Barbara Laughton - Academia.edu (original) (raw)
Papers by Barbara Laughton
Human Brain Mapping
Children with perinatally acquired HIV (CPHIV) have poor cognitive outcomes despite early combina... more Children with perinatally acquired HIV (CPHIV) have poor cognitive outcomes despite early combination antiretroviral therapy (cART). While CPHIV-related brain alterations can be investigated separately using proton magnetic resonance spectroscopy (1 H-MRS), structural magnetic resonance imaging (sMRI), diffusion tensor imaging (DTI), and functional MRI (fMRI), a set of multimodal MRI measures characteristic of children on cART has not been previously identified. We used the embedded feature selection of a logistic elastic-net (EN) regularization to select neuroimaging measures that distinguish CPHIV from controls and measured their classification performance via the area under the receiver operating characteristic curve (AUC) using repeated cross validation. We also wished to establish whether combining MRI modalities improved the models. In single modality analysis, sMRI volumes performed best followed by DTI, whereas individual EN models on spectroscopic, gyrification, and cortical thickness measures showed no class discrimination capability. Adding DTI and 1 H-MRS in basal measures to sMRI volumes produced the highest classification performance validation accuracy ¼ 85%, AUC ¼ 0:80 ð Þ. The best multimodal MRI set consisted of 22 DTI and sMRI volume features, which included reduced volumes of the bilateral globus pallidus and amygdala, as well as increased mean diffusivity (MD) and radial diffusivity (RD) in the right corticospinal tract in cART-treated CPHIV. Consistent with previous studies of CPHIV, select subcortical volumes obtained from sMRI provide reasonable discrimination between CPHIV and controls. This may give insight into neuroimaging measures that are relevant in understanding the effects of HIV on the brain, thereby providing a starting point for evaluating their link with cognitive performance in CPHIV.
ERJ Open Research, 2022
Despite the introduction of ART, HIV-associated pulmonary complications remain prevalent in child... more Despite the introduction of ART, HIV-associated pulmonary complications remain prevalent in children following perinatal HIV infection. In the post-ART era the incidence of opportunistic infections has decreased, however non-infectious complications including diminished lung function are common. It is unclear whether early initiation of ART influences lung function later in life.We performed a cross-sectional study examining pulmonary function tests (PFT) (spirometry, plethysmography, carbon monoxide diffusing capacity) in HIV-unexposed (HU), HIV exposed-uninfected (HEU) and perinatally HIV infected children on early ART (HIV+) recruited from the Cape Town arms of the CHER and IMPAACT 1060 trials. PFT was performed once children could participate (October 2013 to January 2020). Global Lung Initiative reference software was used for Z-standardization of lung function by sex, age and height.In total 394 children (HU n=90, HEU n=162, HIV+ n=142) underwent PFT, median age 8.7 (IQR 7.7–9...
Please help us populate SUNScholar with the post print version of this article. It can be e-maile... more Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.zaGeneeskundeRadiodiagnos
Clinical Infectious Diseases, 2019
BackgroundChildren living with human immunodeficiency virus (HIV) are at neuropsychological risk ... more BackgroundChildren living with human immunodeficiency virus (HIV) are at neuropsychological risk for cognitive and motor dysfunction. However, few prospective, multi-site studies have evaluated neuropsychological outcomes longitudinally among perinatally infected African children who received early antiretroviral treatment (ART).MethodsWe enrolled 611 children aged 5 to 11 years at 6 sites (South Africa [3], Zimbabwe, Malawi, Uganda). Of these, there were 246 children living with HIV (HIV+) who were initiated on ART before 3 years of age in a prior clinical trial comparing nevirapine to lopinavir/ritonavir (International Maternal Pediatric Adolescent Acquired Immunodeficiency Syndrome Clinical Trials [IMPAACT] P1060); 183 age-matched, exposed but uninfected (HEU) children; and 182 unexposed and uninfected (HUU) children. They were compared across 3 assessment time points (Weeks 0, 48, and 96) on cognitive ability (Kaufman Assessment Battery for Children, second edition [KABC-II]), a...
