Avaliação neuropsicológica das funções executivas, desempenho escolar e sintomas de TDAH em crianças e adolescentes com disfunção do trato urinário inferior

Abstract

Lower Urinary Tract Dysfunction (LUTD) is a common condition in the pediatric population. It includes symptoms that comprises a wide spectrum of changes related to the storage and/or voiding phase. Related to storage phase, stands out the symptoms of day-time incontinence and enuresis. The LUTD is associated to psychiatric comorbidities and the Attention Deficit Hyperactivity Disorder (ADHD) is the most common one. ADHD is related to cognitive deficits, mainly in executive functions, and functional impacts besides being related to functional and structural brain abnormalities. These aspects are also seen in LUTD children, although they are less investigated inliterature. The objective of this study was to investigate executive functioning through neuropsychological assessment and its repercussion in school, social and emotional functioning, by the presence of ADHD symptoms. This study enrolled 60 children andadolescents aged between 7 and 18 years, divided into groups LUTD n=25, LUTD+ADHD n=16 and Controls n=19. Cognitive aspects related to executive functions, functional aspects related to school performance and skills were evaluated. There were differences between groups in inhibitory control of executive functions, where patients with LUTD+ADHD performed worse than LUTD and Controls. Functional deficits occurred in reading and writing skills, social functioning, and school report, total problems, internalizing problems and externalizing problems. ADHD symptoms correlated with almost all functional variables while inhibitorycontrol correlated only with behavioral problems and social interaction. The results suggest that deficits in inhibitory control and functional impact are secondary to ADHD symptoms presence in LUTD group. It is important to evaluate ADHD symptoms in patients with LUTD and treat accordingly in order to reduce functional impacts. Neuropsychological assessment allows identify impairment in executive functioning,specifically the inhibitory control that can be a predictor of functional outcomes in this context.