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Attention-deficit/hyperactivity disorder symptoms in children with surgically corrected Ventricular Septal Defect, Transposition of the Great Arteries, and Tetralogy of Fallot

  • Line M. Holst (a1), Jonas B. Kronborg (a1), Jens R. M. Jepsen (a2) (a3), Jette Ø. Christensen (a4), Niels G. Vejlstrup (a5), Klaus Juul (a6), Jesper V. Bjerre (a7), Niels Bilenberg (a8) and Hanne B. Ravn (a1)...

Abstract

Background:

Children with complex CHD are at risk for psychopathology such as severe attention-deficit/hyperactivity disorder symptoms after congenital heart surgery.

Objective:

The aim of this study was to investigate if children with Ventricular Septal Defect, Transposition of Great Arteries, or Tetralogy of Fallot have an increased occurrence of attention-deficit/hyperactivity disorder symptoms compared with the background population and to investigate differences between the three CHDs in terms of occurrence and appearance of attention-deficit/hyperactivity disorder symptoms.

Method:

A national register-based survey was conducted, including children aged 10–16 years with surgically corrected CHDs without genetic abnormalities and syndromes. The Attention-Deficit/Hyperactivity Disorder-Rating Scale questionnaires were filled in by parents and school teachers.

Results:

In total, 159 out of 283 questionnaires were completed among children with CHDs and compared with age- and sex-matched controls. Children with CHDs had significantly increased inattention scores (p = 0.009) and total attention-deficit/hyperactivity disorder scores (p = 0.008) compared with controls. Post hoc analyses revealed that children with Tetralogy of Fallot had significantly higher inattention scores compared with children both with Ventricular Septal Defect (p = 0.043) and controls (p = 0.004).

Conclusion:

Attention-deficit/hyperactivity disorder symptoms and inattention symptoms were significantly more frequent among children aged 10–16 years with CHDs, in particular in children with corrected Tetralogy of Fallot.

Copyright

Corresponding author

Author for correspondence: L. M. Holst, MD, Department of Cardiothoracic Anaesthesiology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100Copenhagen, Denmark. Tel: +45 35454141; Fax: +45 35452785; E-mail: line.marie.broksoe.holst.01@regionh.dk

