Neuropsychological Profile in Pediatric Migraine without Aura: A Pilot Study

Despite the high prevalence of headache in developmental age, current reports about its neuropsychological effects are still lacking. The aim of the present pilot study is to assess the neuropsychological skills among children affected by migraine without aura (MwoA). Fifteen children (7M/8F) (mean age 10.73 ± 2.13) with MwoA, consecutively referred to the Center for Childhood Headache at Università degli Studi della Campania “Luigi Vanvitelli”, underwent the Italian version of the NEPSY-2 after cognitive evaluation. Moreover, to assess the pain level and disability grade during daily activity, the VAS and PedMIDAS scales were used. MwoA children were comparable with the control group of 38 children with respect to age, gender, language, and education level. Written informed consent was obtained from all parents and from children directly, when appropriate. MwoA children differed from controls significantly among the NEPSY-2 subscales, with a relevant relationship between the frequency and intensity of the attacks. In conclusion, the results of the present pilot study may suggest that MwoA could impact significantly neuropsychological functioning in children.

P.083 Early and 30-day clinical and neuropsychological effects of iatrogenic brain infarcts in the ENACT randomized-controlled trial

Background: Small brain infarcts are often seen on diffusion-weighted MRI(DWI) following surgical/endovascular procedures. Little is known about their clinical effects. We examined the association of iatrogenic infarcts with outcomes in the ENACT(Evaluating Neuroprotection in Aneurysm Coiling Therapy) trial of nerinetide in endovascular aneurysm repair. Methods: In this post-hoc analysis, we used multi-variable models to evaluate the association of presence/number of DWI iatrogenic infarcts with NIHSS(National Institutes of Health Stroke Scale), mRS(modified Rankin Scale), and cognitive/neuropsychological scores(30-minute battery) at 1-4 and 30-days post-procedure. We also related infarct number to a Z-score-derived composite outcome score(quantile regression). Results: Among 185 patients(median age:56,IQR:50-64), 124(67.0%) had iatrogenic infarcts(median:4,IQR:2-10.5). Nerinetide resulted in fewer infarcts. Patients with infarcts had lower Mini-Mental State Exam(MMSE) scores at 2-4 days(median:28 vs 29, adjusted-coefficient[acoef] per additional infarct:-1.11,95%CI:-1.88 to -0.34,p=0.005). Infarct number was associated with worse day-1 NIHSS(aOR for NIHSS≥1:1.07,1.02-1.12,p=0.009), day 2-4 mRS(adjusted common odds-ratio[aOR]:1.05,1.01-1.09,p=0.005) and MMSE(acoef:-0.07,-0.13 to -0.003,p=0.040), 30-day mRS(aOR:1.04,1.01-1.07,p=0.016) and Hopkins Verbal Learning Test scores(acoef:-0.21,-0.39 to -0.03,p=0.020), as well as worse composite scores at 1-4 and 30-days(acoef:-0.09,-0.15 to -0.03,p=0.006). Conclusions: Iatrogenic infarcts were associated with subtle differences in post-procedural(1-4 days) and 30-day outcomes in this middle-aged cohort. Future studies should use batteries of similar/greater granularity to validate optimal measures for short- versus long-term manifestations.

A-153 Neuropsychological Effects Assessed Using WISC-IV and WISC-V

Objective This review explores The Weschler Intelligence Scale for Children – Fourth Edition (WISC-IV) and the Weschler Intelligence Scale for Children – Fifth Edition (WISC-V) administered to children with various medical histories including traumatic brain injury, vascular conditions, brain tumor, epilepsy, strokes, sickle cell disease, down syndrome, and neurotoxicity on neurodevelopment. This review aims to explore neuropsychological effects of these medical conditions derived from final scores and scale comparisons. Data Selection Peer-reviewed studies between 2000 and 2020 were gathered from EBSCO, Google Scholar, and Science Direct. Criteria was limited to neurological conditions present in children, who were required to be assessed using either WISC-IV or WISC-V. Children with other developmental or learning disabilities were excluded. Data on Weschler Adult Intelligence Scale (WAIS) were excluded along with any other assessment administered to children. Thirteen articles were included based on the criteria along with two articles that discuss the validity of WISC. Data Synthesis The components of the WISC-IV or WISC-V demonstrated low average or below average scores on many scales, especially overall FSIQ. The largest impairments were present in Processing Speed Index, Verbal Comprehension Index, Working Memory Index, Visual Spatial Index, and overall FSIQ. All children assessed with preexisting neurological conditions demonstrated deficits in neuropsychological domains. The severity of the neurological condition significantly impacted scores when compared to children with no conditions. Conclusions The administration of WISC-IV and WISC-V demonstrated neuropsychological and functioning impairments in children with preexisting neurological conditions. The assessment successfully identified deficit areas and earlier testing can encourage earlier treatments.

Cannabinoids

Tetrahydrocannabinol (THC) is the main psychoactive agent in the leaves of cannabis (marijuana) plants. Many synthetic cannabinoids have been recently developed. Cannabis is the most commonly used illicit drug in the United States; almost 20 million Americans currently consume cannabis. People who use cannabis may experience relaxation, euphoria, and mild hallucinogenic effects. Some may experience nausea and vomiting after use. Synthetic cannabinoids have been associated with more serious complications. Cessation after regular use may result in drug craving, insomnia, anorexia, and restlessness. Metabolites of THC can be detected in the urine up to 1 month after last use; some medications can cause false-positive tests. Serious medical complications of cannabis use are uncommon; the most concerning are neuropsychological problems among adolescent users and acute cognitive and motor impairment. Synthetic cannabinoid use is associated with significant neuropsychological effects. Psychosocial modalities appear to help those who wish to stop or reduce use. There are no medications that have been shown to be effective.