Clinical Infectious Diseases, 2021
Background Invasive group B Streptococcus (iGBS) sepsis and meningitis are important causes of ch... more Background Invasive group B Streptococcus (iGBS) sepsis and meningitis are important causes of child mortality, but studies on neurodevelopmental impairment (NDI) after iGBS are limited. Using Griffiths Mental Development Scales–Extended Revised (GMDS-ER), we described NDI in iGBS survivors and non-iGBS children from South Africa, as part of a 5-country study. Methods We identified children aged 5–8 years with a history of iGBS and children with no history of iGBS between October 2019 and January 2021. Children were matched on sex, and birth data (month, year) (matched cohort study). Moderate or Severe NDI was the primary outcome as a composite of GMDS-ER motor, GMDS-ER cognition, hearing, and vision. Secondary outcomes included mild NDI, any emotional-behavioral problems, and GMDS-ER developmental quotients (DQ) calculated by dividing the age equivalent GMDS-ER score by the chronological age. Results In total, 160 children (iGBS survivors, 43; non-iGBS, 117) were assessed. Among iG...
Paediatrics and International Child Health, 2022
![Research paper thumbnail of isiXhosa Translation of the Patient Health Questionnaire (PHQ-9): A Pilot Study of Psychometric Properties [Stage 1]](https://attachments.academia-assets.com/84626965/thumbnails/1.jpg)
](Frontiers in Psychiatry, 2022
Depression is a debilitating illness, and stigma associated with it often prevents people from se... more Depression is a debilitating illness, and stigma associated with it often prevents people from seeking support. Easy-to-administer and culturally-specific diagnostic tools can allow for early screening for depression in primary care clinics, especially in resource-limited settings. In this pilot study, we will produce the first open-access isiXhosa-language version of the nine-item Patient Health Questionnaire (PHQ-9), a well-validated measure of depression incidence and severity, using a transcultural translation framework. We will validate this isiXhosa PHQ-9 in a small sample of adolescents living with HIV in Cape Town, South Africa who speak isiXhosa at home. Participants have previously completed the ASEBA Youth Self Report (YSR) form, and responses from the YSR will be used as a gold standard to validate the isiXhosa PHQ-9. If validated through this Registered Report, this isiXhosa PHQ-9 may be an invaluable culturally-specific tool for clinicians serving Xhosa people in ident...
Additional file 1. The dataset supporting the conclusions of this article is included within the ... more Additional file 1. The dataset supporting the conclusions of this article is included within the article as an additional file nr.1. (.xls 5 year old tabular data).
Brain Connectivity, 2021
INTRODUCTION Even with the increased access and early initiation of combination antiretroviral th... more INTRODUCTION Even with the increased access and early initiation of combination antiretroviral therapy (cART), children with perinatally acquired HIV (CPHIV) continue to demonstrate white matter alterations. Children perinatally HIV-exposed, but uninfected (CHEU) alike show differences in white matter integrity compared to children who are HIV-unexposed and uninfected (CHUU). OBJECTIVES Mapping white matter connections that link grey matter regions that form resting-state (RS) functional networks may demonstrate whether structural and functional connectivity alterations in HIV infection and exposure may be related. We hypothesized reduced structural connectivity in CPHIV within the default mode network (DMN), visual, ventral default mode network (vDMN), somatosensory, salience, auditory, motor, executive, basal ganglia and posterior default mode network (pDMN). We also hypothesized CHEU will have increased structural connectivity compared to CHUU in the vDMN, somatosensory, pDMN, dorsal attention (dATT), salience, auditory, motor and basal ganglia. METHODS Study participants were 61 7-year-old CPHIV and 46 age matched CHU (19 CHEU). We used diffusion tensor imaging (DTI) -based tractography to investigate white matter connections that link grey matter regions within RS functional networks. RESULTS We found altered white matter integrity in the somatosensory, salience, default mode and motor networks of CPHIV compared to CHU. The superior temporal cortex, superior frontal cortex and putamen were affected in all four networks and have also been reported to demonstrate morphological alterations in the same cohort. In CHEU, white matter integrity was higher in the visual network, pDMN and motor network compared to CHUU. CONCLUSION Our results suggest that altered white matter integrity may influence grey matter morphology and functional network alterations.
