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Beersheba, Israel

Ben-Pazi H.,Neuropediatric Unit | Stoner J.A.,The University of Oklahoma Health Sciences Center | Cunningham M.W.,The University of Oklahoma Health Sciences Center

Background:Sydenham chorea (SC), a neuropsychiatric sequela of group-A streptococcal infection, is associated with basal ganglia autoantibodies. Although autoantibodies have been proposed in neuropsychiatric disorders, little evidence has been shown to link autoimmunity and clinical symptoms. We hypothesized that dopamine receptor-autoantibody interactions may be the basis of neuropsychiatric symptoms in SC.Methods:Sera from 22 children with SC (age 10.7±4.5 years) and 22 age-matched controls were studied. Clinical neuropsychiatric symptoms were measured in SC at sample collection using the UFMG-Sydenham's-Chorea-Rating-Scale (USCRS). Anti-dopamine D1 receptor (D1R) and anti-dopamine D2 receptor (D2R) autoantibodies were measured by the enzyme linked immunosorbent assay (ELISA) and were correlated with clinical symptoms.Results:Anti-D1R and anti-D2R autoantibodies were significantly higher in SC compared to controls (n = 44; p = 0.010 and p = 0.017, respectively). We found that the ratio (anti-D2R/D1R) of the two anti-dopaminergic receptor antibodies correlated with neuropsychiatric symptoms as determined by USCRS measurements (n = 18; r = 0.53, p = 0.024). In addition, anti-D2R titers correlated with antistreptolysin-O titers (n = 43; r = 0.49, p = 0.0008).Interpretation:Our report linked, for the first time, autoimmunity with neuropsychiatric symptoms. The significant correlation was found using ratios of autoantibodies against dopamine receptors (anti-D2R/D1R) rather than the absolute elevated individual anti-D1R or anti-D2R titers. We suggest that autoantibodies may lead to a receptor imbalance and induce greater sensitivity to dopamine signaling potentially leading to neuropsychiatric symptoms in SC. Our novel findings suggesting altered balance in the dopaminergic system may provide a new approach in understanding autoimmune neuropsychiatric disorders with possible implications for diagnosis and treatment. © 2013 Ben-Pazi et al. Source

Van'T Hooft I.,Neuropediatric Unit | Norberg A.L.,Karolinska Institutet

In a pilot study we examined the feasibility of a condensed version of the Swedish Memory and Attention Re-Training on children treated for medulloblastoma combined with a structured coaching programme for their parents. Parental coaching contained the translation of the child's new skills into daily life, and education regarding their own stress mechanisms. Before and after intervention we assessed the children's cognitive performance, social relations and self image as well as their parents stress. All three families continued the programme without interruption. Observations revealed that this condensed version of the programme was more stressful to participants. However, several aspects of the children's attention and memory performance improved from pre to post-training assessment. In addition, all of the children reported enhancement of their social relations and self image. Initially, symptoms of parental stress were pronounced for the three mothers, but fairly low for the fathers. After training and coaching, the stress level of both mothers and fathers was low. Our findings encourage full scale studies examining whether this combination of condensed cognitive training and specific coaching programme for parents may influence not only the children's cognitive performance but also their social relations, self image and their parents stress. © 2010-IOS Press and the authors. All rights reserved. Source

Pollak Y.,Hebrew University of Jerusalem | Pollak Y.,Neuropediatric Unit | Shoham R.,Hebrew University of Jerusalem | Shoham R.,Talpiot College
Journal of Abnormal Child Psychology

Inept probabilistic decision making is commonly associated with ADHD. In experimental designs aimed to model probabilistic decision making in ADHD, feedback following each choice was, in the majority of studies, part of the paradigm. This study examined whether feedback processing plays a role in the maladaptive choice behavior of subjects with ADHD by comparing feedback and no-feedback conditions. Sixty adolescents (49 males), ages 13–18, with and without ADHD, performed a descriptive probabilistic choice task in which outcomes and probabilities were explicitly provided. Subjects performed the task either with or without feedback. Under the no-feedback condition, adolescents with ADHD and controls performed similarly, whereas under the feedback condition, subjects with ADHD chose the unfavorable outcomes more frequently and risked smaller sums than controls. These finding demonstrate the crucial role of feedback in the decision making of adolescents with ADHD. © 2015, Springer Science+Business Media New York. Source

Vakil E.,Bar - Ilan University | Blachstein H.,Bar - Ilan University | Wertman-Elad R.,Neuropediatric Unit | Greenstein Y.,Kinneret and Zefat Academic Colleges
Child Neuropsychology

The primary purpose of the present study is to examine the effects of attention deficits, learning disability, and the combined effects of both on the learning and memory processes, as measured by the Rey Auditory Verbal Learning Test (AVLT). Thirty children (age range 12-17) diagnosed with attention deficit/hyperactivity disorder (ADHD), 18 children (age range 11-17) diagnosed with learning disabilities (LD), and 64 children (age range 12-17) diagnosed with ADHD as well as with LD, and 28, 18, and 62 matched controls, respectively, participated in this study. It was found that the children diagnosed with ADHD did not differ in any of the verbal learning and memory measures derived from the Rey AVLT. The group with LD was impaired in the overall number of words recalled across the learning phase. Performance of the children diagnosed with ADHD +LD showed a similar impairment as the group with LD (i.e., overall amount of words learned) and, in addition, their retrieval efficiency was also impaired. In conclusion, this study indicates that verbal memory is preserved in children with ADHD if they have no LD and their intelligence is in the normal range or above. LD by itself leads to difficulties in acquisition, but the combination of ADHD+LD leads to additional impairment in retrieval processes. © 2012 Psychology Press. Source

Shalev R.,Neuropediatric Unit
Developmental Medicine and Child Neurology

This commentary is on the original article by Santos et al. on pages 654-660 of this issue. Developmental Medicine & Child Neurology. © 2013 Mac Keith Press. Source

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