References

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1.Marino, BS, Lipkin, PH, Newburger, JW, et al.Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 2012; 126: 11431172.
2.Gaynor, JW, Stopp, C, Wypij, D, et al.Neurodevelopmental outcomes after cardiac surgery in infancy. Pediatrics 2015; 135: 816825.
3.Bellinger, DC, Newburger, JW, Wypij, D, Kuban, KC, duPlesssis, AJ, Rappaport, LA.Behaviour at eight years in children with surgically corrected transposition: The Boston Circulatory Arrest Trial. Cardiol Young 2009; 19: 8697.
4.Shillingford, AJ, Glanzman, MM, Ittenbach, RF, Clancy, RR, Gaynor, JW, Wernovsky, G.Inattention, hyperactivity, and school performance in a population of school-age children with complex congenital heart disease. Pediatrics 2008; 121: e759e767.
5.Hansen, E, Poole, TA, Nguyen, V, et al.Prevalence of ADHD symptoms in patients with congenital heart disease. Pediatr Int 2012; 54: 838843.
6.DeMaso, DR, Labella, M, Taylor, GA, et al.Psychiatric disorders and function in adolescents with d-transposition of the great arteries. J Pediatr 2014; 165: 760766.
7.Yamada, DC, Porter, AA, Conway, JL, et al.Early repair of congenital heart disease associated with increased rate of attention deficit hyperactivity disorder symptoms. Can J Cardiol 2013; 29: 16231628.
8.Wang, Q, Hay, M, Clarke, D, Menahem, S.The prevalence and predictors of anxiety and depression in adolescents with heart disease. J Pediatr 2012; 161: 943946.
9.Szomlaiski, N, Dyrborg, J, Rasmussen, H, Schumann, T, Koch, SV, Bilenberg, N.Validity and clinical feasibility of the ADHD rating scale (ADHD-RS) A Danish Nationwide Multicenter Study. Acta Paediatr 2009; 98: 397402.
10.Holland, JE, Cassidy, AR, Stopp, C, et al.Psychiatric Disorders and Function in Adolescents with Tetralogy of Fallot. J Pediatr 2017; 187: 165173.
11.DuPaul, GJ, Morgan, PL, Farkas, G, Hillemeier, MM, Maczuga, S.Academic and social functioning associated with attention-deficit/hyperactivity disorder: latent class analyses of trajectories from kindergarten to fifth grade. J Abnorm Child Psychol 2016; 44: 14251438.
12.Reid, R, DuPaul, GJ, Power, TJ, et al.Assessing culturally different students for attention deficit hyperactivity disorder using behavior rating scales. J Abnorm Child Psychol 1998; 26: 187198.
13.Poulsen, L, Jorgensen, SL, Dalsgaard, S, Bilenberg, N.Danish standardization of the attention deficit hyperactivity disorder rating scale. Ugeskr Laeger 2009; 171: 15001504.
14.American Psychiatric Association. DSM-5 Task Force. Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th edn.American Psychiatric Association, Washington, DC: 2013. xliv, 947 p.
15.Makransky, G, Bilenberg, N.Psychometric properties of the parent and teacher ADHD Rating Scale (ADHD-RS): measurement invariance across gender, age, and informant. Assessment 2014; 21: 694705.
16.DuPaul, GJ, Power, TJ, Anastopoulos, A, et al.ADHD Rating Scale – IV. The Guilford Press, New York, 1998.
17.Uzark, K, Jones, K, Slusher, J, Limbers, CA, Burwinkle, TM, Varni, JW.Quality of life in children with heart disease as perceived by children and parents. Pediatrics 2008; 121: e1060e1067.
18.Varni, JW, Seid, M, Kurtin, PS.PedsQL 4.0: reliability and validity of the pediatric quality of life inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001; 39: 800812.
19.Hall, CL, Guo, B, Valentine, AZ, et al. The validity of the SNAP-IV in children displaying ADHD symptoms. Assessment 2019. doi: 10.1177/1073191119842255.
20.R Core Team. R: a language and environment for statistical computing, Vienna, Australia, 2018. https://www.r-project.org.
21.Lynch, JM, Ko, T, Busch, DR, et al.Preoperative cerebral hemodynamics from birth to surgery in neonates with critical congenital heart disease. J Thorac Cardiovasc Surg 2018; 156: 16571664.
22.Petit, CJ, Rome, JJ, Wernovsky, G, et al.Preoperative brain injury in transposition of the great arteries is associated with oxygenation and time to surgery, not balloon atrial septostomy. Circulation 2009; 119: 709716.
23.Bellinger, DC, Wypij, D, Rivkin, MJ, et al.Adolescents with d-transposition of the great arteries corrected with the arterial switch procedure: neuropsychological assessment and structural brain imaging. Circulation 2011; 124: 13611369.
24.Hovels-Gurich, HH, Konrad, K, Skorzenski, D, Herpertz-Dahlmann, B, Messmer, BJ, Seghaye, MC.Attentional dysfunction in children after corrective cardiac surgery in infancy. Ann Thorac Surg 2007; 83: 14251430.
