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Neurological complications after neonatal bacteremia: The clinical characteristics, risk factors and outcomes
e592
Abstracts / Journal of the Neurological Sciences 333 (2013) e579–e628
Conclusions: Alzheimer's disease has a higher prevalence of occurrence relative to Parkinson and it occurs most frequently among persons of female gender. doi:10.1016/j.jns.2013.07.2065
Abstract — WCN 2013 No: 445 Topic: 36 — Other topic Prevalence of chronic degenerative diseases and traumatic nervous system in adolescents and adults G. Baquero Sastre, M. Dominguez. Neurorehabilitation Physiotherapy, Manuela Beltran University, Bogota, Colombia Introduction: The demographic, social and lifestyle of the population factors have led to the increase in cases of chronic degenerative and traumatic neurological diseases that have significant impacts on the processes of life for people. Objective: To establish the prevalence of chronic degenerative and traumatic diseases of the nervous system in adolescents and adults. Materials and methods: Cross-sectional study in which statistical records were taken care of patients over 15 years old seen in 2012 in the health care practices of Physical Therapy Program at the University Manuela Beltran. Results: During 2012 they attended a total of 4122 people over 15 years old. 25.76% (n = 1062, standard error = 0.00) of these people were intercepted with neurological problems. 17.98% (n = 191, standard error = 0.02) of people with neurological diseases were due to trauma, and 32.39% (n = 344, standard error = 0.02) had chronic degenerative diseases. 44.5% (n = 85, standard error = 0.03) of people with traumatic disease had brain injury, while among those with chronic degenerative diseases the 60.75% (n = 209, standard error = 0.02) reported disease cases, e.g. Alzheimer. 72.94% of people with traumatic brain injury were male (n = 62, standard error = 0.02), and 77.51% (n = 162, standard error = 0.01) of people with Alzheimer's disease were women. Conclusions: Chronic degenerative diseases tend to be more prevalent diseases in the nervous system than traumatic diseases, the first disease chronic degenerative as Alzheimer, and in traumatic disease as brain injury. doi:10.1016/j.jns.2013.07.2066
Abstract — WCN 2013 No: 125 Topic: 36 — Other topic Diffusion-weighted cranial MR imaging in Wernicke's encephalopathy associated with enterocutaneous fistula B. Caglia, A. Tekatasb, S. Tuncela, Y. Celikb. aRadiodiagnostic, Trakya University School of Medicine, Edirne, Turkey; b Neurology, Trakya University School of Medicine, Edirne, Turkey Wernicke's encephalopathy is a rare neurological disease due to tiamin deficiency and characterized by ophthalmoparesis, disturbed consciousness and ataxia. It is known that periventricular white matter, medial thalamic nuclei, massa intermedia, and mammillary bodies are affected in Wernicke's encephalopathy. Chronic alcoholism, anorexia, peritoneal dialysis, hyperemesis gravidarum and total parenteral nutrition are the most common causes of Wernicke's encephalopathy. We presented three patients who had Wernicke's encephalopathy due to total parenteral nutrition and tiamin deficiency. doi:10.1016/j.jns.2013.07.2067
Abstract — WCN 2013 No: 525 Topic: 36 — Other topic Association between DBH gene polymorphisms and attention deficit hyperactivity disorder in Korean children M.H. Lima, C.M. Leeb, H.J. Kwonc. aPsychiatry, Environmental Center, Dankook University, Cheonan, Republic of Korea; bNeurology, Dankook University, Cheonan, Republic of Korea; cPreventive Medicine, Environmental Health Center, Dankook University, Cheonan, Republic of Korea Attention deficit hyperactivity disorder (ADHD) is a common disorder of the school-age population. ADHD is familial and genetic studies estimate heritability at 80–90%. The aim of the present study was to investigate the association between the genetic type and alleles for DBH gene in Korean children with ADHD. The sample consisted of 142 ADHD children and 139 control children. We diagnosed ADHD according to DSM-IV. ADHD symptoms were evaluated with Conners' Parent Rating Scales and Dupaul Parent ADHD Rating Scales. Blood samples were taken from the 281 subjects, DNA was extracted from blood lymphocytes, and PCR was performed for DBH polymorphism. Alleles and genotype frequencies were compared using the Chi-square test. We compared the allele and genotype frequencies of DBH gene polymorphism in the ADHD and control groups. This study showed that there was a significant correlation among the frequencies of the rs1611115 (OR = 0.64, 95% CI = 0.42–0.97, p = 0.034) of alleles of DBH, but the final conclusions are not definite. Follow-up studies with larger patient or pure subgroups are expected. These results suggested that DBH might be related to ADHD symptoms. doi:10.1016/j.jns.2013.07.2068
