***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM Attention deficit with or without hyperactivity ( AD[H]D ) is a common comorbidity of neurofibromatosis type 1 ( NF 1 ) . We tested the hypothesis that permanent medication with methylpheni date can improve cognitive functioning in children with NF 1 and comorbid AD(H)D. PATIENTS AND METHOD We retrospectively analyzed data of a clinical sample of patients with NF 1 with or without AD(H)D , who underwent st and ardized neuropsychological diagnostics twice ( age range : T1 , 6 - 14 years ; T2 , 7 - 16 years ; mean interval , 49.09 months ) . A total of 16 children without AD(H)D ( nine females ) were compared with 14 unmedicated children with AD(H)D ( eight females ) and to 13 medicated children with AD(H)D ( two females ) .  Effects of medication and attention on cognitive outcome ( IQ ) were tested by repeated measures analysis of covariance ( rmANCOVA ) . RESULTS Medicated children with NF 1 improved significantly in full-scale IQ from T1 to T2 ( IQ[T1 ] = 80.38 , IQ[T2 ] = 98.38 , confidence interval [ diff ] : -25.59 to -10.40 , p < 0.0001 ) , this effect was not evident for the other groups . With attention measures as covariates , the effect remained marginally significant . CONCLUSION Children and adolescents with NF 1 and comorbid AD(H)D may profit from MPH medication regarding general cognition . This effect could be specific for the group of patients with NF 1 , and can not be explained solely by improvements in attention . Controlled , prospect i ve studies are warranted to corroborate our findings OBJECTIVE : To determine the prevalence of autism spectrum disorder ( ASD ) in Neurofibromatosis Type 1 ( NF1 ) . METHODS : Second-phase population -based epidemiologic study using an allcase NF1 registry in a defined UK 4.1 million population area . A total of 109 ( 52.7 % ) of 207 responders from the initial screening phase were grouped by using the parent-rated Social Responsiveness Scale ( SRS ) as significant ASD ( SRS≥76 ; n = 32 ) , moderate ASD ( SRS ≥ 60<76 ; n = 29 ) , or non-ASD ( SRS < 60 , n = 48 ) . Twenty-three cases from the significant ASD group , 16 from moderate ASD , and 8 from non-ASD ( total n = 47 ) , invited proportionately by r and om selection , were seen for detailed confirmatory ascertainment . Assessment s on Autism Diagnostic Interview-Revised , Autism Diagnostic Observation Scale-Generic , and verbal IQ were combined by using st and ard Collaborative Program for Excellence in Autism criteria into an ASD categorization for each case ( ASD , broad ASD with partial features , non-ASD ) . A preplanned weighted analysis was used to derive prevalence estimates for the whole population . RESULTS : Fourteen ( 29.5 % ) of 47 showed ASD , 13 ( 27.7 % ) broad ASD , and 20 ( 42.5 % ) non-ASD . The ASD/broad ASD group showed male predominance ( 1.7:1.0 ) , but did not differ significantly from the non-ASD group on IQ , age , socioeconomic status , inheritance , physical severity , or education . The population prevalence estimate is 24.9 % ASD ( 95 % confidence interval 13.1%–42.1 % ) and 20.8 % broad ASD ( 95 % confidence interval 10.0%–38.1 % ) ; a total of 45.7 % showing some ASD spectrum phenotype . CONCLUSIONS : Findings indicate high prevalence of ASD in NF1 , with implication s for clinical practice and further research into NF1 as a single-gene model for autism Lovastatin has been shown to reverse learning deficits in a mouse model of Neurofibromatosis Type 1 ( NF1 ) , a common monogenic disorder caused by a mutation in the Ras‐MAPK pathway and associated with learning disabilities . We conducted a r and omized double‐blind placebo‐controlled trial to assess lovastatin 's effects on cognition and behavior in patients with NF1 Background Neurofibromatosis type 1 ( NF1 ) is an autosomal dominant disorder with an estimated prevalence of about 1/3000 , independent of ethnicity , race , or gender . Attention Deficit Hyperactivity like Disorder (ADHD)-like characteristics are often reported in patients with NF1 . We hypothesised that learning disabilities in NF1 children were related to ADHD symptoms . Treatment with methylpheni date ( MPD ) has improved learning disabilities in ADHD by acting on neurotransmitters . Our objective was to evaluate its efficacy on ADHD-like symptoms in neurofibromatosis type 1 children ( 7–12 years ) . Methods This was a r and omised , double blind , placebo controlled , and crossover trial comparing 