G98 Attention deficits in paediatric sickle cell disease; links with nocturnal oxygen desaturation in adolescents, but not children

AimHomozygous sickle cell anaemia (SCA; HbSS) is associated with neurological compromise and attention difficulties. Previous work has shown tentative links between executive dysfunction and daytime oxygen desaturation in SCA. Previous work has not however examined the effects of nocturnal oxygen sa...

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Published in:Archives of disease in childhood 2017-05, Vol.102 (Suppl 1), p.A40-A41
Main Authors: Stotesbury, H, Kirkham, FJ, Balfour, P, Koelbel, M, Inusa, B, Chakraborty, S, Rees, DC, Downes, M, Kawadler, J
Format: Article
Language:English
Subjects:
Adolescent Development
Adolescents
Attention
Brain
Children
Cognitive ability
Economic Status
Hypoxia
Morbidity
Oxygen
Oxygen saturation
Pediatrics
Performance Tests
Reaction Time
Saturation
Sickle cell disease
Socioeconomics
Teenagers
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container_end_page A41
container_issue Suppl 1
container_start_page A40
container_title Archives of disease in childhood
container_volume 102
creator Stotesbury, H
Kirkham, FJ
Balfour, P
Koelbel, M
Inusa, B
Chakraborty, S
Rees, DC
Downes, M
Kawadler, J
description AimHomozygous sickle cell anaemia (SCA; HbSS) is associated with neurological compromise and attention difficulties. Previous work has shown tentative links between executive dysfunction and daytime oxygen desaturation in SCA. Previous work has not however examined the effects of nocturnal oxygen saturation on attention, nor has it considered whether any relationship is confounded by the effects of socio-economic status (SES) or age.MethodsThirteen children (8–12 years, 6 Female) and twentytwo adolescents (13–18 years, 11 Female) with SCA enrolled on the Prevention of Morbidity in Sickle Cell Disease Phase 2 randomised controlled trial of auto-adjusting continuous positive airways pressure underwent cognitive assessment at baseline, which included the Conners’ Continuous Performance Test (CPT). Overnight oximetry was conducted at home within two weeks of assessment. Multiple deprivation indices (MDI) were derived from postcodes.ResultsIn adolescents, after correcting for the effects of MDI, correlations were found between time spent with oxygen saturation
doi_str_mv 10.1136/archdischild-2017-313087.97
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Previous work has shown tentative links between executive dysfunction and daytime oxygen desaturation in SCA. Previous work has not however examined the effects of nocturnal oxygen saturation on attention, nor has it considered whether any relationship is confounded by the effects of socio-economic status (SES) or age.MethodsThirteen children (8–12 years, 6 Female) and twentytwo adolescents (13–18 years, 11 Female) with SCA enrolled on the Prevention of Morbidity in Sickle Cell Disease Phase 2 randomised controlled trial of auto-adjusting continuous positive airways pressure underwent cognitive assessment at baseline, which included the Conners’ Continuous Performance Test (CPT). Overnight oximetry was conducted at home within two weeks of assessment. Multiple deprivation indices (MDI) were derived from postcodes.ResultsIn adolescents, after correcting for the effects of MDI, correlations were found between time spent with oxygen saturation &lt;94% and Conners’ CPT detectability (r=0.430, p=0.036) and omissions (r=0.418, p=0.042), and between the time spent with oxygen saturation &lt;84% and detectability (r=0.728, p=0.0001), omissions (r=0.566, p=0.004), commissions (r=0.679, p=0.0001), perseverations (r=0.898, p=0.0001), hit reaction time (r=0.372, p=0.0001), and variability (r=0.776, p=0.0001). Relationships were also found between mean nocturnal oxygen saturation and hit reaction time (RT; r= 0.374, p=0.072), omissions (r=0.360, p=0.084) and RT standard deviation (r= 0.389, p=0.060), between minimum nocturnal oxygen saturation and perseverations (r= 0.374, p=0.072) and between the number of 3% oxygen dips per hour and RT (r=0.354, p=0.089). In children the only relationship found was a trend in the opposite direction between RT and mean overnight oxygen saturation (r=0.502, p=0.067).ConclusionThis study confirms, for the first time in SCA, links between hypoxia and attention deficits. The relationships hold when SES is taken into account. The absence of similar links and existence of a relationship in the opposite direction in children requires further scrutiny. These preliminary data indicate that the effects of hypoxia on these domains may only emerge during brain development in adolescence. CPT performance may serve as a useful cognitive endpointfor trials of reducing hypoxic exposure.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2017-313087.97</identifier><language>eng</language><publisher>London: BMJ Publishing Group LTD</publisher><subject>Adolescent Development ; Adolescents ; Attention ; Brain ; Children ; Cognitive ability ; Economic Status ; Hypoxia ; Morbidity ; Oxygen ; Oxygen saturation ; Pediatrics ; Performance Tests ; Reaction Time ; Saturation ; Sickle cell disease ; Socioeconomics ; Teenagers</subject><ispartof>Archives of disease in childhood, 2017-05, Vol.102 (Suppl 1), p.A40-A41</ispartof><rights>2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>2017 2017, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2894904904/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2894904904?