A UK nurse has been sentenced to life in prison for murdering seven babies in a neonatal unit. In what is the longest murder trial in recent UK history, 33-year old Lucy Letby was also convicted of attempting to kill six other babies, and further investigation by the BBC has also revealed how hospital management at the time deflected concerns by doctors and actively silenced them.
Between June 2015 and June 2016, Letby deliberately injected air into babies’ parenteral nutrition lines, force-fed milk to others and administered huge doses of insulin to two others. In the years before, less than three death per year had been recorded at Countess of Chester Hospital at the neonatal unit where she worked.
According to The Guardian, Mr Justice Goss said during her sentencing: “This was a cruel, calculated, and cynical campaign of child murder involving the smallest and most vulnerable of children, knowing that your actions were causing significant physical suffering and would cause untold mental suffering.”
She was found not guilty of two other counts of attempted murder, but the jury consisting of four men and seven women were unable to reach a verdict on six additional attempted murder charges. The court will consider whether to attempt to retry these six charges.
Dr Stephen Brearey, lead consultant at the neonatal unit where Letby worked told the BBC he first raised concerns about the nurse in October 2015, but not no action was taken and she went on to attack five more babies.
He that hospital management failed to investigate allegations against her and also tried to silence doctors. An investigation by BBC Panorama BBC News revealed just how Letby was able to get away with murdering and harming the babies for so long.
The hospital’s top manager ordered doctors to make written apologies to to Letby, and two consultants had to undertake mediation with the nurse, despite their suspecting she had killed babies. Efforts to bring in the police were also quashed by senior management, who said in an email “This is absolutely being treated with the same degree of urgency … All emails cease forthwith”.
Dr Ravi Jayaram, a consultant paediatrician at the hospital, wrote on social media that he felt relief at the oft-maligned justice system working “this time”.
But he continued there were “things that need to come out about why it took several months from concerns being raised to the top brass before any action was taken to protect babies”.
He also added: “And why from that time it then took almost a year for those highly-paid senior managers to allow the police to be involved.”
Cancer researchers have shown that immunotherapy after stem cell transplantation effectively combats neuroblastomas in children. Crucially, stem cells from a parent provide children with a new immune system that responds much better to immunotherapies. These results of an early clinical trial were published in the Journal of Clinical Oncology.
Tumours of the nervous system, neuroblastomas are associated with an unfavourable prognosis if the tumour is classified as a high-risk type. and particularly poor for patients in the relapsed stage. In this study by scientists at St. Anna Children’s Cancer Research Institute and the Eberhard Karls University of Tübingen, immunotherapy following stem cell transplantation is now associated with long-term survival in a substantial proportion of the patients. Compared to an earlier study the survival rate was increased.
“After the transplantation of stem cells from a parent, the patients are equipped with a new immune system. This enables a better immune response to the subsequent immunotherapy and clearly improves the outcome,” explains Prof Ruth Ladenstein, MD, co-first author.
Five-year survival exceeds 50%
“After a median follow-up of about eight years, we see that more than half of the study patients live five years or longer with their disease,” Prof Ladenstein reports (5-year overall survival: 53%). In comparison, the 5-year overall survival in an earlier study, in which stem cell transplantation was not followed by immunotherapy, was only 23%. Those patients who showed a complete or partial response to prior treatment had significantly better survival.
“In summary, immunotherapy with dinutuximab beta following transplantation of stem cells from matched family donors resulted in remarkable outcomes when patients had at least a partial response to prior treatment,” says Prof Ladenstein. “In our study, there were no unexpected side effects and the frequency of graft-versus-host-disease was low.”
Restoring natural killer cell potency
Dinutuximab beta is a monoclonal antibody that binds to a molecule, GD2, on the surface of tumour cells, marking them for destruction by natural killer cells. But prior chemotherapies may impair natural killer cells. “Therefore, a transplantation of intact natural killer cells from matched family donors seems reasonable before immunotherapy is administered. The transplanted, new natural killer cells are now able to target the tumour cells more efficiently – by means of an antibody-dependent reaction,” explains Prof Ladenstein.