0.5 to 0.8 mg/kg/d of MPD as it is indicated for ADHD to placebo in NF1 children with ADHD-like symptoms . Children aged 7 to 12 years were eligible when their IQ was between 80 and 120 . The total follow-up was 9 weeks including 4 weeks for each period and 1 week wash out . Fifty subjects ( 25 for each period ) were required for testing the primary study hypothesis . The main outcome was an improvement in scores on the simplified Conners ’ Parent Rating Scale . Results Thirty-nine patients were included between April 2004 and December 2010 . Twenty participants received  MPD and 19 placebo during the first period . They all completed the trial . MPD  decreased the simplified Conners by 3.9 points ( ±1.1 , p = 0 . 0003 ) . Conclusions This is the first r and omised controlled trial showing the short-term benefit of MPD on simplified Conners scores in NF1 children . Trial registration Clinical Trials.gov NCT00169611 The objectives of this study were to describe the nature of the attention deficits in children with Neurofibromatosis type 1 ( NF1 ) in comparison with typically developing ( TD ) children , using the Virtual Classroom ( VC ) , and to assess the utility of this instrument for detecting attention deficits . Twenty-nine NF1 children and 25 age- and gender-matched controls , aged 8 - 16 , were assessed in a VC . Parents ' ratings on the  Conners ' Parent Rating Scales-Revised : Long ( CPRS-R : L ) question naire were used to screen for Attention Deficit-Hyperactivity Disorder ( ADHD ) . Significant differences were found between the NF1 and the control groups on the number of targets correctly identified ( omission errors ) and the number of commissions ( commission errors ) in the VC , with poorer performance by the NF1 children ( p < 0.005 ) . Significant correlations were obtained between the number of targets correctly identified , the number of commission errors , and the reaction time . Significant correlations were also found between the total correct hits and the cognitive problems/inattention scale , as well as two other indexes of the CPRS-R : L : the DSM-IV Symptoms Subscale and the ADHD Index . The VC results support the hypothesis that NF1 is marked by inattention and impulsivity and that participants with NF1 are more inattentive ( omission errors ) and impulsive ( commission errors ) than normal controls . The VC appears to be a sensitive and ecologically valid assessment tool for use in the diagnosis of attention deficits among children with NF1 Background T2 hyperintensities ( T2H ) on MRI are the most common CNS lesions in individuals with neurofibromatosis type 1 ( NF1 ) . Objectives The aim was to determine the frequency , signal characteristics and localization of T2H at different ages . In addition , we examined the sensitivity of different MR imaging sequences in detecting these lesions . Material s and methods We studied prospect ively a cohort of children , adolescents and young adults with NF1 using T2-volume ( T2-V ) and conventional MRI sequences . Lesions were design ated as either discrete or diffuse , and the region of signal abnormality was recorded . A total of 103 patients were studied ( age range 8.0–25.4 years , mean 13.9 years ) . Results The frequency , size , and intensity of T2H decreased with age in the basal ganglia ( BG ) and the cerebellum/brainstem ( CB/BS ) . The majority of thalamic and CB/BS lesions were diffuse . Of the total cohort , 80 % had diffuse bilateral hippocampal hyperintensities and 18.4 % had hemispheric lesions best demonstrated on FLAIR ; there was no significant difference in the frequency or signal intensity of hemispheric lesions with age . Conclusion Lesions in the cerebral hemispheres and hippocampus imaged by MR do not change in prevalence over time , suggesting a different pathological basis from the lesions in the in BG and CB/BS that resolve with age . FLAIR and T2-V sequences are more sensitive in detecting lesions than st and ard T2-weighted sequences Objective : To assess the efficacy of lovastatin on visuospatial learning and attention for treating cognitive and behavioral deficits in children with neurofibromatosis type 1 ( NF1 ) . Methods : A multicenter , international , r and omized , double-blind , placebo-controlled trial was conducted between July 2009 and May 2014 as part of the NF Clinical Trials Consortium . Children with NF1 aged 8–15 years were screened for visuospatial learning or attention deficits ( n = 272 ) ; 146 