Neurocognitive functioning in children with mild and moderate asthma in the Childhood Asthma Management Program

Background: The Childhood Asthma Management Program (CAMP) is a multicenter double-blind, randomized, placebo-controlled, clinical trial of two anti-i nflammatory agents and placebo in children with mild and moderate asthma. Objective: The interrelationship between asthma severity and neurocognitive functioning among 1041 children (age range, 5-12 years) enrolled in the CA MP trial was examined. Methods: Asthma severity was established at baseline with a clinical histor y of asthma symptomatology and measures of lung function (spirometry and me thacholine challenge). Diary cards were used in a screening to record night time awakenings and doctor contacts caused by asthma symptoms, symptom seve rity, and number of puffs from a rescue inhaler, All children received a co mprehensive neurocognitive assessment at the end of the 28-day screening pe riod (before randomization), including measures of intelligence, attention, memory, and academic achievement. Results: Significant differences were found between children with mild and moderate asthma on lung function and symptom outcome variables (log(e)FEV(1 )PC(20),Delta FEV1 percent predicted, change in peak flow percent predicted , nighttime awakenings caused by asthma, average symptom severity score, an d average daily number of puffs from a rescue inhaler) but not on neurocogn itive variables. Multiple regression analyses revealed that asthma outcomes could not be predicted by neurocognitive variables despite controlling for socioeconomic status. The prevalence of neurocognitive dysfunction, as ind icated by the use of psychostimulant medication, was found to be consistent with that found in the existing literature. Conclusion: Mild and moderate asthma symptoms are not related to neurocogni tive functioning in the children enrolled in CAMP, Mean performance on neur ocognitive variables was found to be similar to that of national normative data.