According to the authors, further studies are needed to determine the individual components of the therapeutic approaches. Recently, conventional chemotherapy has also been combined with immunotherapy early in the treatment strategy, resulting in similarly improved response rates. The hope is that a renewed immune system through a healthy parent in combination with the described transplantation procedure could further increase survival rates: “Our approach could thus result in stronger and longer lasting tumour control. A randomised study would be necessary to scientifically substantiate the additional potential benefit of a new immune system in the context of relapse therapy,” Prof Ladenstein adds.
Ten percent of babies born before 32 weeks will develop cerebral palsy resulting from infections that damage white matter, nerve fibres deep in the brain. While it’s known that the white matter loss will lead to neurological deficits, there is currently no treatment to avoid this.
Now, researchers at Duke Health have conducted experiments using neonatal mice and identified a fatty molecule in breast milk that triggers a process in which stem cells in the brain produce cells that create new white matter, reversing the injury.
The study appears in the journal Cell Stem Cell. Corresponding author Eric Benner, MD, PhD, said that further study in a clinical trial is needed, but the finding is promising.
“Developing therapies for children – especially such medically fragile children – is very difficult to do because there are justifiably strict safety concerns,” Benner said. “The fact that this molecule is already found in something that is safe for premature babies – breast milk – is extremely encouraging.
“It’s been known that fats in breast milk benefit a child’s brain development, but there are many types of fats in breast milk,” Benner said. “This work has identified a lipid molecule in breast milk that promotes white matter development. Now, we can begin to develop a therapy that isolates and delivers this lipid in a way that is safe for the unique challenges of these infants.”
Benner is a neonatologist at Duke University and one of the co-founders of Tellus Therapeutics, a Duke spinout company developed with the help of the Duke University Office for Translation & Commercialization to bring this therapy from the bench into the neonatal intensive care unit.
The fatty molecule identified in the study will be administered intravenously to patients in an upcoming clinical trial. This is significant because many of the infants who are part of this vulnerable population also have gastrointestinal issues and cannot safely be given milk or medication by mouth.
The lipid molecule enters the brain and binds with stem cells there, encouraging the stem cells to become or produce a type of cell called oligodendrocytes.
The oligodendrocytes are like a hub that allow for the production of white matter in the central nervous system. This newly produced white matter in pre-term infants prevents the neurological damage that would otherwise impact the child’s ability to move – the hallmarks of cerebral palsy.
“The timing of brain injury is extremely difficult to predict, thus a treatment that could be safely given to all preterm babies at risk would be revolutionary,” said Agnes Chao, MD, a former fellow in the Division of Neonatology and first author of the paper.
“As a neonatologist, I’m so excited that I may be able to offer a treatment to families with babies that are affected by preterm brain injury who would otherwise have no other options,” Chao said.
A US study shows that use of low-dose atropine eyedrops, commonly used in a higher dose to treat lazy eye, was no better than a placebo at slowing myopia progression and elongation of the eye among children treated for two years.
The first randomised controlled trial of its kind aimed at identifying an effective way to manage myopia was published last week in JAMA Ophthalmology. It was conducted by the Pediatric Eye Disease Investigator Group at at Vanderbilt University Medical Center (VUMC) and 11 other hospitals and practices across the United States and funded by the National Eye Institute (NEI).
“We found, interestingly, and honestly shockingly, that there was no difference in the use of 0.01% atropine and placebo in treating these children who ranged in age from 5 to 12,” said associate professor Lori Ann Kehler, OD, and the Vanderbilt site principal investigator for the study.
The onset of myopia usually occurs between the ages of 7 and 16 when developing eyes can start growing too long axially (from front to back). Instead of focusing images on the retina, images of distant objects are focused at a point in front of the retina which causes people to have poor distance vision while their near vision remains unchanged.
The condition results in the need for eyeglasses to improve distance vision, and it can also result in medical complications and serious uncorrectable vision loss later in life, like retinal detachments or myopic macular degeneration.
