Analysis of speech fluency in Williams syndrome

Williams syndrome (WS) is a neurodevelopmental genetic disorder, often referred as being characterized by dissociation between verbal and non-verbal abilities, although the number of studies disputing this proposal is emerging. Indeed, although they have been traditionally reported as displaying increased speech fluency, this topic has not been fully addressed in research. In previous studies carried out with a small group of individuals with WS, we reported speech breakdowns during conversational and autobiographical narratives suggestive of language difficulties. In the current study, we characterized the speech fluency profile using an ecologically based measure - a narrative task (story generation) was collected from a group of individuals with WS (n = 30) and typically developing group (n = 39) matched in mental age. Oral narratives were elicited using a picture stimulus - the cookie theft picture from Boston Diagnosis Aphasia Test. All narratives were analyzed according to typology and frequency of fluency breakdowns (non-stuttered and stuttered disfluencies). Oral narratives in WS group differed from typically developing group, mainly due to a significant increase in the frequency of disfluencies, particularly in terms of hesitations, repetitions and pauses. This is the first evidence of disfluencies in WS using an ecologically based task (oral narrative task), suggesting that these speech disfluencies may represent a significant marker of language problems in WS. (C) 2011 Elsevier Ltd. All rights reserved.

Psycholinguistic abilities of children with Williams syndrome

The objective of this study was to investigate the psycholinguistic abilities of children with Williams syndrome (WS) and typically developing children using the Illinois Test of Psycholinguistic Abilities (ITPA). Performance on the ITPA was analysed in a group with WS (N = 20, mean age = 8.5 years, SD = 1.62) and two typically developing groups, matched in mental (MA, N = 20, mean age = 4.92 years, SD = 1.14) and chronological age (CA, N = 19, mean age = 8.35 years, SD = 3.07). Overall, within-group analyses showed that individuals with WS displayed higher scalar scores on the visual reception and visual association subtests. When groups were compared, we observed inferior performance of the WS group on all ITPA subtests when compared with typically developing groups. Moreover, an interaction between reception and group was found, only the WS group demonstrated superior performance on the visual reception subtest when compared to the auditory reception subtest. Evidence from this study offers relevant contributions to the development of educational intervention programs for children with WS. (C) 2011 Elsevier Ltd. All rights reserved.

Perfil comunicativo de indivíduos com a síndrome de Williams-Beuren

OBJETIVO: Descrever o perfil comunicativo de indivíduos com a síndrome de Williams-Beuren. MÉTODOS: A casuística foi composta por 12 indivíduos com a síndrome com idade cronológica entre 6;6 a 23;6 (Grupo 1) que foram comparados a outros 12 sem a síndrome e com idade mental semelhante e sem dificuldades de linguagem/aprendizagem (Grupo 2). Os indivíduos foram avaliados em situação de conversação para classificação dos comportamentos verbais e não-verbais, segundo critérios pragmáticos, levantamento do número de turnos por minuto, enunciados por turno, Extensão Média de Enunciados, levantamento quanto à freqüência e tipologia de disfluências da fala e classificação quanto ao tipo de pausas plenas do discurso. RESULTADOS: O perfil comunicativo do Grupo 1 mostrou facilidade para interagirem em situação de comunicação com a presença de limitações lingüísticas estruturais e funcionais variáveis, quando comparados aos indivíduos do Grupo 2. Os indivíduos do Grupo 1 freqüentemente utilizaram estratégias comunicativas, na tentativa de preencherem o espaço comunicativo, como o uso de clichês, efeitos sonoros, recursos entonacionais e as pausas plenas que mostraram ser favoráveis do ponto de vista sócio-comunicativo, enquanto que os comportamentos verbais ecolálicos e perseverativos prejudicam o desempenho comunicativo desses indivíduos. CONCLUSÃO: O desempenho comunicativo mais prejudicado do Grupo 1 permitiu especular que comprometimentos lingüísticos nesta condição podem estar presentes, independente da diferença entre idade cronológica e mental. Estudos mais abrangentes poderão responder ao questionamento da dissociação de habilidades cognitivas e lingüísticas nesta síndrome e também no que diz respeito à complexa esta correlação em meio aos distúrbios da comunicação humana.