Abstract — WCN 2013 No: 527 Topic: 36 — Other topic Neurological complications after neonatal bacteremia: The clinical characteristics, risk factors and outcomes S.-M. Chua, J.-F. Hsua, M.H. Tsaib. aChang Gung Memorial Hospital, Taoyuan, Taiwan, ROC; bChang Gung Memorial Hospital, Yunlin, Taiwan, ROC Background: Neonates with bacteremia are at risk of neurological complications, but the relevant information is understudied. Objective: To characterize the clinical features, risk factors, and outcomes of neonatal bacteremia-related neurological complications (BNCs). Methods and materials: A retrospective cohort study of neonates with BNCs in a tertiary-level neonatal intensive care unit was conducted. Systemic chart review was performed to identify clinical characteristics and outcomes. A cohort of related conditions was constructed as the control group, and logistic regression was used to identify independent risk factors for BNC. Results: Of 1075 episodes of bacteremia, 35 neonates had BNCs. Three-fifth (21/35) of BNCs were due to meningitis, six were presumed meningitis and eight occurred after hypoxia and septic shock. The most common pathogen to cause BNC is Group B streptococcus (GBS) (15/35, 42.9%) and Escherichia coli (6/35, 17.1%). The major BNCs consisted of seizure (27), hydrocephalus (19), encephalomalacia (11), cerebral infarction (7), subdural empyema (6), and post-infectious encephalopathy (3). 8 (22.8%) neonates died, and 7 neonates were discharged at critical condition after the family requested and withdrew all treatment. Among 20 survivors, 10 had neurological sequelae when discharged. In the cohort of neonates with meningitis and septic shock, extremely preterm (gestational age b28 weeks) and meningitis caused by GBS were independent risk factors for development of BNC.
Abstracts / Journal of the Neurological Sciences 333 (2013) e579–e628
Conclusion: Neonatal bacteremia with meningitis is associated with high risk of neurological complications, especially caused by GBS. Aggressive treatment is worth consideration because bacteremiarelated neurological complications potentially result in mortality and morbidities. doi:10.1016/j.jns.2013.07.2069
Abstract — WCN 2013 No: 511 Topic: 36 — Other topic Vestibular evoked myogenic potentials (VEMPS) from upper limb muscles E.S. Papathanasioua, C. Iosifb, S.S. Papacostasa. aClinic B, The Cyprus Institute of Neurology & Genetics, Cyprus; bCyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus Background: Vestibular evoked myogenic potentials (VEMPs) are a relatively new method of recording function from the vestibular nervous system. It relies on the fact that the saccule has retained its sensitivity to sound and can be stimulated by such. Recordings are frequently performed from the sternocleidomastoid muscle (cervical VEMPs or cVEMPs) and more recently from the inferior oblique muscle (ocular VEMPs or oVEMPs). Recording from the limbs is rarer and has so far been done in only a few selected muscles such as the gastrocnemius and triceps. A systematic study of all limb muscles within and between individuals has not so far been done. Objective: To systematically study the characteristics of VEMPs from upper limb muscles. Material and methods: Fourteen physiologically normal volunteers were recruited (age range 17–25 years, 4 males and 10 females). Together with the cVEMPs and oVEMPs, attempts to record VEMPs in response to moderate intensity (120 dB pSPL) tone (500 Hz) stimulation were done from the deltoid, biceps brachii, triceps brachii and flexor carpi radialis muscles. Results: Reproducible responses against a background of tonic contraction were obtained from all muscles, with mean initial peak times of 15 ms (cVEMP), 9.9 ms (oVEMP), 11.5 ms (deltoid), 12.3 ms (biceps), 12.12 ms (triceps) and 16.0 ms (FCR). Conclusion: It is possible to record VEMPs from various upper limb muscles with different mean latencies. This should prove useful in the future to evaluate lesions in the anterior funiculus of the spinal cord at different levels.
