Neuropsychology of early‐treated phenylketonuria: Specific executive function deficits

MC Welsh, BF Pennington, S Ozonoff… - Child …, 1990 - Wiley Online Library
MC Welsh, BF Pennington, S Ozonoff, B Rouse, ERB McCabe
Child development, 1990Wiley Online Library
This study explored the hypothesis that children with early‐treated phenylketonuria (PKU)
are selectively impaired on executive function measures, even when still on diet. The
rationale for this hypothesis is that even mild elevations in phenylalanine (Phe) can lead to
lower central levels of biogenic amines, including dopamine (DA). We hypothesize that this
mild DA depletion causes subtle prefrontal dysfunction, which in turn affects executive
functions such as set maintenance, planning, and organized search. 11 preschool …
This study explored the hypothesis that children with early‐treated phenylketonuria (PKU) are selectively impaired on executive function measures, even when still on diet. The rationale for this hypothesis is that even mild elevations in phenylalanine (Phe) can lead to lower central levels of biogenic amines, including dopamine (DA). We hypothesize that this mild DA depletion causes subtle prefrontal dysfunction, which in turn affects executive functions such as set maintenance, planning, and organized search. 11 preschool earlytreated PKU children (M age = 4.64) and a sample of age‐ and IQ‐matched unaffected peers (n 11) were evaluated on a battery of executive function (EF) measures. In addition, a “non‐executive function” task, recognition memory, was administered to all subjects. Group comparisons demonstrated that PKU children were significantly impaired on an executive function composite score; there were no group differences, however, in recognition memory. These results supported the hypothesized specific deficit in executive function. Furthermore, within the PKU group the executive function composite score was significantly negatively correlated with concurrent phenylalanine levels, even after controlling for the correlation between IQ and executive function skills. This second finding provides support for the proposed biochemical mechanism underlying the specific cognitive deficits.
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