IBRO Neuroscience Reports, 2021
SSRN Electronic Journal, 2019
Frontiers in human neuroscience, 2017
Although HIV has been shown to impact brain connectivity in adults and youth, it is not yet known... more Although HIV has been shown to impact brain connectivity in adults and youth, it is not yet known to what extent long-term early antiretroviral therapy (ART) may alter these effects, especially during rapid brain development in early childhood. Using both independent component analysis (ICA) and seed-based correlation analysis (SCA), we examine the effects of HIV infection in conjunction with early ART on resting state functional connectivity (FC) in 7 year old children. HIV infected (HIV+) children were from the Children with HIV Early Antiretroviral Therapy (CHER) trial and all initiated ART before 18 months; uninfected children were recruited from an interlinking vaccine trial. To better understand the effects of current and early immune health on the developing brain, we also investigated among HIV+ children the association of FC at 7 years with CD4 count and CD4%, both in infancy (6-8 weeks) and at scan. Although we found no differences within any ICA-generated resting state ne...
The Pediatric Infectious Disease Journal, 2017
Cerebral palsy is an umbrella term. It is not sufficient just to make the diagnosis of CP; the te... more Cerebral palsy is an umbrella term. It is not sufficient just to make the diagnosis of CP; the term needs to be further qualified by a more detailed description of the clinical condition. The clinical signs may change over time. The diagnosis and initial assessments should be made by professionals experienced in the field where possible. If a sound and logical approach is used, patients with CP can be managed at primary and secondary level for a number of their problems. Intervention is aimed at reaching maximum function and potential and preventing further complications. Physiotherapy is the mainstay of physical treatment and early referral, good positioning and passive movements are paramount. There are a number of associated problems that also need to be recognised and managed appropriately. An experienced orthopaedic surgeon is an essential part of the team.
MSc, Child Health Neurodevelopment, Faculty of Health Sciences, University of the Witwatersrand
South African Journal of Child Health, Dec 8, 2010
Children with human immunodeficiency virus (HIV) infection are more likely to have hearing loss a... more Children with human immunodeficiency virus (HIV) infection are more likely to have hearing loss and are more susceptible to middle ear infections. The purpose of this study was to quantitatively measure middle ear function, using tympanometry,
Human Brain Mapping
Children with perinatally acquired HIV (CPHIV) have poor cognitive outcomes despite early combina... more Children with perinatally acquired HIV (CPHIV) have poor cognitive outcomes despite early combination antiretroviral therapy (cART). While CPHIV-related brain alterations can be investigated separately using proton magnetic resonance spectroscopy (1 H-MRS), structural magnetic resonance imaging (sMRI), diffusion tensor imaging (DTI), and functional MRI (fMRI), a set of multimodal MRI measures characteristic of children on cART has not been previously identified. We used the embedded feature selection of a logistic elastic-net (EN) regularization to select neuroimaging measures that distinguish CPHIV from controls and measured their classification performance via the area under the receiver operating characteristic curve (AUC) using repeated cross validation. We also wished to establish whether combining MRI modalities improved the models. In single modality analysis, sMRI volumes performed best followed by DTI, whereas individual EN models on spectroscopic, gyrification, and cortical thickness measures showed no class discrimination capability. Adding DTI and 1 H-MRS in basal measures to sMRI volumes produced the highest classification performance validation accuracy ¼ 85%, AUC ¼ 0:80 ð Þ. The best multimodal MRI set consisted of 22 DTI and sMRI volume features, which included reduced volumes of the bilateral globus pallidus and amygdala, as well as increased mean diffusivity (MD) and radial diffusivity (RD) in the right corticospinal tract in cART-treated CPHIV. Consistent with previous studies of CPHIV, select subcortical volumes obtained from sMRI provide reasonable discrimination between CPHIV and controls. This may give insight into neuroimaging measures that are relevant in understanding the effects of HIV on the brain, thereby providing a starting point for evaluating their link with cognitive performance in CPHIV.