The study contradicts earlier studies from East Asia that showed the small dose of atropine is effective in slowing progression of myopia.
In 2017 the Academy of Ophthalmology endorsed the findings from East Asia saying that although the FDA had not approved atropine for this use, there was sufficient evidence for prescribing the low dose for myopia. Ophthalmologists across the country, including at VUMC, began to offer the prescription to young patients with myopia.
“That was a really exciting finding at the time because we had had no treatment options for many years,” Kehler said. The prescription of atropine for treating myopia is not covered by most insurance plans.
“The incidence of myopia is increasing worldwide,” Kehler said. “By 2030 it’s predicted that 39 million people in the US will have myopia. By 2050 that number is expected to increase to more than 44 million people in the US and to 50% of the global population. Once it’s detected in children, it tends to get worse every year,” she said. “Investigators all over the world have tried strategies to intervene, to either stop or slow the worsening of myopia.”
Kehler said it is not known why the incidence of myopia is increasing. “There are several theories. Some believe it’s the increase in the use of screens and screen time, but myopia was increasing even before screens were part of children’s lives. Others think it has to do with industrialisation. We were an agricultural society. We were outside more. We weren’t reading. We weren’t looking up close all day. Really, the prevailing thought is whether we’re at a screen or looking at a math book or reading most of the day, we think the lack of sunlight and sustained near effort is what’s causing the increase of myopia.”
Kehler said the percentage of children with myopia using the atropine drop at VUMC is low and estimates fewer than 5% of children with myopia are using the drops nationally.
Going forward, eye specialists should have a frank discussion with parents of children with myopia about the conflicting data between the Asian studies and the new U.S. study.
“The absence of a treatment benefit in our US-based study, compared to East Asian studies, may reflect racial differences in atropine response. The study enrolled fewer Asian children, whose myopia progresses more quickly, and included Black children, whose myopia progresses less quickly compared with other races,” noted the study’s lead co-author, Michael X. Repka, MD, professor of Ophthalmology at Johns Hopkins University, in a news release from the NEI.
“All the studies have shown the drops are safe, so we aren’t putting children at risk if we continue to prescribe the 0.01%,” Kehler said. “But we are telling them there is a difference in these studies and it might have to do with your genetics; it might be that it’s more effective in children from Asia than in the U.S. population,” she said.
Further study is needed, Kehler said. The next step is likely to study a higher dose of atropine to see if children in the U.S. experience a benefit.
The LAMP study out of Hong Kong found that 0.05% might be more effective.
Kehler said other groups are studying the use of red-light therapy to slow the progression of myopia, and there are also new eyeglass lenses that have been developed to slow the progression of myopia, but they are not yet available in the U.S.
“It’s much harder to get drops in very young children,” Kehler said. “But if we had a spectacle option, that would open the door to treating our younger patients.”
Myopia usually stabilises in about half of children around 16 years of age and among an increasingly larger percentage as they get older. By their early 20s, about 10% of individuals with myopia will continue to grow more nearsighted, and by age 24 that percentage is 4%.
In children with suspected sinusitis, a nasal swab to test for three types of bacteria can tell whether antibiotics are likely to be effective or not, according to a new JAMAstudy by researchers at the University of Pittsburgh and UPMC. They also found that nasal discharge colour was no help in differentiating a viral or bacterial infection.
“Sinusitis is one of the most common diseases we see in children, but it’s difficult to diagnose because it’s based on the duration of symptoms: If the child has a runny nose or congestion for more than 10 days, we suspect sinusitis,” said said lead author Nader Shaikh, MD. “For an ear infection, we can look inside the ear; for pneumonia, we listen to the lungs. But for sinusitis, we have nothing to go on from a physical exam. That was very unsatisfying to me.”
With the goal of developing a better tool to diagnose bacterial sinusitis, Shaikh and his team enrolled about 500 children with sinusitis symptoms from six centres across the US and randomly assigned them to receive either a course of antibiotics or placebo. The researchers also took nasal swabs from each child and tested for the three main types of bacteria involved in sinusitis.
