Electroencephalography signals and neurodevelopment after Kawasaki disease: A pilot study

Background: Acute Kawasaki disease ( KD) induces central nervous system inflammation and excessive irritability. Long--term impacts on children's neurodevelopment have only been studied marginally. This pilot study aimed to describe the neuropsychological profile of primary school--aged children with a history of KD and to explore the impacts of KD on electroencephalography (EEG) markers associated with attention and brain maturation. Methods: Fifteen children (8.8 +/- 2.5 years) were recruited 4.9 +/- 2.7 years after KD onset. Intellectual abilities, long--term memory, and auditory sustained attention were evaluated. Parents completed standardized questionnaires assessing (1) executive functioning; (2) internalizing and externalizing difficulties; (3) attention deficit hyperactivity disorder symptoms; and (4) autism spectrum disorder symptoms. Theta/beta ratio ( TBR) and alpha peak (AP) were extracted from resting--state EEG and compared with 32 controls (8.9 +/- 2.1 years). The alpha band was analyzed using a feature reduction algorithm to detect potential groupings. Results: Performances showed preserved intellectual abilities and memory. Sustained attention performance was within the lower range for 4/14 participants (29%), with considerable parental reports of inattention (43%), working memory difficulties (50%), and hyperactivity--impulsivity (36%). No alterations in the TBR were found but the KD group presented a significantly lower AP amplitude ratio. A clear separation of KD cohort into two clusters showed that acute irritability is associated with a weaker AP. Conclusions: Despite overall preserved cognitive functions, there is a possible association between KD and attention deficit concerns. This first EEG--based study indicates alpha peak abnormality after KD, predominantly in children with acute irritability. Longitudinal studies are warranted to better characterize patients' neurodevelopmental trajectory.

Automated summary

This pilot study aimed to explore the impacts of acute Kawasaki disease (KD) on neurodevelopment and found a possible association between KD and attention deficit concerns, especially in children with acute irritability. Despite overall preserved cognitive functions, further longitudinal studies are needed to better characterize patients' neurodevelopmental trajectory.