doi:10.1016/j.jns.2013.07.2070
Abstract — WCN 2013 No: 514 Topic: 36 — Other topic Neural correlates of inspection time task performance: A developmental study S.S. Papacostasa, E.S. Papathanasioua, C. Christoforoub, G. Spanoudisb. a Clinic B, The Cyprus Institute of Neurology & Genetics, Cyprus; b Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus Background: Inspection Time Task (ITT) is used as an index of individual differences in perceptual discrimination speed. It is a reliable predictor of the relation between processing speed and psychometric intelligence. Converging findings showed that people with higher IQ identify a briefly presented stimulus more quickly and with greater accuracy than those of a lower IQ.
e593
Objective: To examine the neural correlates of developing intelligence by contrasting the behavioral performance as well as the event-related potentials (ERPs) of two groups of children, one with high IQ scores and one with low. To our knowledge, speed of processing as neural correlate of intelligence has not been studied systematically during school age and adolescence. Material and methods: This study involved two age-matched samples of 158 children aged 7 through 18 years, selected on the basis of their scores on Wechsler Abbreviated Scales of Intelligence. Children performed the ITT while their electro-cortical activity was registered using a high-density 128-channel electroencephalography acquisition system. Results: Differences were found in the amplitude course of ERPs between 'high IQ' and 'low IQ' individuals which are consistent with their differences in inspection time. 'High IQ' individuals were faster, less prone to err, and demonstrated significantly larger N1 responses. N1 latency and other ERP components did not differentiate between the two IQ groups. Conclusion: Given the specificity of ERP group differences to the N1, the results of the present study suggested that allocation of attentional resources is more difficult for individuals with lower IQ scores.
doi:10.1016/j.jns.2013.07.2071
Abstract — WCN 2013 No: 505 Topic: 36 — Other topic Hyperactivity and impulsivity in children with allergic rhinitis M.-T. Yanga, C.-C. Chena, J.-S. Lianga, W.-T. Leeb. aPediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC; bPediatrics, National Taiwan University Hospital, Taipei, Taiwan, ROC Background: Allergic rhinitis (AR) is the most common chronic allergic disease in school-age children. In addition to physical complications, sleep disturbances, poor school performance, and hyperactivity are all mental complications seen in many children related to their nasal allergies. Increased prevalence and odds ratio of attention-deficit/hyperactivity disorder (ADHD) in AR patients were also noted by analyzing the Taiwan's National Health Insurance Research Database. Inattention and hyperactivity in AR children have not been investigated by objective and scientific measurements. Objective: The goal of this study was to see if there was a difference in inattention and hyperactivity between AR children and agematched control children by questionnaires and software. Patients and methods: In this study, we applied the AR symptom score (T5SS), the ADHD symptom and severity scale (SNAP-IV) and the computerized continuous performance test (CPT) to study the attention and the impulsivity in AR children and age-matched control children (aged 6 to 15 years old). Results: Fifty-nine AR children and seventeen control children were enrolled. There were no differences of age and gender between two groups. Hyperactivity subscales of SNAP-IV from both parents and teachers scored significantly higher in AR children (p b 0.01). CPT revealed higher commission error rate, shorter reaction time, and higher d-prime (p b 0.01). Conclusion: AR children were more hyperactive and impulsive than control children. For AR children, behavior and emotion problems in family and at school need close attention and further investigation.
