EPN which was calculated in each subtracted waveform (self vs. familiar and familiar vs. unfamiliar), indicated self-awareness and familiarity with respect to face cognition in the control adults and children. Furthermore, the P300 amplitude in the control adults was significantly greater in the self-face condition than in the familiar-face condition. However, no significant differences in the EPN and P300 components were observed among the self-, familiar-, and unfamiliar-face conditions in the PDD children. The results suggest a deficit of semantic encoding of faces in children with PDD, which may be implicated in their delay in social communication.

Reduced prefrontal hemodynamic response in children with ADHD during the Go/NoGo task: a NIRS study.

The current study examined the hemodynamic response during the Go/NoGo task in children with/without attention deficit/hyperactivity disorder (ADHD). Using near-infrared spectroscopy, oxy-Hb and deoxy-Hb concentration changes in the frontal areas were compared during the conditions with/without inhibitory demand. Compared with typically developing children, children with ADHD showed significantly reduced activation during the conditions with inhibitory demand (NoGo-condition) in the frontal areas. However, no significant differences in activation during the conditions without inhibitory demand (Go-condition) were found between the two groups. The current findings revealed that children with ADHD exhibit an altered hemodynamic response specifically during response inhibition, but not during response execution, and suggested the clinical usefulness of near-infrared spectroscopy for the evaluation of response inhibition deficits in children with ADHD.

Sleep-Related Nighttime Crying (Yonaki) in Japan: A Community-Based Study

Objective. To examine factors associated with the phenomenon of yonaki, or sleep-related nighttime crying (SRNC), in Japanese children Methods. A cross-sectional design incorporating parental self-report was used to investigate relationships between developmental, psychologic, and constitutional/physiological factors in the incidence of SRNC. Participants were the parents of 170 infants, 174 toddlers, and 137 children at a well-infant clinic in Tokyo, Japan. Results. The lifetime incidence rates of SRNC were 18.8% (infants), 64.9% (toddlers), and 59.9% (children). At all ages, children were most likely to cosleep with their parents; however, infants with reported SRNC were found to cosleep more frequently, whereas infants without SRNC were more likely to sleep in separate, child-dedicated beds. Toddlers with frequent SRNC were more likely to have irregular bedtimes and to have nonparental day care than were those without SRNC. Preschoolers who typically slept 9.5 to 10.5 hours per night were less likely to report SRNC than were children with longer or shorter nighttime sleep durations. In all groups, children with frequent SRNC were more likely to suffer from chronic eczema, and toddlers and preschoolers with SRNC exhibited bruxism more frequently. Conclusions. The traditional Japanese arrangement of cosleeping represents an environment in which parents are readily accessible to children during waking episodes. Physical proximity to the parents in infancy, but not at other ages, is associated with SRNC. The higher incidence of bruxism, chronic eczema, and day care use among children with frequent SRNC supports the hypothesis that nighttime anxiety may promote SRNC.

Neurobehavioral and hemodynamic evaluation of Stroop and reverse Stroop interference in children with attention-deficit/hyperactivity disorder

Failure of executive function (EF) is a core symptom of attention-deficit/hyperactivity disorder (ADHD). However, various results have been reported and sufficient evidence is lacking. In the present study, we evaluated the characteristics of children with ADHD using the Stroop task (ST) and reverse Stroop task (RST) that reflects the inhibition function of EF. We compared children with ADHD, typically developing children (TDC), and children with autism spectrum disorder (ASD), which is more difficult to discriminate from ADHD. A total of 10 children diagnosed with ADHD, 15 TDC, and 11 children diagnosed with ASD, all matched by age, sex, language ability, and intelligence quotient, participated in this study. While each subject performed computer-based ST and RST with a touch panel, changes in oxygenated hemoglobin (oxy-Hb) were measured in the prefrontal cortex (PFC) by near-infrared spectroscopy (NIRS) to correlate test performance with neural activity. Behavioral performance significantly differed among 3 groups during RST but not during ST. The ADHD group showed greater color interference than the TDC group. In addition, there was a negative correlation between right lateral PFC (LPFC) activity and the severity of attention deficit. Children with ADHD exhibit several problems associated with inhibition of color, and this symptom is affected by low activities of the right LPFC. In addition, it is suggested that low hemodynamic activities in this area are correlated with ADHD.

