title: The adverse influence of attention-deficit disorder with or without hyperactivity on cognition in neurofibromatosis type 1.
abstract: OBJECTIVE
  A substantial proportion of patients with neurofibromatosis type 1 (NF1) have attention-deficit disorder with or without hyperactivity (AD[H]D). This study explored the influence of AD(H)D symptoms on the intellectual profile of patients with NF1.
  
  
  METHODS
  We retrospectively analysed neuropsychological data from 114 children (66 males, 48 females; age range 6-16y; mean age 9y 3mo [SE 3mo]) with NF1 from an NF1 outpatients department. Assessment included psychiatric diagnosis of AD(H)D (DSM-IV-TR criteria) and intelligence testing (Wechsler Intelligence Scale for Children, German version). Magnetic resonance images were available for all patients, intracranial findings being an exclusion criterion. The effects of AD(H)D symptoms on intelligence and on the cognitive profile were tested by analyses of variance.
  
  
  RESULTS
  Patients with AD(H)D symptoms performed significantly worse than those without AD(H)D symptoms on all intelligence measures (main effects for Full-scale, Verbal, and Performance IQ; p<0.005). Subtests typically impaired in patients with NF1 (visuospatial skills and arithmetic) were not specifically influenced by AD(H)D symptoms. There were no differences between AD(H)D subtypes.
  
  
  CONCLUSIONS
  AD(H)D symptoms have a negative impact on the intellectual development of children with NF1. This impact seems to be of an unspecific nature, with a general attenuation of the cognitive profile.
authors.affiliation: Department of Developmental Neurology, University Children's Hospital, Tübingen, Germany. karen.lidzba@med.uni-tuebingen.de
authors.forename: Karen
authors.initials: K
authors.lastname: Lidzba
authors.forename: Sofia
authors.initials: S
authors.lastname: Granström
authors.forename: Jorge
authors.initials: J
authors.lastname: Lindenau
authors.forename: Victor-Felix
authors.initials: VF
authors.lastname: Mautner
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D015897:Comorbidity; D003299:Cooperative Behavior; D042241:Early Diagnosis; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D007360:Intelligence; D033183:Interdisciplinary Communication; D007859:Learning Disabilities / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D008297:Male; D009456:Neurofibromatosis 1 / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D009483:Neuropsychological Tests; D020339:Optic Nerve Glioma / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D014888:Wechsler Scales