doi:10.1016/j.jns.2013.07.2072
Abstracts / Journal of the Neurological Sciences 333 (2013) e579–e628
Conclusions: Alzheimer's disease has a higher prevalence of occurrence relative to Parkinson and it occurs most frequently among persons of female gender. doi:10.1016/j.jns.2013.07.2065
Abstract — WCN 2013 No: 445 Topic: 36 — Other topic Prevalence of chronic degenerative diseases and traumatic nervous system in adolescents and adults G. Baquero Sastre, M. Dominguez. Neurorehabilitation Physiotherapy, Manuela Beltran University, Bogota, Colombia Introduction: The demographic, social and lifestyle of the population factors have led to the increase in cases of chronic degenerative and traumatic neurological diseases that have significant impacts on the processes of life for people. Objective: To establish the prevalence of chronic degenerative and traumatic diseases of the nervous system in adolescents and adults. Materials and methods: Cross-sectional study in which statistical records were taken care of patients over 15 years old seen in 2012 in the health care practices of Physical Therapy Program at the University Manuela Beltran. Results: During 2012 they attended a total of 4122 people over 15 years old. 25.76% (n = 1062, standard error = 0.00) of these people were intercepted with neurological problems. 17.98% (n = 191, standard error = 0.02) of people with neurological diseases were due to trauma, and 32.39% (n = 344, standard error = 0.02) had chronic degenerative diseases. 44.5% (n = 85, standard error = 0.03) of people with traumatic disease had brain injury, while among those with chronic degenerative diseases the 60.75% (n = 209, standard error = 0.02) reported disease cases, e.g. Alzheimer. 72.94% of people with traumatic brain injury were male (n = 62, standard error = 0.02), and 77.51% (n = 162, standard error = 0.01) of people with Alzheimer's disease were women. Conclusions: Chronic degenerative diseases tend to be more prevalent diseases in the nervous system than traumatic diseases, the first disease chronic degenerative as Alzheimer, and in traumatic disease as brain injury. doi:10.1016/j.jns.2013.07.2066
Abstract — WCN 2013 No: 125 Topic: 36 — Other topic Diffusion-weighted cranial MR imaging in Wernicke's encephalopathy associated with enterocutaneous fistula B. Caglia, A. Tekatasb, S. Tuncela, Y. Celikb. aRadiodiagnostic, Trakya University School of Medicine, Edirne, Turkey; b Neurology, Trakya University School of Medicine, Edirne, Turkey Wernicke's encephalopathy is a rare neurological disease due to tiamin deficiency and characterized by ophthalmoparesis, disturbed consciousness and ataxia. It is known that periventricular white matter, medial thalamic nuclei, massa intermedia, and mammillary bodies are affected in Wernicke's encephalopathy. Chronic alcoholism, anorexia, peritoneal dialysis, hyperemesis gravidarum and total parenteral nutrition are the most common causes of Wernicke's encephalopathy. We presented three patients who had Wernicke's encephalopathy due to total parenteral nutrition and tiamin deficiency. doi:10.1016/j.jns.2013.07.2067
Abstract — WCN 2013 No: 525 Topic: 36 — Other topic Association between DBH gene polymorphisms and attention deficit hyperactivity disorder in Korean children M.H. Lima, C.M. Leeb, H.J. Kwonc. aPsychiatry, Environmental Center, Dankook University, Cheonan, Republic of Korea; bNeurology, Dankook University, Cheonan, Republic of Korea; cPreventive Medicine, Environmental Health Center, Dankook University, Cheonan, Republic of Korea Attention deficit hyperactivity disorder (ADHD) is a common disorder of the school-age population. ADHD is familial and genetic studies estimate heritability at 80–90%. The aim of the present study was to investigate the association between the genetic type and alleles for DBH gene in Korean children with ADHD. The sample consisted of 142 ADHD children and 139 control children. We diagnosed ADHD according to DSM-IV. ADHD symptoms were evaluated with Conners' Parent Rating Scales and Dupaul Parent ADHD Rating Scales. Blood samples were taken from the 281 subjects, DNA was extracted from blood lymphocytes, and PCR was performed for DBH polymorphism. Alleles and genotype frequencies were compared using the Chi-square test. We compared the allele and genotype frequencies of DBH gene polymorphism in the ADHD and control groups. This study showed that there was a significant correlation among the frequencies of the rs1611115 (OR = 0.64, 95% CI = 0.42–0.97, p = 0.034) of alleles of DBH, but the final conclusions are not definite. Follow-up studies with larger patient or pure subgroups are expected. These results suggested that DBH might be related to ADHD symptoms. doi:10.1016/j.jns.2013.07.2068
