ADHD Is a Risk Factor for Cognitive Development in NF1
26 April 2017 (online)
Background: Attention deficit with and without hyperactivity (ADHD) is a well-known risk factor for cognitive development and is one of the core neurocognitive symptoms in neurofibromatosis type 1 (NF1). The goal of our study is to investigate if comorbid ADHD is a risk factor for cognitive development in children with NF1 (H1), and if intellectual functioning improves with amelioration of attention functions (H2).
Methods: Neuropsychological assessments regarding intellectual functions and attention were performed twice within 12 months in 64 children, aged between 6 and 12 years (30 NF1 plus ADHD, 14 pure NF1, and 20 pure ADHD). To test H1, full-scale IQ was examined for each test date with an ANCOVA. To test H2, a median-split was performed across both ADHD groups with respect to change in attention functions, and the two groups were fed into a repeated measures ANCOVA. Disease group was treated as covariable.
Results: H1: Patients with pure NF1 performed significantly better than patients with NF1 plus ADHD on both test dates (T1: p = 0.002; T2: p = 0.016) and patients with pure ADHD performed significantly better than patients with NF1 plus ADHD on the second test date (p = 0.049). H2: Results of the repeated measures ANCOVA revealed a significant effect of time on IQ (p = 0.021), but amelioration of attention functions did not significantly influence IQ changes (p = 0.206), nor was there a significant interaction between attention functions and disease group.
Conclusion: The combination of NF1 and ADHD seems to be a risk factor for cognitive development independently from ameliorations in attention functions.