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,21378,21394,27924,27925,33611,33877,43733,43880,74221,74397</link.rule.ids></links><search><creatorcontrib>Stotesbury, H</creatorcontrib><creatorcontrib>Kirkham, FJ</creatorcontrib><creatorcontrib>Balfour, P</creatorcontrib><creatorcontrib>Koelbel, M</creatorcontrib><creatorcontrib>Inusa, B</creatorcontrib><creatorcontrib>Chakraborty, S</creatorcontrib><creatorcontrib>Rees, DC</creatorcontrib><creatorcontrib>Downes, M</creatorcontrib><creatorcontrib>Kawadler, J</creatorcontrib><title>G98 Attention deficits in paediatric sickle cell disease; links with nocturnal oxygen desaturation in adolescents, but not children</title><title>Archives of disease in childhood</title><description>AimHomozygous sickle cell anaemia (SCA; HbSS) is associated with neurological compromise and attention difficulties. Previous work has shown tentative links between executive dysfunction and daytime oxygen desaturation in SCA. Previous work has not however examined the effects of nocturnal oxygen saturation on attention, nor has it considered whether any relationship is confounded by the effects of socio-economic status (SES) or age.MethodsThirteen children (8–12 years, 6 Female) and twentytwo adolescents (13–18 years, 11 Female) with SCA enrolled on the Prevention of Morbidity in Sickle Cell Disease Phase 2 randomised controlled trial of auto-adjusting continuous positive airways pressure underwent cognitive assessment at baseline, which included the Conners’ Continuous Performance Test (CPT). Overnight oximetry was conducted at home within two weeks of assessment. Multiple deprivation indices (MDI) were derived from postcodes.ResultsIn adolescents, after correcting for the effects of MDI, correlations were found between time spent with oxygen saturation &lt;94% and Conners’ CPT detectability (r=0.430, p=0.036) and omissions (r=0.418, p=0.042), and between the time spent with oxygen saturation &lt;84% and detectability (r=0.728, p=0.0001), omissions (r=0.566, p=0.004), commissions (r=0.679, p=0.0001), perseverations (r=0.898, p=0.0001), hit reaction time (r=0.372, p=0.0001), and variability (r=0.776, p=0.0001). Relationships were also found between mean nocturnal oxygen saturation and hit reaction time (RT; r= 0.374, p=0.072), omissions (r=0.360, p=0.084) and RT standard deviation (r= 0.389, p=0.060), between minimum nocturnal oxygen saturation and perseverations (r= 0.374, p=0.072) and between the number of 3% oxygen dips per hour and RT (r=0.354, p=0.089). In children the only relationship found was a trend in the opposite direction between RT and mean overnight oxygen saturation (r=0.502, p=0.067).ConclusionThis study confirms, for the first time in SCA, links between hypoxia and attention deficits. The relationships hold when SES is taken into account. The absence of similar links and existence of a relationship in the opposite direction in children requires further scrutiny. These preliminary data indicate that the effects of hypoxia on these domains may only emerge during brain development in adolescence. 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links with nocturnal oxygen desaturation in adolescents, but not children</atitle><jtitle>Archives of disease in childhood</jtitle><date>2017-05</date><risdate>2017</risdate><volume>102</volume><issue>Suppl 1</issue><spage>A40</spage><epage>A41</epage><pages>A40-A41</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><abstract>AimHomozygous sickle cell anaemia (SCA; HbSS) is associated with neurological compromise and attention difficulties. Previous work has shown tentative links between executive dysfunction and daytime oxygen desaturation in SCA. Previous work has not however examined the effects of nocturnal oxygen saturation on attention, nor has it considered whether any relationship is confounded by the effects of socio-economic status (SES) or age.MethodsThirteen children (8–12 years, 6 Female) and twentytwo adolescents (13–18 years, 11 Female) with SCA enrolled on the Prevention of Morbidity in Sickle Cell Disease Phase 2 randomised controlled trial of auto-adjusting continuous positive airways pressure underwent cognitive assessment at baseline, which included the Conners’ Continuous Performance Test (CPT). Overnight oximetry was conducted at home within two weeks of assessment. Multiple deprivation indices (MDI) were derived from postcodes.ResultsIn adolescents, after correcting for the effects of MDI, correlations were found between time spent with oxygen saturation &lt;94% and Conners’ CPT detectability (r=0.430, p=0.036) and omissions (r=0.418, p=0.042), and between the time spent with oxygen saturation &lt;84% and detectability (r=0.728, p=0.0001), omissions (r=0.566, p=0.004), commissions (r=0.679, p=0.0001), perseverations (r=0.898, p=0.0001), hit reaction time (r=0.372, p=0.0001), and variability (r=0.776, p=0.0001). Relationships were also found between mean nocturnal oxygen saturation and hit reaction time (RT; r= 0.374, p=0.072), omissions (r=0.360, p=0.084) and RT standard deviation (r= 0.389, p=0.060), between minimum nocturnal oxygen saturation and perseverations (r= 0.374, p=0.072) and between the number of 3% oxygen dips per hour and RT (r=0.354, p=0.089). In children the only relationship found was a trend in the opposite direction between RT and mean overnight oxygen saturation (r=0.502, p=0.067).ConclusionThis study confirms, for the first time in SCA, links between hypoxia and attention deficits. The relationships hold when SES is taken into account. The absence of similar links and existence of a relationship in the opposite direction in children requires further scrutiny. These preliminary data indicate that the effects of hypoxia on these domains may only emerge during brain development in adolescence. CPT performance may serve as a useful cognitive endpointfor trials of reducing hypoxic exposure.</abstract><cop>London</cop><pub>BMJ Publishing Group LTD</pub><doi>10.1136/archdischild-2017-313087.97</doi></addata></record>
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subjects Adolescent Development
Adolescents
Attention
Brain
Children
Cognitive ability
Economic Status
Hypoxia
Morbidity
Oxygen
Oxygen saturation
Pediatrics
Performance Tests
Reaction Time
Saturation
Sickle cell disease
Socioeconomics
Teenagers
title G98 Attention deficits in paediatric sickle cell disease; links with nocturnal oxygen desaturation in adolescents, but not children
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