Correlações entre sono-vigília, memória e melatonina em Síndrome de Williams-Beuren

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Estimativa da frequência da inversão SWBinv-1 entre pais de portadores ds síndrome de Williams-Beuren e pais de filhos normais do Brasil

Pós-graduação em Ciências Biológicas (Genética) - IBB

Fluorescent in situ hybridization (FISH) as a diagnostic tool for Williams-Beuren syndrome

Fluorescent in situ hybridization (FISH) with commercial probes covering the elastin gene (ELN) was used to determine the frequency of the 7q11.23 deletion in 18 children clinically diagnosed with Williams-Beuren syndrome (WBS). A de novo deletion was detected in 15 of the children (83%). Diagnostic investigation for WBS started late in childhood (median = 5.8 years). All the children showed facial features typical of the syndrome, mental retardation and developmental delay. Over-friendliness was observed in the majority of cases. Clinodactyly of the 5th finger (n = 13), cardiovascular disease (n = 9), loquacity (n = 9), low birthweight (n = 8), and failure to thrive (n = 9) were observed only in those children with the deletion. Respiratory problems (n = 9), though not previously reported in the literature, was a common finding in the group studied. Our results confirmed that FISH is useful in identifying 7q11.23 deletions in cases of WBS. Clinical manifestations were more evident in the deletion-positive children.

Assessment of clinical scoring systems for the diagnosis of Williams-Beuren syndrome

Williams-Beuren syndrome (WBS) is a genetic disorder characterized by physical and intellectual developmental delay, associated with congenital heart disease and facial dysmorphism. WBS is caused by a microdeletion on chromosome 7 (7q11.23), which encompasses the elastin (ELN) gene and about 27 other genes. The gold standard for WBS laboratory diagnosis is FISH (fluorescence in situ hybridization), which is very costly. As a possible alternative, we investigated the accuracy of three clinical diagnostic scoring systems in 250 patients with WBS diagnosed by FISH. We concluded that all three systems could be used for the clinical diagnosis of WBS, but they all gave a low percentage of false-positive (6.0-9.2%) and false-negative (0.8-4.0%) results. Therefore, their use should be associated with FISH testing. © FUNPEC-RP.

Lung ultrasound in acute respiratory distress syndrome and acute lung injury

Purpose of reviewLung ultrasound at the bedside can provide accurate information on lung status in critically ill patients with acute respiratory distress syndrome.Recent findingsLung ultrasound can replace bedside chest radiography and lung computed tomography for assessment of pleural effusion, pneumothorax, alveolar- interstitial syndrome, lung consolidation, pulmonary abscess and lung recruitment/de-recruitment. It can also accurately determine the type of lung morphology at the bedside (focal or diffuse aeration loss), and therefore it is useful for optimizing positive end-expiratory pressure. The learning curve is brief, so most intensive care physicians will be able to use it after a few weeks of training.SummaryLung ultrasound is noninvasive, easily repeatable and allows assessment of changes in lung aeration induced by the various therapies. It is among the most promising bedside techniques for monitoring patients with acute respiratory distress syndrome.

Unilateral Facial Paralysis Caused by Ramsay Hunt Syndrome

The Ramsay Hunt syndrome is a rare disease caused by an infection of the geniculate ganglion by the varicella-zoster virus. The main clinical features of the syndrome are as follows: Bell palsy unilateral or bilateral, vesicular eruptions on the ears, ear pain, dizziness, preauricular swelling, tingling, tearing, loss of taste sensation, and nystagmus. We describe a 23-year-old white woman, who presented with facial paralysis on the left side of the face, pain, fever, ear pain, and swelling in the neck and auricular region on the left side. She received appropriate treatment with acyclovir, vitamin B complex, and CMP nucleus. After 30 days after presentation, the patient did not show any signs or symptoms of the syndrome. At follow-up at 1 year, she showed no relapse of the syndrome.

Perfil da fluência da fala na síndrome de Williams-Beuren: estudo preliminar

TEMA: o padrão de fala fluente atribuído aos indivíduos com a síndrome de Williams-Beuren sustenta-se pela efetividade da alça fonológica. Alguns estudos citaram a ocorrência de disfluências decorrentes de prejuízos léxico-semânticos, entretanto, a quebra de fluência não foi bem especificada quanto ao tipo e freqüência de ocorrência. OBJETIVO: obter o perfil da fluência da fala de indivíduos com a SWB e comparar com um grupo controle pareado por gênero e idade mental semelhante. MÉTODO: foram avaliados 12 sujeitos com síndrome de Williams-Beuren a com idade cronológica entre 6,6 a 23,6 e idade mental de 4,8 a 14,3 anos que foram comparados a outros 12 sujeitos de idade mental semelhante com ausência de dificuldades de linguagem/aprendizagem. Para avaliação da fluência foi utilizado o Teste de Linguagem Infantil - ABFW, na área de fluência, que possibilitou classificar, quantificar e comparar os dois grupos quanto às tipologias e freqüência de rupturas e velocidade de fala. RESULTADOS: o grupo com a síndrome de Williams-Beuren (SWB) apresentou maior porcentagem de descontinuidade de fala e freqüência aumentada para disfluências comuns do tipo hesitação e repetição de palavras quando comparados aos indivíduos com idade mental semelhante e com desenvolvimento típico de fala e linguagem. CONCLUSÃO: O perfil da fluência da fala apresentado pelos indivíduos com a SWB neste estudo mostrou a presença de disfluências que podem ser decorrentes de prejuízo no processamento léxico-semântico e sintático da informação verbal; ressaltando-se, pois a necessidade de investigações mais sistemáticas sobre este tema.