Children who tested positive for the bacteria had better resolution of symptoms with antibiotic treatment compared to those who did not have bacteria. These findings suggest that testing for bacteria could be a simple and effective way to detect children who are likely to benefit from antibiotics and avoid prescribing antibiotics to those who wouldn’t.
“If antibiotics aren’t necessary, then why use them?” said Shaikh. “These medications can have side effects, such as diarrhoea, and alter the microbiome, which we still don’t understand the long-term implications of. Overuse of antibiotics can also encourage antibiotic resistance, which is an important public health threat.”
According to Shaikh, a common belief among parents and doctors is that yellow or green snot signals a bacterial infection. Although several small studies have suggested that nasal discharge colour is not meaningful, Shaikh and his team formally tested this idea by asking parents to identify the hue of their child’s snot on a colour card.
“If kids with green or yellow discharge benefitted more from antibiotics than those with clear-coloured discharge, we would know that colour is relevant for bacterial infection,” explained Shaikh. “But we found no difference, which means that colour should not be used to guide medical decisions.”
The researchers are now looking at how to best roll out nasal testing in the clinic. A major challenge is that bacterial culture-based tests used in the study are not easy for most family doctors to order and can take several days to get results. A more practical approach could be commercially available molecular testing, which could return results overnight, said Shaikh.
Another possibility could be development of rapid antigen tests that work like COVID-19 at-home testing kits. The researchers also plan to delve deeper into the data from this study to see whether there could be another type of biomarker in nasal discharge indicating the presence of bacteria that would be easier to test for.
Infants that have a food allergy have an increased risk of asthma and reduced lung function later in childhood, according to a world first study published in the Lancet Child & Adolescent Health.
Food allergy affects 10% of babies and 5% of children and adolescents. The research, led by Murdoch Children’s Research Institute, found that early life food allergy was associated with an increased risk of both asthma and reduced lung growth at six years of age.
Murdoch Children’s Associate Professor Rachel Peters said this was the first study to examine the relationship between challenge-confirmed food allergy in infancy and asthma and poorer lung health later in childhood.
The Melbourne research involved 5276 infants from the HealthNuts study, who underwent skin prick testing to common food allergens, such as peanut and egg, and oral food challenges. At six years, children were followed up with further food allergy and lung function tests.
The study found by six years of age, 13.7% reported a diagnosis of asthma. Babies with a food allergy were almost four times more likely to develop asthma at six years of age, compared to children without a food allergy. The impact was greatest in children whose food allergy persisted to age six as opposed to those who had outgrown their allergy. Children with a food allergy were also more likely to have reduced lung function.
Associate Professor Peters said food allergy in infancy, whether it resolved or not, was linked to poorer respiratory outcomes in children.
“This association is concerning given reduced lung growth in childhood is associated with health problems in adulthood including respiratory and heart conditions,” she said.
“Lung development is related to a child’s height and weight and children with a food allergy can be shorter and lighter compared to their peers without an allergy. This could explain the link between food allergy and lung function. There are also similar immune responses involved in the development of both food allergy and asthma.
“The growth of infants with food allergy should be monitored. We encourage children who are avoiding foods because of their allergy to be under the care of a dietician so that nutrition can be catered for to ensure healthy growth.”
A new study has added to the evidence that excessive TV watching as a child can lead to poor health in adulthood. The research, published this week in the journal Pediatrics, found that children who watched more television were more likely to develop metabolic syndrome as an adult.
Metabolic syndrome is a cluster of conditions including hypertension, hyperglycaemia, excess body fat, and abnormal cholesterol levels that lead to an increased risk of heart disease, diabetes and stroke.
Using data from 879 participants of the Dunedin study, researchers found those who watched more television between the ages of 5 and 15 were more likely to have these conditions at age 45.
Television viewing times were asked at ages 5, 7, 9, 11, 13 and 15. On average, they watched just over two hours per weekday.
“Those who watched the most had a higher risk of metabolic syndrome in adulthood,” says Professor Bob Hancox, who led the study.
“More childhood television viewing time was also associated with a higher risk of overweight and obesity and lower physical fitness.”