25.Lauridsen, MH, Uldbjerg, N, Henriksen, TB, et al.Cerebral oxygenation measurements by magnetic resonance imaging in fetuses with and without heart defects. Circ Cardiovasc Imaging 2017; 10: e006459.
26.Bailliard, F, Anderson, RH.Tetralogy of Fallot. Orphanet J Rare Dis 2009; 4: 2.
27.Peyvandi, S, De Santiago, V, Chakkarapani, E, et al.Association of prenatal diagnosis of critical congenital heart disease with postnatal brain development and the risk of brain injury. JAMA Pediatr 2016; 170: e154450.
28.Lim, JM, Porayette, P, Marini, D, et al.Associations between age at arterial switch operation, brain growth, and development in infants with transposition of the great arteries. Circulation 2019; 139: 27282738.
29.Lytzen, R, Vejlstrup, N, Bjerre, J, et al.Live-born major congenital heart disease in Denmark: incidence, detection rate, and termination of pregnancy rate from 1996 to 2013. JAMA Cardiol 2018; 3: 829837.
30.Wilens, TE, Spencer, TJ.Understanding attention-deficit/hyperactivity disorder from childhood to adulthood. Postgrad Med 2010; 122: 97109.
31.Barkley, RA.International consensus statement on ADHD. Clin Child Fam Psychol Rev 2002; 5: 89111.
32.Kasmi, L, Bonnet, D, Montreuil, M, et al.Neuropsychological and psychiatric outcomes in dextro-transposition of the great arteries across the lifespan: a state-of-the-art review. Front Pediatr 2017; 5: 59.
33.Murray, DW, Kollins, SH, Hardy, KK, et al.Parent versus teacher ratings of attention-deficit/hyperactivity disorder symptoms in the Preschoolers with Attention-Deficit/Hyperactivity Disorder Treatment Study (PATS). J Child Adolesc Psychopharmacol 2007; 17: 605620.
34.Marin-Mendez, JJ, Borra-Ruiz, MC, Alvarez-Gomez, MJ, Soutullo Esperon, C.Psychomotor development and learning difficulties in preschool children with probable attention deficit hyperactivity disorder: an epidemiological study in Navarre and La Rioja. Neurologia 2017; 32: 487493.
35.Maedgen, JW, Carlson, CL.Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes. J Clin Child Psychol 2000; 29: 3042.
36.Herman, KC, Lambert, SF, Ialongo, NS, Ostrander, R.Academic pathways between attention problems and depressive symptoms among urban African American children. J Abnorm Child Psychol 2007; 35: 265274.
37.Holst, LM, Kronborg, JB, Idorn, L, et al.Impact of congenital heart surgery on quality of life in children and adolescents with surgically corrected ventricular Septal defect, Tetralogy of Fallot, and transposition of the great arteries. Cardiol Young 2019; 29:10821087.
38.Robson, VK, Stopp, C, Wypij, D, et al.Longitudinal associations between neurodevelopment and psychosocial health status in patients with repaired D-transposition of the great arteries. J Pediatr 2019; 204: 3845.
39.Neal, AE, Stopp, C, Wypij, D, et al.Predictors of health-related quality of life in adolescents with tetralogy of Fallot. J Pediatr 2015; 166: 132138.
40.Sistino, JJ, Atz, AM, Simpson, KN, Ellis, C, Ikonomidis, JS, Bradley, SM.The prevalence of attention-deficit/hyperactivity disorder following neonatal aortic arch repair. Cardiol Young 2015; 25: 663669.
41.Lim, CG, Poh, XWW, Fung, SSD, et al.A randomized controlled trial of a brain-computer interface based attention training program for ADHD. PLoS One 2019; 14: e0216225.
42.Gaynor, JW, Nord, AS, Wernovsky, G, et al.Apolipoprotein E genotype modifies the risk of behavior problems after infant cardiac surgery. Pediatrics 2009; 124: 241250.
43.Takayanagi, N, Yoshida, S, Yasuda, S, et al.Psychometric properties of the Japanese ADHD-RS in preschool children. Res Dev Disabil 2016; 55: 268278.
44.Okumura, Y, Yamasaki, S, Ando, S, et al. Psychosocial burden of undiagnosed persistent ADHD symptoms in 12-year-old children: a population-based birth cohort study. J Atten Disord 2019. doi: 10.1177/1087054719837746.

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Attention-deficit/hyperactivity disorder symptoms in children with surgically corrected Ventricular Septal Defect, Transposition of the Great Arteries, and Tetralogy of Fallot

  • Line M. Holst (a1), Jonas B. Kronborg (a1), Jens R. M. Jepsen (a2) (a3), Jette Ø. Christensen (a4), Niels G. Vejlstrup (a5), Klaus Juul (a6), Jesper V. Bjerre (a7), Niels Bilenberg (a8) and Hanne B. Ravn (a1)...

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