Cerebral cortical dysplasia: assessment by MRI and SPECT

The objective of this study was to establish correlations between image findings and pathologic deficits in patients with cerebral cortical malformations. The results of magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) in addition to clinical data for 15 patients with cerebral cortical malformations were reviewed retrospectively. MRI led to the diagnoses of bilateral perisylvian syndrome, hemimegalencephaly, focal polymicrogyria, band-heterotopia, and focal cortical dysplasia (FCD). Interictal SPECT did not reveal hypoperfusion in any case of polymicrogyria. Ictal SPECT images revealed hyperperfusion of the lesion in three patients with polymicrogyria, with accompanying hyperperfusion of the basal ganglia in two of the three patients. On the other hand, interictal SPECT images demonstrated hypoperfusion of the lesion in four patients with FCD. Ictal SPECT images revealed hypoperfusion of the lesion in two patients, hyperperfusion of the lesion in one patient, and hypoperfusion of the basal ganglia in two patients with FCD. This difference in perfusion between polymicrogyria and FCD observed in this study may reflect histologically different characteristics. This relative hyperperfusion of the cortex and the basal ganglia observed on ictal SPECT, which was found in two polymicrogyria patients with complex partial seizures and partial seizures evolving to secondary generalized seizures, respectively, suggests that the cortical-subcortical interaction is related to the mechanism of loss of consciousness or seizure generation.

Language Disorders in Landau-Kleffner Syndrome

In the present long-term study, we analyzed language disorders in four patients with Landau-Kleffner syndrome. Their common first symptoms were disability in understanding spoken words, followed by inarticulation and a decreased amount of speech. All patients showed auditory verbal agnosia to some degree at some stage of their illness. However, one patient showed typical sensory aphasia as the first symptom, and another patient showed nonverbal auditory agnosia followed by pure word deafness. Thus, patients with Landau-Kleffner syndrome show sequential and sometimes hierarchical language disorders beginning with sensory aphasia, followed by auditory agnosia, and finally word deafness during their disease process. During long-term follow-up (20 to 30 years), all patients showed marked recovery in language without any intellectual handicap, but with some disability in spoken language, auditory verbal perception, and a discrepancy between Wechsler Verbal and Performance IQ scores. (J Child Neurol 1999; 14:118-122).

Increased Prefrontal Oxygenation Related to Distractor-Resistant Working Memory in Children with Attention-Deficit/ Hyperactivity Disorder (ADHD)

This study aimed at investigating the effect of distraction on working memory and its underlying neural mechanisms in children with attention-deficit/hyperactivity disorder (ADHD). To this end, we studied hemodynamic activity in the prefrontal cortex using near-infrared spectroscopy while 16 children with ADHD and 10 typically developing (TD) children performed a working memory task. This task had two conditions: one involved a distraction during the memory delay interval, whereas the other had no systematic distraction. The ADHD patients showed significantly poorer behavioral performance compared with the TD group, particularly under the distraction. The ADHD group exhibited significantly higher level of prefrontal activation than did TD children. The activity level was positively correlated with the severity of ADHD symptoms. These results suggest that the impairment in the inhibition of distraction is responsible for the working memory deficits observed in ADHD children. Inefficient processing in the prefrontal cortex appears to underlie such deficits.

Diagnosis of Alexander disease in a Japanese patient by molecular genetic analysis

AbstractAlexander disease is a leukodystrophy that is neuropathologically characterized by the presence of numerous Rosenthal fibers in astrocytes. Recently, mutations in the gene encoding glial fibrillary acidic protein (GFAP) were identified in patients with Alexander disease. We sequenced the GFAP gene of a Japanese girl who presented with typical symptoms of Alexander disease but in whom the diagnosis was not proven by histopathology. We identified a missense mutation, R239C, which is identical to the mutation previously reported to be most frequent. As was the case in previously described patients, our patient was also heterozygous for the de novo mutation. Interestingly, despite the fact that this is a de novo mutation, R239C was found to be common in different ethnic groups, implying that the site is a “hot spot” for mutagenesis. Molecular genetic analysis now makes the antemortem diagnosis of Alexander disease possible.

Developmental changes of distortion product and transient evoked otoacoustic emissions in different age groups

The developmental changes of distortion product otoacoustic emissions (DPOAEs) and transient evoked otoacoustic emissions (TEOAEs) were evaluated in 275 normal subjects aged from 1 month to 39 years. The DP-grams showed an M-shaped pattern with peaks at 1587 Hz and 5042 Hz for all age groups. In subjects younger than 3 years, low frequency DPOAEs did not rise above the noise floor. The DP levels at high frequency (5042 Hz) did not change much from infancy to young adulthood (12.9-16.5 dB SPL), however, those at low and middle frequency significantly decreased with age. Total echo power (TEP) of TEOAE was greatest in early infancy, decreased rapidly before 6-7 years old, and then decreased gradually (TEP = 16.6 - 1.9 X ln (age)). Wave reproducibility was constant across age. The frequency area peak power (FAPP) to middle and high frequency sounds changed little with age, however, FAPP at low frequency sounds dramatically increased with age. FAPP at 5000 Hz was relatively depressed levels at each age. The TEOAE value was more prominent at middle and low frequencies while DPOAE was predominant at high frequencies. These two measurements may reflect different functions of outer hair cells in the developing cochlea.