Boys watched slightly more television than girls and metabolic syndrome was more common in men, than women (34% and 20% respectively). The link between childhood television viewing time and adult metabolic syndrome was seen in both sexes however, and may even be stronger in women.
There was little evidence that watching less television as an adult reduced the association between childhood television viewing and adult health.
“While, like any observational study, researchers cannot prove that the association between television viewing at a young age directly causes adult metabolic syndrome, there are several plausible mechanisms by which longer television viewing times could lead to poorer long-term health.
“Television viewing has low energy expenditure and could displace physical activity and reduce sleep quality,” he says.
“Screentime may also promote higher energy intake, with children consuming more sugar-sweetened beverages and high-fat dietary products with fewer fruit and vegetables. These habits may persist into adulthood.”
The results are important because screen times have increased in recent years with new technologies.
“Children today have far more access to screen-based entertainment and spend much more time being sedentary. It is likely that this will have even more detrimental effects for adult health.
“These findings lend support to the World Health Organization recommendation that children and young teenagers should limit their recreational screen time.”
New mothers can expect sleep deprivation in the first few years of baby’s life. But too little sleep can take a toll on the health of both mother and child. Published in Journal of Developmental & Behavioral Pediatrics, a new study from at maternal and infant sleep patterns, identifying predictors and providing recommendations for instilling healthy habits, such as earlier bedtimes and instilling routines.
“The first two years is a really critical period where a lot of development is going on, and sleep is important for health. We wanted to look at the association of mother and infant sleep and whether it changes over time,” said Tianying Cai, now a postdoctoral researcher at Northwestern University.
“We identified two distinct groups, a low maternal sleep group where the mothers get 5 to 6 hours of sleep per night, and an average maternal sleep group, which meets the national recommended sleep guidelines with 7 to 8 hours per night. Children in the low maternal sleep group also slept less, although the difference wasn’t as large as for the mothers,” Cai stated.
Researchers from the University of Illinois Urbana-Champaign followed parents of 464 infants in the first two years of life. Mothers completed surveys about bedtime routines, their child’s sleep duration, night-time waking, and sleep problems at 3, 12, 18, and 24 months of age.
The families were part of STRONG Kids 2, a program at the U. of I. that promotes nutrition and healthy habits in families with young children. STRONG Kids 2 co-directors Barbara Fiese, professor emerita of HDFS, and Sharon Donovan, professor of food science and human nutrition, also contributed to the study.
Mothers who fit the low maternal sleep profile got an average of 5.74 hours of sleep per night at 3 months and 5.9 hours at 12 to 24 months, while their children got 9.6 and 10.52 hours, respectively. In the average sleep profile, mothers got 7.31 hours at 3 months and 7.28 hours at 12 to 24 months, while child sleep averaged 9.99 hours at 3 months and 11 hours at 12 to 24 months.
The research team also identified factors that influence the amount of sleep a mother gets. Not surprisingly, one of the strongest predictors is infant-signalled night-time waking, which means the infant is more likely to alert the parent at night. This could be either because these infants woke more frequently, or because the mothers were more likely to wake up when infants stirred, Cai noted.
Mothers who had longer employment hours were more likely to be in the low sleep group at 3 months, although that was no longer a factor by 12 months. Furthermore, those who breastfed their infant at 12 months were more likely to be in the average sleep group.
Over time, many families transitioned from the low to the average sleep group as infant sleep patterns consolidated. At 3 months, 60% were in the low maternal sleep group and 40% were in the average group, while at 12 months the numbers were reversed. Most of those who were in the average sleep group at 3 months continued to be so throughout the study period.
The researchers found that an earlier bedtime and consistent routines were associated with better sleep patterns, corroborating a previous study from Fiese and Cai.
“If parents can establish early bedtime routines at three months, it improves sleep duration and reduces sleep problems,” Fiese said. “Parents may feel overwhelmed and don’t realise that they have this in their toolkit. Something as simple as setting a regular bedtime early on and having routines, like reading a story to your child before they go to bed. You may not think they’re understanding, but the rhythm of your voice establishes predictability, and you can expand this bedtime routine over the first few years of life.”
