SummaryPurpose-Associations between rolandic epilepsy (RE) with reading disability (RD) and speech sound disorder (SSD) have not been tested in a controlled study. We conducted a case-control study to determine whether (1) RD and SSD odds are higher in RE probands than controls and (2) an RE proband predicts a family member with RD or SSD, hence suggesting a shared genetic etiology for RE, RD, and SSD.Methods-Unmatched case-control study with 55 stringently defined RE cases, 150 controls in the same age range lacking a primary brain disorder diagnosis, and their siblings and parents. Odds ratios (OR) were calculated by multiple logistic regression, adjusted for sex and age, and for relatives, also adjusted for comorbidity of RD and SSD in the proband.Results-RD was strongly associated with RE after adjustment for sex and age: OR 5.78 (95% CI: 2. 86-11.69). An RE proband predicts RD in family members: OR 2.84 (95% CI: 1.38-5.84), but not independently of the RE proband's RD status: OR 1.30 (95% CI: 0.55-12.79). SSD was also comorbid with RE: adjusted OR 2.47 (95%CI: 1. 22-4.97). An RE proband predicts SSD in relatives, even after controlling for sex, age and proband SSD comorbidity: OR 4.44 (95% CI: 1.93-10.22).Conclusions-RE is strongly comorbid with RD and SSD. Both RD and SSD are likely to be genetically influenced and may contribute to the complex genetic etiology of the RE syndrome. Siblings of RE patients are at high risk of RD and SSD and both RE patients and their younger siblings should be screened early. KeywordsPhonologic disorder; Articulation disorder; Speech delay; Developmental dysphasia; Developmental dyslexia; Centrotemporal sharp waves; Complex genetic; Familial aggregation; Comorbidity; Cognitive deficit; Family study Address correspondence and reprint requests to Tara Clarke, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, U.S.A. E-mail: tc2226@columbia.edu. The study was conceived by DKP, LJS, BB and TC. DKP, BB, TC, PLM, JC, SF, GT, BRG, and ND designed the study. BB, TC, JC, SF, and DKP collected the data. TC, LJS, PLM and DKP analyzed the data. TC wrote the first draft. All authors contributed to redrafting. Conflict of Interest:The authors declare that they have no competing financial interests. Rolandic epilepsy (RE) is the most common epilepsy syndrome affecting children . It is a developmental epilepsy with a complex genetic inheritance that has yet to be elucidated (Bali et al., 2005). Centrotemporal spikes (CTS) are the electroencephalographic hallmark of RE. The association of RE or CTS with reading disability (RD) and language impairment has often been suggested (Staden et al., 1998;Vinayan et al., 2005), as has association with impairment in the development of speech motor control, also known as speech sound disorder (SSD) (Bladin, 1987;Doose, 1989;Lundberg et al., 2005;Park et al., 2005). Neither the association between RE and RD nor between RE and SSD has been rigorously tested in a case-control study, and thus association has not been unequivocally e...

Several factors influence dementia caregiver desire to institutionalize; however, little is known about differences in caregivers who desire institutionalization versus those who do not. The current study compares predictors of desire to institutionalize in dementia caregivers. Seventy-two caregivers completed the Desire to Institutionalize Scale (DIS) and several psychosocial measures, including burden, dementia knowledge, self-efficacy, depression, health, care recipient daily functioning and memory/behavior problems, family functioning, and social support. Based on DIS responses, caregivers were divided into No DI versus DI groups. DI caregivers had significantly higher burden, greater dementia knowledge, more family dysfunction, and decreased social support compared with No DI caregivers. Findings emphasize the importance of caregiver and family relationship variables in DIS, suggesting potentially modifiable targets for caregiver interventions. Dementia knowledge was associated with higher DIS, suggesting that educational programs alone may not be helpful to delay institutionalization.

The purpose of this study was to examine the relationship between common laboratory values and cognitive functioning among 129 inpatients referred for neuropsychological evaluation. Laboratory values were recorded at admission, at the time point closest to neuropsychological evaluation, and at the time of peak metabolic derangement. Cognitive status was evaluated with the modified Mini-Mental State Exam. Patients with hyperglycemia, hypochloremia, and/or elevated creatinine at admission exhibited cognitive deficits. Patients with hyperglycemia, hyperchloremia, hypernatremia, hyperkalemia, leukocytosis, low hemoglobin, elevated blood urea nitrogen, and/or elevated creatinine at the time of peak metabolic derangement exhibited cognitive deficits. Different lab abnormalities at the time of peak metabolic derangement accounted for unique patterns of neuropsychological impairment. Lab values drawn at the time point closest to neuropsychological evaluation were not significantly associated with cognitive functioning. Results support and quantify common clinical beliefs that metabolic abnormalities are associated with global cognitive changes among elderly inpatients.

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