ERJ Open Research, 2022
Despite the introduction of ART, HIV-associated pulmonary complications remain prevalent in child... more Despite the introduction of ART, HIV-associated pulmonary complications remain prevalent in children following perinatal HIV infection. In the post-ART era the incidence of opportunistic infections has decreased, however non-infectious complications including diminished lung function are common. It is unclear whether early initiation of ART influences lung function later in life.We performed a cross-sectional study examining pulmonary function tests (PFT) (spirometry, plethysmography, carbon monoxide diffusing capacity) in HIV-unexposed (HU), HIV exposed-uninfected (HEU) and perinatally HIV infected children on early ART (HIV+) recruited from the Cape Town arms of the CHER and IMPAACT 1060 trials. PFT was performed once children could participate (October 2013 to January 2020). Global Lung Initiative reference software was used for Z-standardization of lung function by sex, age and height.In total 394 children (HU n=90, HEU n=162, HIV+ n=142) underwent PFT, median age 8.7 (IQR 7.7–9...
Please help us populate SUNScholar with the post print version of this article. It can be e-maile... more Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.zaGeneeskundeRadiodiagnos
Clinical Infectious Diseases, 2019
BackgroundChildren living with human immunodeficiency virus (HIV) are at neuropsychological risk ... more BackgroundChildren living with human immunodeficiency virus (HIV) are at neuropsychological risk for cognitive and motor dysfunction. However, few prospective, multi-site studies have evaluated neuropsychological outcomes longitudinally among perinatally infected African children who received early antiretroviral treatment (ART).MethodsWe enrolled 611 children aged 5 to 11 years at 6 sites (South Africa [3], Zimbabwe, Malawi, Uganda). Of these, there were 246 children living with HIV (HIV+) who were initiated on ART before 3 years of age in a prior clinical trial comparing nevirapine to lopinavir/ritonavir (International Maternal Pediatric Adolescent Acquired Immunodeficiency Syndrome Clinical Trials [IMPAACT] P1060); 183 age-matched, exposed but uninfected (HEU) children; and 182 unexposed and uninfected (HUU) children. They were compared across 3 assessment time points (Weeks 0, 48, and 96) on cognitive ability (Kaufman Assessment Battery for Children, second edition [KABC-II]), a...
Clinical Infectious Diseases, 2021
Background Invasive group B Streptococcus (iGBS) sepsis and meningitis are important causes of ch... more Background Invasive group B Streptococcus (iGBS) sepsis and meningitis are important causes of child mortality, but studies on neurodevelopmental impairment (NDI) after iGBS are limited. Using Griffiths Mental Development Scales–Extended Revised (GMDS-ER), we described NDI in iGBS survivors and non-iGBS children from South Africa, as part of a 5-country study. Methods We identified children aged 5–8 years with a history of iGBS and children with no history of iGBS between October 2019 and January 2021. Children were matched on sex, and birth data (month, year) (matched cohort study). Moderate or Severe NDI was the primary outcome as a composite of GMDS-ER motor, GMDS-ER cognition, hearing, and vision. Secondary outcomes included mild NDI, any emotional-behavioral problems, and GMDS-ER developmental quotients (DQ) calculated by dividing the age equivalent GMDS-ER score by the chronological age. Results In total, 160 children (iGBS survivors, 43; non-iGBS, 117) were assessed. Among iG...
Paediatrics and International Child Health, 2022
Frontiers in Psychiatry, 2022
Depression is a debilitating illness, and stigma associated with it often prevents people from se... more Depression is a debilitating illness, and stigma associated with it often prevents people from seeking support. Easy-to-administer and culturally-specific diagnostic tools can allow for early screening for depression in primary care clinics, especially in resource-limited settings. In this pilot study, we will produce the first open-access isiXhosa-language version of the nine-item Patient Health Questionnaire (PHQ-9), a well-validated measure of depression incidence and severity, using a transcultural translation framework. We will validate this isiXhosa PHQ-9 in a small sample of adolescents living with HIV in Cape Town, South Africa who speak isiXhosa at home. Participants have previously completed the ASEBA Youth Self Report (YSR) form, and responses from the YSR will be used as a gold standard to validate the isiXhosa PHQ-9. If validated through this Registered Report, this isiXhosa PHQ-9 may be an invaluable culturally-specific tool for clinicians serving Xhosa people in ident...