Abstract — WCN 2013 No: 527 Topic: 36 — Other topic Neurological complications after neonatal bacteremia: The clinical characteristics, risk factors and outcomes S.-M. Chua, J.-F. Hsua, M.H. Tsaib. aChang Gung Memorial Hospital, Taoyuan, Taiwan, ROC; bChang Gung Memorial Hospital, Yunlin, Taiwan, ROC Background: Neonates with bacteremia are at risk of neurological complications, but the relevant information is understudied. Objective: To characterize the clinical features, risk factors, and outcomes of neonatal bacteremia-related neurological complications (BNCs). Methods and materials: A retrospective cohort study of neonates with BNCs in a tertiary-level neonatal intensive care unit was conducted. Systemic chart review was performed to identify clinical characteristics and outcomes. A cohort of related conditions was constructed as the control group, and logistic regression was used to identify independent risk factors for BNC. Results: Of 1075 episodes of bacteremia, 35 neonates had BNCs. Three-fifth (21/35) of BNCs were due to meningitis, six were presumed meningitis and eight occurred after hypoxia and septic shock. The most common pathogen to cause BNC is Group B streptococcus (GBS) (15/35, 42.9%) and Escherichia coli (6/35, 17.1%). The major BNCs consisted of seizure (27), hydrocephalus (19), encephalomalacia (11), cerebral infarction (7), subdural empyema (6), and post-infectious encephalopathy (3). 8 (22.8%) neonates died, and 7 neonates were discharged at critical condition after the family requested and withdrew all treatment. Among 20 survivors, 10 had neurological sequelae when discharged. In the cohort of neonates with meningitis and septic shock, extremely preterm (gestational age b28 weeks) and meningitis caused by GBS were independent risk factors for development of BNC.
Abstracts / Journal of the Neurological Sciences 333 (2013) e579–e628
Conclusion: Neonatal bacteremia with meningitis is associated with high risk of neurological complications, especially caused by GBS. Aggressive treatment is worth consideration because bacteremiarelated neurological complications potentially result in mortality and morbidities. doi:10.1016/j.jns.2013.07.2069
Abstract — WCN 2013 No: 511 Topic: 36 — Other topic Vestibular evoked myogenic potentials (VEMPS) from upper limb muscles E.S. Papathanasioua, C. Iosifb, S.S. Papacostasa. aClinic B, The Cyprus Institute of Neurology & Genetics, Cyprus; bCyprus School of Molecular Medicine, The Cyprus Institute of Neurology & Genetics, Nicosia, Cyprus Background: Vestibular evoked myogenic potentials (VEMPs) are a relatively new method of recording function from the vestibular nervous system. It relies on the fact that the saccule has retained its sensitivity to sound and can be stimulated by such. Recordings are frequently performed from the sternocleidomastoid muscle (cervical VEMPs or cVEMPs) and more recently from the inferior oblique muscle (ocular VEMPs or oVEMPs). Recording from the limbs is rarer and has so far been done in only a few selected muscles such as the gastrocnemius and triceps. A systematic study of all limb muscles within and between individuals has not so far been done. Objective: To systematically study the characteristics of VEMPs from upper limb muscles. Material and methods: Fourteen physiologically normal volunteers were recruited (age range 17–25 years, 4 males and 10 females). Together with the cVEMPs and oVEMPs, attempts to record VEMPs in response to moderate intensity (120 dB pSPL) tone (500 Hz) stimulation were done from the deltoid, biceps brachii, triceps brachii and flexor carpi radialis muscles. Results: Reproducible responses against a background of tonic contraction were obtained from all muscles, with mean initial peak times of 15 ms (cVEMP), 9.9 ms (oVEMP), 11.5 ms (deltoid), 12.3 ms (biceps), 12.12 ms (triceps) and 16.0 ms (FCR). Conclusion: It is possible to record VEMPs from various upper limb muscles with different mean latencies. This should prove useful in the future to evaluate lesions in the anterior funiculus of the spinal cord at different levels.
