Research Article

The effect of the age of treatment onset and quality of dietary control on language and intelligence functions in patients with Phenylketonuria

Abstract

Background and Aim: Phenylketonuria (PKU) is an inherited metabolic disease. The aim of this study was investigation the intelligence and language function in children with PKU based on the age of treatment onset and quality of dietary control.
Methods: In this cross-sectional study, the language and intelligence of 31 children with PKU at the age of 4 to 6.5 years were investigated by test of language development-third edition (TOLD-3) and Wechsler preschool and primary scale of intelligence (WIPPSI), respectively; the data compared with of 42 normal children. Patients were classified into 2 groups with different level of dietary control as good and poor [serum phenylalanine (Phe) level less and more than 6 mg/dl, respectively].
Results: There were significantly differences (p=0.001) between children with PKU and controls in intelligence and language scores. Early treatment improved significantly the intelligence and language scores in comparison with late treatment (p=0.019). Comparing late treatment before and after the age of 1 year showed that late treatment until 1 years of age improved significantly (p=0.050) all of functions except performance intelligence quotient (IQ). In early treated PKU, good dietary control improved significantly (p=0.021) and also, verbal and total IQ in comparison with poor dietary control.
Conclusion: Although, the language development in children with PKU is affected by age of treatment onset, cognitive development features such as verbal and total IQ is affected not only by the time of treatment onset but also by the quality of dietary control.

1. Waisbren SE, Noel K, Fahrbach K, Cella C, Frame D, Dorenbaum A, et al. Phenylalanine blood levels and clinical outcomes in phenylketonuria: a systematic literature review and meta-analysis. Mol Genet Metab. 2007;92(1-2):63-70.
2. Ghiasvand NM, Aledavood A, Ghiasvand R, Seyedin Borojeny F, Aledavood AR, Seyed S, et al. Prevalence of classical phenylketonuria in mentally retarded individuals in Iran. J Inherit Metab Dis. 2009;32 Suppl 1:S283-7.
3. Michel U, Schmidt E, Batzler U. Results of psychological testing of patients aged 3-6 years. Eur J Pediatr.1990;149 Suppl 1:S34-8.
4. Brumm VL, Grant ML. The role of intelligence in phenylketonuria: a review of research and management. Mol Genet Metab. 2010;99 Suppl 1:S18-21.
5. Antshel KM. ADHD, learning, and academic performance in phenylketonuria. Mol Genet Metab. 2010;99 Suppl 1:S52-8.
6. Gassió R, Fusté E, López-Sala A, Artuch R, Vilaseca MA, Campistol J. School performance in early and continuously treated phenylketonuria. Pediatr Neurol. 2005;33(4):267-71.
7. Griffiths PV, Demellweek C, Fay N, Robinson PH, Davidson DC. Wechsler subscale IQ and subtest profile in early treated phenylketonuria. Arch Dis Child. 2000;82(3):209-15.
8. Janzen D, Nguyen M. Beyond executive function: non-executive cognitive abilities in individuals with PKU. Mol Genet Metab. 2010;99 Suppl 1:S47-51.
9. Koch R, Moseley K, Ning J, Romstad A, Guldberg P, Guttler F. Long-term beneficial effects of the phenylalanine-restricted diet in late-diagnosed individuals with phenylketonuria. Mol Genet Metab. 1999;67(2):148-55.
10. Levy HL. Comments on final intelligence in late treated patients with phenylketonuria. Eur J Pediatr. 2000;159 Suppl 2:S149.
11. Maleki Shahmahmood T, Soleymani Z, Faghihzade S. The study of language performances of Persian children with specific language impairment. Audiol. 2011;20(2):11-21. Persian.
12. Shahim S. Correlations for Wechsler intelligence scale for children--revised and the wechsler preschool and primary scale of intelligence for Iranian children. Psychol Rep. 1992;70(1):27-30.
13. Welsh M, DeRoche K, Gilliam D. Neurocognitive models of early-treated Phenylketonuria: insights from meta-analysis and new molecular genetic findings. In: Nelson CA, Luciana M, editors. Handbook of developmental cognitive neuroscience. 2nd ed. Cambridge: The MIT Press; 2008. p. 677-89.
14. Ris MD, Williams SE, Hunt MM, Berry HK, Leslie N. Early-treated phenylketonuria: adult neuropsychologic outcome. J Pediatr. 1994;124(3):388-92.
15. Melnick CR, Michals KK, Matalon R. Linguistic development of children with phenylketonuria and normal intelligence. J Pediatr. 1981;98(2):269-72.
IssueVol 22 No 3 (2013) QRcode
SectionResearch Article(s)
Keywords
Phenylketonuria language total intelligence verbal intelligence performance intelligence

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Keramati N, Soleymani Z, Rouhani F, Jalaie S, Alaee MR. The effect of the age of treatment onset and quality of dietary control on language and intelligence functions in patients with Phenylketonuria. Aud Vestib Res. 2017;22(3):42-51.