McLaughlin, K. A., Fox, N. A., Zeanah, C. H., Sheridan, M. A., Marshall, P., & Nelson, C. A. (2010). Delayed maturation in brain electrical activity
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1 McLaughlin, K. A., Fox, N. A., Zeanah, C. H., Sheridan, M. A., Marshall, P., & Nelson, C. A. (2010). Delayed maturation in brain electrical activity partially explains the association between early environmental deprivation and symptoms of attention-deficit/hyperactivity disorder. Biological psychiatry, 68(4),
2 Background Deprivation in institutional settings psychosocial, linguistic, and sensory A wide-range of developmental abnormalities are highly associated with institutionalization e.g., physical, mental, cognitive, language, social and emotional development Are elevations in psychiatric problems among institutionalized children attributable to atypical patterns of brain development resulting from institutional deprivation?
3 Methods & Materials: Sample Bucharest Early Intervention Project (BEIP) A longitudinal study on institutionalized vs. community children in Romania Groups (age matched 6-30 m/o): 136 institutionalized children randomly assigned into: Foster care intervention: 69 (à 41) Institutional care: 67 (à 57) 72 community children (à 60)
4 Methods & Materials: General Procedure Comprehensive assessments: At initial entry, 30 and 42 m/o Health, cognitive ability, and brain functioning EEG measurements Psychiatric disorders assessment: At 54 m/o Preschool Age Psychiatric Assessment (PAPA) Structured caregiver interview Symptoms of ADHD, anxiety disorders, major depression, and oppositional defiant disorder (ODD) Diagnoses based on DSM-IV
5 Methods & Materials: EEG Resting EEG collected at initial entry At least 9 m/o Standard experimental protocol for infants and toddlers: 10 sec Colored balls in spinning bingo wheel 10 sec Wheel stopped Changed balls 9 times Frequency bands of interest Theta (3-5 Hz), alpha (6-9 Hz), and beta (10-18 Hz) Relative power (RP) Proportion of power at a given electrode site relative to total power at that same electrode site
6 Methods & Materials: Statistical Analysis Standard Tests of Statistical Mediation Evidence for Mediation: 1. Association between the exposure and outcome of interest Institutionalization & Psychopathology 2. Association between the exposure and the putative mediator Institutionalization & Brain Development 3. Association between the mediator and the outcome Brain Development & Psychopathology 4. The degree of attenuation in the association between the exposure and outcome in a model that includes the mediator Mediation Models
7 Methods & Materials: Statistical Analysis (Cont.) Mediation Models Exposure Outcome Mediator
8 Results Institutionalization & Psychopathology Children who were institutionalized had a greater number of symptoms than community children in ADHD, anxiety, depression, and ODD Lower levels of anxiety and depression in fostered children than non-fostered group, but no difference of symptoms in ADHD and ODD
9 Results (Cont.) Institutionalization & Brain Development Significantly increased theta (in frontal, temporal and occipital regions) and decreased alpha (in frontal and occipital regions) relative power in institutionalized children than their community counterparts No group difference in beta relative power
10 Results (Cont.) Brain Development & Psychopathology Increased theta relative power in the temporal region and decreased alpha relative power in the frontal region significantly predicted the hyperactivity symptoms Increased theta relative power in the frontal, temporal, and parietal regions and decreased alpha relative power in the frontal and parietal regions significantly predicted the hyperactivity and impulsivity symptoms Beta relative power is not associated with either hyperactivity or impulsivity Generally, no other psychiatric symptoms are associated with the EEG relative power across all frequency bands
11 Results (Cont.) Mediation Models Exposure Outcome Mediator 0.81 Impulsivity -19.2% -17.3% 0.67 Impulsivity
12 Take-Home Message Children reared in institutions evidenced greater symptoms of ADHD, anxiety, depression, and ODD Decreased alpha and increased theta relative power suggested a delay in cortical maturation among institutionalized children, predicting symptoms of hyperactivity and impulsivity EEG power was not associated with other psychopathological symptoms Results suggesting deprivation in social and environmental conditions may perturb early patterns of neurodevelopment and manifest as psychiatric problems later in life
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