doi:10.1016/j.jns.2013.07.2070
Abstract — WCN 2013 No: 514 Topic: 36 — Other topic Neural correlates of inspection time task performance: A developmental study S.S. Papacostasa, E.S. Papathanasioua, C. Christoforoub, G. Spanoudisb. a Clinic B, The Cyprus Institute of Neurology & Genetics, Cyprus; b Department of Psychology and Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus Background: Inspection Time Task (ITT) is used as an index of individual differences in perceptual discrimination speed. It is a reliable predictor of the relation between processing speed and psychometric intelligence. Converging findings showed that people with higher IQ identify a briefly presented stimulus more quickly and with greater accuracy than those of a lower IQ.
e593
Objective: To examine the neural correlates of developing intelligence by contrasting the behavioral performance as well as the event-related potentials (ERPs) of two groups of children, one with high IQ scores and one with low. To our knowledge, speed of processing as neural correlate of intelligence has not been studied systematically during school age and adolescence. Material and methods: This study involved two age-matched samples of 158 children aged 7 through 18 years, selected on the basis of their scores on Wechsler Abbreviated Scales of Intelligence. Children performed the ITT while their electro-cortical activity was registered using a high-density 128-channel electroencephalography acquisition system. Results: Differences were found in the amplitude course of ERPs between 'high IQ' and 'low IQ' individuals which are consistent with their differences in inspection time. 'High IQ' individuals were faster, less prone to err, and demonstrated significantly larger N1 responses. N1 latency and other ERP components did not differentiate between the two IQ groups. Conclusion: Given the specificity of ERP group differences to the N1, the results of the present study suggested that allocation of attentional resources is more difficult for individuals with lower IQ scores.
doi:10.1016/j.jns.2013.07.2071
Abstract — WCN 2013 No: 505 Topic: 36 — Other topic Hyperactivity and impulsivity in children with allergic rhinitis M.-T. Yanga, C.-C. Chena, J.-S. Lianga, W.-T. Leeb. aPediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC; bPediatrics, National Taiwan University Hospital, Taipei, Taiwan, ROC Background: Allergic rhinitis (AR) is the most common chronic allergic disease in school-age children. In addition to physical complications, sleep disturbances, poor school performance, and hyperactivity are all mental complications seen in many children related to their nasal allergies. Increased prevalence and odds ratio of attention-deficit/hyperactivity disorder (ADHD) in AR patients were also noted by analyzing the Taiwan's National Health Insurance Research Database. Inattention and hyperactivity in AR children have not been investigated by objective and scientific measurements. Objective: The goal of this study was to see if there was a difference in inattention and hyperactivity between AR children and agematched control children by questionnaires and software. Patients and methods: In this study, we applied the AR symptom score (T5SS), the ADHD symptom and severity scale (SNAP-IV) and the computerized continuous performance test (CPT) to study the attention and the impulsivity in AR children and age-matched control children (aged 6 to 15 years old). Results: Fifty-nine AR children and seventeen control children were enrolled. There were no differences of age and gender between two groups. Hyperactivity subscales of SNAP-IV from both parents and teachers scored significantly higher in AR children (p b 0.01). CPT revealed higher commission error rate, shorter reaction time, and higher d-prime (p b 0.01). Conclusion: AR children were more hyperactive and impulsive than control children. For AR children, behavior and emotion problems in family and at school need close attention and further investigation.
doi:10.1016/j.jns.2013.07.2072