Abstract
OBJECTIVE: The goal was to evaluate polymorphisms of the APOE gene as modifiers of neurobehavioral outcomes for preschool-aged children with congenital heart defects, after cardiac surgery. METHODS: A prospective observational study with neurodevelopmental evaluation between the fourth and fifth birthdays was performed. Attention and behavioral skills were assessed through parental report. RESULTS: Parents of 380 children completed the neurobehavioral measures. Child Behavior Checklist scores for the pervasive developmental problem scale were in the at-risk or clinically significant range for 15% of the cohort, compared with 9% for the normative data (P < .00001). Attention problem scores were in the at-risk or clinically significant range for 12% of the cohort, compared with 7% for the normative data (P = .0002). The Attention-Deficit/Hyperactivity Disorder Rating Scale-IV, Preschool Version, was completed for 378 children; 30% scored in the clinically significant range for inattention and 22% for impulsivity. After adjustment for covariates, the APOE ε2 allele was significantly associated with higher scores (worse problems) for multiple Child Behavior Checklist indices, including somatic complaints (P = .009), pervasive developmental problems (P = .032), and internalizing problems (P=.009). In each case, the ε4 allele was associated with a better outcome. APOE ε2 carriers had impaired social skills, compared with ε4 carriers (P = .009). CONCLUSIONS: For preschool-aged children with congenital heart defects requiring surgery, parental rating scales showed an increased prevalence of restricted behavior patterns, inattention, and impaired social interactions. The APOE ε2 allele was associated with increased behavior problems, impaired social interactions, and restricted behavior patterns.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 241-250 |
| Number of pages | 10 |
| Journal | Pediatrics |
| Volume | 124 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jul 1 2009 |
| Externally published | Yes |
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Keywords
- Apolipoprotein E
- Attention-deficit/hyperactivity disorder
- Autistic disorder
- Behavioral symptoms
- Congenital heart defects
- Genetic predisposition to disease
- Impulsive behavior
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
Apolipoprotein E genotype modifies the risk of behavior problems after infant cardiac surgery. / Gaynor, J. William; Nord, Alexander; Wernovsky, Gil; Bernbaum, Judy; Solot, Cynthia B.; Burnham, Nancy; Zackai, Elaine; Heagerty, Patrick J.; Clancy, Robert R.; Nicolson, Susan C.; Jarvik, Gail P.; Gerdes, Marsha.
In: Pediatrics, Vol. 124, No. 1, 01.07.2009, p. 241-250.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Apolipoprotein E genotype modifies the risk of behavior problems after infant cardiac surgery
AU - Gaynor, J. William
AU - Nord, Alexander
AU - Wernovsky, Gil
AU - Bernbaum, Judy
AU - Solot, Cynthia B.
AU - Burnham, Nancy
AU - Zackai, Elaine
AU - Heagerty, Patrick J.
AU - Clancy, Robert R.
AU - Nicolson, Susan C.
AU - Jarvik, Gail P.
AU - Gerdes, Marsha
PY - 2009/7/1
Y1 - 2009/7/1
N2 - OBJECTIVE: The goal was to evaluate polymorphisms of the APOE gene as modifiers of neurobehavioral outcomes for preschool-aged children with congenital heart defects, after cardiac surgery. METHODS: A prospective observational study with neurodevelopmental evaluation between the fourth and fifth birthdays was performed. Attention and behavioral skills were assessed through parental report. RESULTS: Parents of 380 children completed the neurobehavioral measures. Child Behavior Checklist scores for the pervasive developmental problem scale were in the at-risk or clinically significant range for 15% of the cohort, compared with 9% for the normative data (P < .00001). Attention problem scores were in the at-risk or clinically significant range for 12% of the cohort, compared with 7% for the normative data (P = .0002). The Attention-Deficit/Hyperactivity Disorder Rating Scale-IV, Preschool Version, was completed for 378 children; 30% scored in the clinically significant range for inattention and 22% for impulsivity. After adjustment for covariates, the APOE ε2 allele was significantly associated with higher scores (worse problems) for multiple Child Behavior Checklist indices, including somatic complaints (P = .009), pervasive developmental problems (P = .032), and internalizing problems (P=.009). In each case, the ε4 allele was associated with a better outcome. APOE ε2 carriers had impaired social skills, compared with ε4 carriers (P = .009). CONCLUSIONS: For preschool-aged children with congenital heart defects requiring surgery, parental rating scales showed an increased prevalence of restricted behavior patterns, inattention, and impaired social interactions. The APOE ε2 allele was associated with increased behavior problems, impaired social interactions, and restricted behavior patterns.
AB - OBJECTIVE: The goal was to evaluate polymorphisms of the APOE gene as modifiers of neurobehavioral outcomes for preschool-aged children with congenital heart defects, after cardiac surgery. METHODS: A prospective observational study with neurodevelopmental evaluation between the fourth and fifth birthdays was performed. Attention and behavioral skills were assessed through parental report. RESULTS: Parents of 380 children completed the neurobehavioral measures. Child Behavior Checklist scores for the pervasive developmental problem scale were in the at-risk or clinically significant range for 15% of the cohort, compared with 9% for the normative data (P < .00001). Attention problem scores were in the at-risk or clinically significant range for 12% of the cohort, compared with 7% for the normative data (P = .0002). The Attention-Deficit/Hyperactivity Disorder Rating Scale-IV, Preschool Version, was completed for 378 children; 30% scored in the clinically significant range for inattention and 22% for impulsivity. After adjustment for covariates, the APOE ε2 allele was significantly associated with higher scores (worse problems) for multiple Child Behavior Checklist indices, including somatic complaints (P = .009), pervasive developmental problems (P = .032), and internalizing problems (P=.009). In each case, the ε4 allele was associated with a better outcome. APOE ε2 carriers had impaired social skills, compared with ε4 carriers (P = .009). CONCLUSIONS: For preschool-aged children with congenital heart defects requiring surgery, parental rating scales showed an increased prevalence of restricted behavior patterns, inattention, and impaired social interactions. The APOE ε2 allele was associated with increased behavior problems, impaired social interactions, and restricted behavior patterns.
KW - Apolipoprotein E
KW - Attention-deficit/hyperactivity disorder
KW - Autistic disorder
KW - Behavioral symptoms
KW - Congenital heart defects
KW - Genetic predisposition to disease
KW - Impulsive behavior
UR - http://www.scopus.com/inward/record.url?scp=67649611234&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67649611234&partnerID=8YFLogxK
U2 - 10.1542/peds.2008-2281
DO - 10.1542/peds.2008-2281
M3 - Article
C2 - 19564306
AN - SCOPUS:67649611234
VL - 124
SP - 241
EP - 250
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 1
ER -