The researchers noted they did not observe any significant differences due to demographic characteristics in the sample.
“Maternal education, income, or ethnicity did not predict sleep group memberships across 3 to 24 months; all parents were facing similar challenges. I think having a baby is a great equaliser for a lot of things, although moms who have to go back to work or work longer hours may have more pressures,” Donovan said.
Even so, there are steps everyone can take to improve bedtime habits and sleep patterns.
“Getting kids to bed earlier and trying to meet the American Academy of Pediatrics guidelines is really important because studies have shown that sleep is associated with a lot of neurocognitive outcomes and health in kids. The parents can be quite proactive even early in life to get their kids off on the right foot,” she concluded.
Experiments have shown that microwaving plastic baby food containers available on the shelves of US stores can release huge numbers of micrometre or smaller-sized plastic particles – in some cases, more than 2 billion nanoplastics and 4 million microplastics for every square centimetre of container.
Though the health effects of consuming micro- and nanoplastics remain unclear, the University of Nebraska-Lincoln researchers further found that three-quarters of cultured embryonic kidney cells had died after two days of being introduced to those same particles. A 2022 report from the World Health Organization recommended limiting exposure to such particles.
“It is really important to know how many micro- and nanoplastics we are taking in,” said Kazi Albab Hussain, the study’s lead author and a doctoral student in civil and environmental engineering at the University of Nebraska-Lincoln. “When we eat specific foods, we are generally informed or have an idea about their caloric content, sugar levels, other nutrients. I believe it’s equally important that we are aware of the number of plastic particles present in our food.
“Just as we understand the impact of calories and nutrients on our health, knowing the extent of plastic particle ingestion is crucial in understanding the potential harm they may cause. Many studies, including ours, are demonstrating that the toxicity of micro- and nanoplastics is highly linked to the level of exposure.”
The team embarked on its study in 2021, the same year that Hussain became a father. While prior research had investigated the release of plastic particles from baby bottles, the team realised that no studies had examined the sorts of plastic containers and pouches that Hussain found himself shopping for, and that millions of other parents regularly do, too.
Hussain and his colleagues decided to conduct experiments with two baby food containers made from polypropylene and a reusable pouch made of polyethylene, both FDA-approved plastics. In one experiment, the researchers filled the containers with either deionised water or 3% acetic acid (the latter intended to simulate dairy products, fruits, vegetables and other relatively acidic consumables) then heated them at full power for three minutes in a 1000-watt microwave. Afterward, they analysed the liquids for evidence of micro- and nanoplastics: the micro- being particles at least a micrometre in diameter, the nano- any particles smaller.
The actual number of each particle released by the microwaving depended on multiple factors, including the plastic container and the liquid within it. But based on a model that factored in particle release, body weight, and per-capita ingestion of various food and drink, the team estimated that infants drinking products with microwaved water and toddlers consuming microwaved dairy products are taking in the greatest relative concentrations of plastic. Experiments designed to simulate the refrigeration and room-temperature storage of food or drink over a six-month span also suggested that both could lead to the release of micro- and nanoplastics.
“For my baby, I was unable to completely avoid the use of plastic,” Hussain said. “But I was able to avoid those (scenarios) which were causing more of the release of micro- and nanoplastics. People also deserve to know those, and they should choose wisely.”
With the help of Svetlana Romanova from the University of Nebraska Medical Center, the team then cultured and exposed embryonic kidney cells to the actual plastic particles released from the containers – a first, as far as Hussain can tell. Rather than introduce just the number of particles released by one container, the researchers instead exposed the cells to particle concentrations that infants and toddlers might accumulate over days or from multiple sources.
After two days, just 23% of kidney cells exposed to the highest concentrations had managed to survive – a much higher mortality rate than that observed in earlier studies of micro- and nanoplastic toxicity. The team suspects that kidney cells might be more susceptible to the particles than are other cell types examined in prior research. But those earlier studies also tended to examine the effects of larger polypropylene particles, some of them potentially too large to penetrate cells. If so, the Hussain-led study could prove especially sobering: Regardless of its experimental conditions, the Husker team found that polypropylene containers and polyethylene pouches generally release about 1000 times more nanoplastics than microplastics.