children demonstrated deficits at baseline and were r and omly assigned to lovastatin ( n = 74 ; 40 mg/d ) or placebo ( n = 70 ) . Treatment was administered once daily for 16 weeks . Primary outcomes were total errors on the Cambridge Neuropsychological Test Automated Battery Paired Associate Learning task ( visuospatial learning ) and the Score subtest from the Test of Everyday Attention for Children ( sustained attention ) . Secondary outcomes measured executive function , attention , visuospatial skills , behavior , and quality of life . Primary analyses were performed on the intention-to-treat population . Results : Lovastatin had no significant effect on primary outcomes after 16 weeks of treatment : visuospatial learning ( Cohen d = −0.15 , 95 % confidence interval −0.47 to 0.18 ) or sustained attention ( Cohen d = 0.19 , 95 % confidence interval −0.14 to 0.53 ) . Lovastatin was well tolerated , with no increase in reported adverse events compared to placebo . Conclusions : Lovastatin administered once daily for 16 weeks did not improve visuospatial learning or attention in children with NF1 and is not recommended for amelioration of cognitive deficits in this population . Clinical Trials.gov identifier : This study was registered at Clinical Trials.gov ( NCT00853580 ) and Australian New Zeal and Clinical Trials Registry ( ACTRN12607000560493 ) . Classification of evidence : This study provides Class I evidence that for children with NF1  , lovastatin does not improve visuospatial learning or attention deficits Background : Cognitive impairment and fine motor deficits are frequent manifestations in patients with neurofibromatosis type 1 ( NF1 ) . More than 50 % of patients with NF1 show focal areas of high signal intensity ( T2H ) on T2-weighted MRI of the brain . It has been hypothesized that T2H may be associated with the cognitive and motor problems . Methods : The authors investigated 100 patients with NF1 and 100 healthy control subjects matched for age , sex , and socioeconomic status for their IQ ( Wechsler Intelligence Scale for Children-Revised [ WISC-R ] and Wechsler Adult Intelligence Scale-Revised [ WAIS-R ] ) , fine motor abilities ( Motorische Leistungs-Serie [ motor performance task ] ) , and T2H ( MRI ) . Results : As a group , the 100 patients performed within normal limits of WISC-R and WAIS-R scores . However , the scores for the NF1 patients with normal MRI were at the mean , whereas those for the patients who had T2H ( n = 58 ) were significantly depressed . On measures of fine motor skills , patients with T2H performed poorer than patients with normal MRI . Conclusion : Hyperintensities on T2-weighted MRI represent a biological marker for impaired cognitive and fine motor performance in patients with NF1 Background : Cognitive impairment is the most common complication of neurofibromatosis type 1 ( NF1 ) in childhood . Current research suggests a strong relationship between cognitive deficits and brain T2-hyperintensities . The majority of these lesions disappear as the child ages . Cross-sectional data suggest that there also are improvements in intellect . Objective : To determine the natural history of cognitive functioning and MRI T2-hyperintensities from childhood into adulthood , and whether changes in MRI T2-hyperintensities over time are predictive of changes in cognitive functioning . Methods : The authors conducted a prospect i ve longitudinal study of a cohort of 32 patients with NF1 and 11 unaffected sibling controls . All patients underwent neuropsychological assessment s and 27 children underwent MRI examinations .  The patients 
    Output:
    
Results Compared with controls , children and adolescents with NF1 present significant alterations in language , reading , visuospatial skills , motor function , executive function , attention , behavior , emotion , and social skills .
The prevalence of attention-deficit/hyperactivity disorder ( ADHD ) is important and can affect cognition and executive function variables .
A high prevalence of autistic traits and autistic spectrum disorder were reported .
The benefits of using statins to treat cognitive deficits are unclear .
However , children with NF1 and ADHD seem to benefit from methylpheni date treatment .
The presence of hyperintensities in brain magnetic resonance imaging data seem to be related to poor cognitive performance .
Analysis of these lesions could help to predict cognitive alterations in children with NF1 .