Genética e linguagem na síndrome de Williams-Beuren: uma condição neuro-cognitiva peculiar

TEMA: aspectos genéticos, cognitivos e de linguagem na Síndrome de Williams-Beuren (SWB). OBJETIVO: revisar a literatura sobre a SWB, destacando aspectos genéticos, cognitivos e de linguagem. CONCLUSÕES: a literatura mostrou que a etiologia da SWB é conhecida, embora o diagnóstico precoce pode ser difícil pela variabilidade de manifestações clínicas dessa condição. O fenótipo variável tem sido atribuído a deleção de vários genes na região 7q11.23. que inclui o gene da elastina. A deleção desse gene é identificada pelo estudo citogenético molecular denominado Hibridização in situ por Fluorescência (FISH). A freqüência populacional desta síndrome é de 1 em 20,000 nascimentos e é resultante de uma alteração genética de novo. O quadro da SWB é caracterizado principalmente por fácies típica conhecida como face de duende, alterações cardíacas, prejuízos cognitivos e aspectos comportamentais que incluem a linguagem. A característica falante e sociável associada as dificuldades viso-construtivas conferem a esta síndrome um quadro neuro-cognitivo peculiar. A deficiência mental é variável e pode ou não estar presente. Estudos que descreveram as habilidades de linguagem nesta síndrome destacaram que a habilidade sintática pode estar íntegra ou parcialmente íntegra, a produção verbal pode ser precisa e inteligível, mostrando a integridade do sistema fonológico. O vocabulário receptivo-auditivo é citado em alguns estudos como adequado e em outros como prejudicado para a idade mental. Pesquisas na área têm produzido, resultados incongruentes com respeito ao perfil de habilidades cognitivas e lingüísticas nos portadores dessa condição. A correlação entre as habilidades de linguagem e a cognição e a divergência de achados na literatura serão abordadas neste artigo.

Prevalence and nonrandom distribution of exonic mutations in interferon regulatory factor 6 in 307 families with Van der Woude syndrome and 37 families with popliteal pterygium syndrome

Purpose: Interferon regulatory factor 6 encodes a member of the IRF family of transcription factors. Mutations in interferon regulatory factor 6 cause Van der Woude and popliteal pterygium syndrome, two related orofacial clefting disorders. Here, we compared and contrasted the frequency and distribution of exonic Mutations in interferon regulatory factor 6 between two large geographically distinct collections of families with Van der Woude and between one collection of families with popliteal pterygium syndrome. Methods: We performed direct sequence analysis of interferon regulatory factor 6 exons oil samples from three collections, two with Van der Woude and one with popliteal pterygium syndrome. Results: We identified mutations in interferon regulatory factor 6 exons in 68% of families in both Van der Woude collections and in 97% of families with popliteal pterygium syndrome. In sum, 106 novel disease-causing variants were found. The distribution of mutations in the interferon regulatory factor 6 exons in each collection was not random; exons 3, 4, 7, and 9 accounted for 80%. In the Van der Woude collections, the mutations were evenly divided between protein truncation and missense, whereas most mutations identified in the popliteal pterygium syndrome collection were missense. Further, the missense mutations associated with popliteal pterygium syndrome were localized significantly to exon 4, at residues that are predicted to bind directly to DNA. Conclusion: The nonrandom distribution of mutations in the interferon regulatory factor 6 exons suggests a two-tier approach for efficient mutation screens for interferon regulatory factor 6. The type and distribution of mutations are consistent with the hypothesis that Van der Woude is caused by haploinsufficiency of interferon regulatory factor 6. Oil the other hand, the distribution of popliteal pterygium syndrome-associated mutations suggests a different, though not mutually exclusive, effect oil interferon regulatory factor 6 function. Genet Med 2009:11(4):241-247.