Additional file 1. The dataset supporting the conclusions of this article is included within the ... more Additional file 1. The dataset supporting the conclusions of this article is included within the article as an additional file nr.1. (.xls 5 year old tabular data).
Brain Connectivity, 2021
INTRODUCTION Even with the increased access and early initiation of combination antiretroviral th... more INTRODUCTION Even with the increased access and early initiation of combination antiretroviral therapy (cART), children with perinatally acquired HIV (CPHIV) continue to demonstrate white matter alterations. Children perinatally HIV-exposed, but uninfected (CHEU) alike show differences in white matter integrity compared to children who are HIV-unexposed and uninfected (CHUU). OBJECTIVES Mapping white matter connections that link grey matter regions that form resting-state (RS) functional networks may demonstrate whether structural and functional connectivity alterations in HIV infection and exposure may be related. We hypothesized reduced structural connectivity in CPHIV within the default mode network (DMN), visual, ventral default mode network (vDMN), somatosensory, salience, auditory, motor, executive, basal ganglia and posterior default mode network (pDMN). We also hypothesized CHEU will have increased structural connectivity compared to CHUU in the vDMN, somatosensory, pDMN, dorsal attention (dATT), salience, auditory, motor and basal ganglia. METHODS Study participants were 61 7-year-old CPHIV and 46 age matched CHU (19 CHEU). We used diffusion tensor imaging (DTI) -based tractography to investigate white matter connections that link grey matter regions within RS functional networks. RESULTS We found altered white matter integrity in the somatosensory, salience, default mode and motor networks of CPHIV compared to CHU. The superior temporal cortex, superior frontal cortex and putamen were affected in all four networks and have also been reported to demonstrate morphological alterations in the same cohort. In CHEU, white matter integrity was higher in the visual network, pDMN and motor network compared to CHUU. CONCLUSION Our results suggest that altered white matter integrity may influence grey matter morphology and functional network alterations.
IBRO Neuroscience Reports, 2021
SSRN Electronic Journal, 2019
Frontiers in human neuroscience, 2017
Although HIV has been shown to impact brain connectivity in adults and youth, it is not yet known... more Although HIV has been shown to impact brain connectivity in adults and youth, it is not yet known to what extent long-term early antiretroviral therapy (ART) may alter these effects, especially during rapid brain development in early childhood. Using both independent component analysis (ICA) and seed-based correlation analysis (SCA), we examine the effects of HIV infection in conjunction with early ART on resting state functional connectivity (FC) in 7 year old children. HIV infected (HIV+) children were from the Children with HIV Early Antiretroviral Therapy (CHER) trial and all initiated ART before 18 months; uninfected children were recruited from an interlinking vaccine trial. To better understand the effects of current and early immune health on the developing brain, we also investigated among HIV+ children the association of FC at 7 years with CD4 count and CD4%, both in infancy (6-8 weeks) and at scan. Although we found no differences within any ICA-generated resting state ne...
The Pediatric Infectious Disease Journal, 2017
Cerebral palsy is an umbrella term. It is not sufficient just to make the diagnosis of CP; the te... more Cerebral palsy is an umbrella term. It is not sufficient just to make the diagnosis of CP; the term needs to be further qualified by a more detailed description of the clinical condition. The clinical signs may change over time. The diagnosis and initial assessments should be made by professionals experienced in the field where possible. If a sound and logical approach is used, patients with CP can be managed at primary and secondary level for a number of their problems. Intervention is aimed at reaching maximum function and potential and preventing further complications. Physiotherapy is the mainstay of physical treatment and early referral, good positioning and passive movements are paramount. There are a number of associated problems that also need to be recognised and managed appropriately. An experienced orthopaedic surgeon is an essential part of the team.
MSc, Child Health Neurodevelopment, Faculty of Health Sciences, University of the Witwatersrand
South African Journal of Child Health, Dec 8, 2010
Children with human immunodeficiency virus (HIV) infection are more likely to have hearing loss a... more Children with human immunodeficiency virus (HIV) infection are more likely to have hearing loss and are more susceptible to middle ear infections. The purpose of this study was to quantitatively measure middle ear function, using tympanometry,