The question of cell infiltration is just one among many that will require answers, Hussain said, before determining the true risks of consuming micro- and nanoplastics. But to the extent that they do pose a health threat – and that plastics remain a go-to for baby food storage – parents would have a vested interest in seeing that the companies manufacturing plastic containers seek out viable alternatives, he said.
“We need to find the polymers which release fewer (particles),” Hussain said. “Probably, researchers will be able to develop plastics that do not release any micro- or nanoplastics – or, if they do, the release would be negligible.
“I am hopeful that a day will come when these products display labels that read ‘microplastics-free’ or ‘nanoplastics-free.'”
The angst parents feel when their children sustain injuries is surely one of the universal conditions of parenthood. That anxiety is heightened greatly when those injuries involve concussions. But a new study led out of the University of Calgary, published today in the medical journal Pediatrics, may set worried parental minds slightly at ease.
Derived from data on emergency room visits in children’s hospitals in Canada and the US, the findings show that IQ and intelligence is not affected in a clinically meaningful way by paediatric concussions.
The study compares 566 children diagnosed with concussion to 300 with orthopaedic injuries. The children range in age from eight to 16 and they were recruited from two cohort studies. In the five Canadian hospitals that participated, patients completed IQ tests three months postinjury.
The US cohort was conducted at two children’s hospitals in Ohio, wherein patients completed IQ tests three to 18 days, postinjury.
“Obviously there’s been a lot of concern about the effects of concussion on children, and one of the biggest questions has been whether or not it affects a child’s overall intellectual functioning,” says Dr. Keith Yeates, PhD, a professor in UCalgary’s Department of Psychology and senior author of the Pediatrics paper. Yeates is a renowned expert on the outcomes of childhood brain disorders, including concussion and traumatic brain injuries.
“The data on this has been mixed and opinions have varied within the medical community,” says Yeates. “It’s hard to collect big enough samples to confirm a negative finding. The absence of a difference in IQ after concussion is harder to prove than the presence of a difference.”
Combining the Canadian and U.S. cohorts gave the Pediatrics study an abundant sample and it allowed Yeates and his co-authors to test patients with a wide range of demographics and clinical characteristics.
“We looked at socioeconomic status, patient sex, severity of injuries, concussion history, and whether there was a loss of consciousness at the time of injury,” says Yeates. “None of these factors made a difference. Across the board, concussion was not associated with lower IQ.”
The children with concussion were compared to children with orthopaedic injuries other than concussion to control for other factors that that might affect IQ, such as demographic background and the experience of trauma and pain. This allowed the researchers to determine whether the children’s IQs were different than what would be expected minus the concussion.
The findings of the study are important to share with parents, says Dr Ashley Ware, PhD, a professor at Georgia State University and lead author of the paper.
“Understandably, there’s been a lot of fear among parents when dealing with their children’s concussions,” Ware says. “These new findings provide really good news, and we need to get the message to parents.”
Dr Stephen Freedman, PhD, co-author of the paper and a professor of paediatrics and emergency medicine, agrees. “It’s something doctors can tell children who have sustained a concussion, and their parents, to help reduce their fears and concerns,” says Freedman. “It is certainly reassuring to know that concussions do not lead to alterations in IQ or intelligence.”
Another strength of the Pediatrics research is that incorporates the two cohort studies, one testing patients within days of their concussions and the other after three months.
“That makes our claim even stronger,” says Ware. “We can demonstrate that even in those first days and weeks after concussion, when children do show symptoms such as a pain and slow processing speed, there’s no hit to their IQs. Then it’s the same story three months out, when most children have recovered from their concussion symptoms. Thanks to this study we can say that, consistently, we would not expect IQ to be diminished from when children are symptomatic to when they’ve recovered.”
She adds: “It’s a nice ‘rest easy’ message for the parents.”
